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By Noah Pines, Executive Vice President, GfK V2, and Cathy Su, Senior Manager, Market Research, Gilead Sciences
The gates are open and your new medication brand is off and running! The stakes are high. Thousands of hours of meetings, hundreds of millions of dollars not to mention blood, sweat and tears are now being put to the ultimate test by physicians and patients.
At this juncture of high anxiety, one of the pivotal questions faced by the brand team is: What are the best ways to track – and enhance – the performance in the market of this newborn brand?
The purpose of this article is to characterize the gamut of primary marketing research techniques, both standard and innovative, that pharmaceutical companies have at their disposal not only to gauge their products’ performance, but also to enhance the early impact a product may have on the market.
Before embarking on a discussion of novel approaches, it is important to review the most common and basic primary marketing research approach relied upon to track brand performance: the venerable “awareness, trial and usage” or ATU. An ATU study is essential to providing the team with a comprehensive scorecard by which to understand a product’s performance and impact over time.
As its name implies, the ATU is a quantitative study employed to examine the customer’s (typically physicians’ and patients’) degree of familiarity, perceptions and usage of a brand in relation to its competition.
Professional/physician-oriented ATU studies typically encompass a spectrum of market-based diagnostics and dynamics including:
- Customers’ unaided and aided awareness of and familiarity with the brand in question in comparison to other brands in the competition set
- Self-stated extent of prescribing vs. other brands in the set as well as type or types of patients in which a brand is being used
- Perceived importance of key product attributes that govern physicians’ treatment decision making
- Physicians' perceptions of the brand vs. its competitors, which is usually captured through a detailed attribute ratings and associations battery
- Perceptual mapping to identify where the brand and competitors fit in relation to the attributes
- Relevant physician practice criteria and patient demographic criteria, which often are used to characterize respondents based upon their behaviors and/or attitudes
Physician-oriented ATU studies also may be utilized to track key aspects of the treatment of the disease in question such as the attitudes and beliefs germane to the treatment area and/or which would be desirable for customers to espouse, the overall trends of the market and any paradigm shifts in the market.
In contrast, patient-focused ATUs often focus on a somewhat different set of indicators and criteria:
- Patient satisfaction and experiences with the brand, especially how the product in question has impacted their quality of life
- Evaluation of how the product performs based upon patient expectations (as well as vs. previous medications taken)
- Patient participation in the treatment decision-making process, i.e., whether or not they requested the brand in question
- Patient recall of direct-to-patient/consumer (DTP/DTC) advertising, both in terms of location and message delivered
- Patient recognition and utilization of promotional programs such as discount cards or co-pay coupons
- Patient demographic criteria, e.g., socioeconomic status (SES), family situation, comorbid illnesses, insurance type, gender, ethnicity, etc.
From a logistical standpoint, physician and patient ATU studies frequently are conducted via the Internet or computer aided telephone interview since they are generally comprised of closed-ended questions that lend themselves to electronic completion. Internet is the ideal mode of data collection where survey respondents can complete such questions in an unaided manner and on their own time. Data can be immediately entered, tabulated and viewed by the clients.
There are many important nuances to consider in conducting ATU studies relating to sampling, scope (in terms of which countries are included), how frequently the study is conducted and what types of marketing incidences are assessed over time. These factors should be considered based upon the therapeutic area and customer type being surveyed, the competitive landscape, which global markets are crucial to the brand’s success, as well as the visibility of the brand in question.
Specific to a new product, ATU studies typically are initiated prior to the launch of the product, with one-to-two baseline/prelaunch waves being conduct to establish a baseline set of metrics that can then be compared longitudinally to the result of subsequent waves postlaunch. They are typically repeated, using a standardized set of metrics at quarterly intervals. However, in cases where the brand team requires results earlier than that, companies may conduct what is termed an “early indicators” research, which may look at the same indices within a smaller sample to permit rapid turnaround time.
Often, new product ATU studies are conducted with both users and nonusers of the product in an effort to determine what distinguishes those who have adopted the product into their armamentarium from those who have not.
One pivotal question that brand managers often ask of marketing research is whether and the extent to which the brand message is being delivered to physicians, whether it is recalled – and understood – by customers. Thus the need for detail frequency and message recall research.
While companies may include detail message frequency and recall in ATU studies, many utilize a service offered by GfK Market Measures called Fastape. Fastape offers rapid capture and analysis of physicians’ recall of key detail messages immediately after product launch and is helpful in gauging whether sales representatives are communicating the correct messages to the physicians – as well as the impact those messages are having on physicians’ prescribing.
Over time, similar to ATUs, companies can monitor detail reach and frequency, message recall, impact of the messages on prescribing, “share of voice” (SOV) and perceived effectiveness of sales representatives. Message tracking studies are also a useful way to monitor competitive detailing (i.e., counter-detailing) activities and messages.
Pharmaceutical companies use campaign tracking to routinely evaluate the effectiveness of a promotional campaign and manage the impact of competitive promotional messages by measuring the campaign awareness, message retention, message diagnostics and impact on prescribing intentions. Although companies can design proprietary tracking studies like ATUs, many prefer to rely on standardized services like AC Nielsen CTS PosTest to relate their performance to standardized indices (i.e., norms) which benchmark brand performance in relation to the category norm, industry norm and in relation to the key competition.
In the wake of a major product launch, the brand team may not only want to examine broad quantitative indices through ATU and message recall studies, but also attain a more granular inspection of customers’ decision-making, prescribing and usage experiences and in-depth feedback regarding detailing and other promotional programs. Such studies may be highly appropriate in specialized and complex specialty medicine areas such as oncology and HIV/AIDS because of variability in treatment practices, individualized treatment approaches and a relatively limited prescriber universe.
In such cases, companies may elect to conduct telephone or in-person depth interviews with customers to ascertain their opinions, drivers of their usage of a product and impressions of both advertising communications and advisory board meetings (which are employed more commonly in highly complex therapeutic areas as HIV, oncology and hepatitis to support a newly launched brand). While an ATU questionnaire can take several weeks to get off the ground because of successive rounds of edits, pretesting, and fielding with a large number of physicians, a smaller, qualitative tracking study involving 30 to 40 users (and nonusers) can provide a great depth of insight to the brand team more rapidly.
As noted earlier, user vs. nonuser comparisons often are extremely helpful in gauging why a certain proportion of the market may have taken on a new product while others have not. Often the differences reside in such questions as patient population, available patients or potential perceptions of the product (e.g., safety concerns). Differences between users and nonusers also may reside in differences in normal adoption patterns, since certain physicians tend to be early adopters while others won't start prescribing until a product has been on the market for a period of time.
One novel approach to tracking (and enhancing) brand performance developed by GfK V2 is called Sequential Iterative Interviewing (SII); it is a process designed to understand differences in attitudes, beliefs and motivations among various customer groups. SII allows a brand team to not only understand why different groups of customers behave differently, but also how the marketer might leverage the experiences of one group to change the beliefs and behavior of another group of customers. SII also can help elucidate what messages and tactics will be effective in converting the low/nonusers of a specific brand to high users.
The origin of SII is peer influence marketing – where the “converted” share their experiences with the “nonconverrted” – and it can be applied to new and mature brands. The typical application is where near-optimal market penetration has been achieved or has occurred in certain segments but not others and a company is seeking to understand how to effectively reach the nonpenetrated segments. This methodology also can be applied to determine how to defend high-user segments from potential competitive messages.
Typically, a company has identified a segment of its market comprised of high users of its product or those who have readily adopted its product. The company also has identified another segment similar to the first group in many respects but comprised of low or nonusers of the brand. SII works to identify why these groups feel differently and what the necessary arguments could be employed to convert the low/nonuser group to high users. This is primarily accomplished via a series of iterative sequential interviews where the learning from one interview or group is then applied to the second group and vice versa (in a back-and-forth process).
The first step in this process involves interviews or focus groups with respondents representing the high user group. During these IDIs or focus groups, the goal is to reveal why these customers are high users and ascertain what they know and believe about the product that has made them high users. Additionally, respondents are queried specifically to determine what messages and tactics they would recommend to motivate low or nonusers to increase their usage of the brand. In the next step, a similar number of representatives of the low/nonuser group would be interviewed to learn why this group has not embraced the product and to determine whether other key factors differentiate these low/nonusers from the high users.
These low/nonusers are presented with the messages and tactics recommended by the high users of the brand to evaluate the effectiveness of these messages and tactics in motivating them to increase usage of the brand in question. These respondents then are queried with regard to their reactions and particularly their concerns and objections to the messages and tactics proposed by the high users.
The next set of IDIs or focus groups is then conducted with the high users to confirm why they are high users in terms of their attitudes, beliefs, etc., and to learn if there is consistency among them. Again, arguments would be collected to be used in convincing the low/nonusers but also obtain the high users’ reactions to the concerns and objections raised by the low/nonusers. Based on these interviews, it can be determined not only how to overcome these objections but also the extent to which the low/nonuser arguments might make the high users vulnerable. This process continues back and forth as reasons for high use and low/nonusage crystallize along with the development of the necessary arguments to convert the low/nonusers.
The output of the process is typically offensive and/or defensive brand messages and tactical recommendations. Of note, combining high users and low/nonusers of a brand in one research exercise can be problematic and counterproductive; SII provides a systematic approach to linking the views of these disparate customer segments toward the goal of enhancing brand performance.
There are several other primary research studies that can be brought to bear at various points in the new product tracking process beyond those enumerated in this article:
- Payer feedback: Qualitative research among managed care formulary directors can be useful in ascertaining the current and prospective future coverage/reimbursement situation for a new product.
- Feedback from Key Opinion Leaders (KOLs): Since academic-based KOLs are familiar with both current and forthcoming research, they are often in a good position to identify both potential opportunities and threats to a given brand.
- New opportunity assessment: Provides assessment of additional potential for products – new patient type, physician segment, potential for direct-to-patient or direct-to-consumer and new indications.
- Brand equity research: Qualitative research using projective techniques to understand the emotional insights of physicians and patients about the product. This methodology is being used in more and more pharmaceutical research.
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Standard and Innovative Methods for Tracking Pharmaceutical Brand Performance
