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GfK HealthCare | May 2011 | |
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Reconsidering Patients as Payers – Market Research Outside the United States  By Yoko Okamoto, Vice President and Ray Chan, Ph.D., Senior Vice PresidentWe can probably all agree that the notion of patient as payer is not a new concept, especially in emerging markets where premium products are predominantly paid out-of-pocket by patients or families. It is indeed a purchasing decision to pay – or not to pay – for a premium product. But here, we want to discuss the unique challenge this concept poses for pharmaceutical marketing professionals: how to communicate and/or influence these payers even though you are prohibited from speaking to them directly. Many may take for granted that pharmaceutical marketing and sales enjoy a unique advantage in the U.S. since it is the only key market that allows direct-to-consumer advertising and marketing of pharmaceutical products. But despite this unique advantage, the pharmaceutical industry has traditionally focused the bulk of its marketing expenditure and efforts on health care professionals, institutional payers and regulators. However, as the importance of markets outside the U.S. grows, the tide is shifting and pharmaceutical marketers must deviate from U.S.-centric thinking and adopt a global perspective to ensure successful sales. No doubt, health care professionals (prescribers and in some cases pharmacists) are still extremely important players, and their recommendations carry much weight. However, we argue that they are not as influential as they once were. Patients are becoming more empowered to take the driver’s seat in the therapy choice. As such, we need to understand how patients make health care expenditure decisions and what the drivers and barriers are to product selection/acceptance of physician recommendations. Physicians are not just the pharmaceutical marketers’ key audience to influence; physicians are increasing becoming the channels through which marketers communicate and convince payers, i.e., patients and their families. Globally, patients have increasingly greater access to information of all types, accurate as well as inaccurate, mostly because of the Internet. Patients and consumers of global pharmaceutical brands worldwide are more informed, organized and powerful. In developed countries such as those in the EU and Japan and Canada, there is ever-increasing scrutiny of public health care budgets and increased pressure from austerity measures. With the help of accelerated generic penetration – the patent cliff-payers (regulators) are decreasing their coverage of branded medications. As a result, resourceful consumers and multinational corporations are boosting purchases of supplemental coverage for premium services such as branded pharmaceutical products. In these instances, pharmaceutical marketers must argue a successful case to the consumers who are purchasing premium/supplemental coverage that affords access to premium, branded pharmaceutical products. Further, in emerging economies known as the BRIC-TM (Brazil, Russia/Eastern Europe, India, China, Turkey/Middle East and Mexico), we see a sharp growth of the middle class, coupled with inadequate growth of health care infrastructures. Patients who can afford such are demanding better care, internationally branded products and are willing to pay for premium services, perhaps as another way to further enhance their status as having arrived into the middle and upper classes. What does all this mean to marketers who are charged with ensuring the growth of their brand? Globally, health care is trending to patient empowerment in making health care decisions. More consumers (both patients are caregivers, including parents of the young and children of the elderly) are making financial decisions that impact their health care choices. The ever present trade-off between cost and benefit now rests also in the hands of consumers, who may or may not have a firm grasp on clinical trial, efficacy, adverse events, PK curves, etc. – the bread and butter of pharmaceutical marketing to health care providers. In fact, pharmaceutical companies ahead of the curve have been embracing patients to realize market success by understanding patient experience with diseases and treatments. They are actively and aggressively addressing patients’ needs and desires. Such success stories include Novo Nordisk’s customer-centric insulin delivery system (insulin pen, developed and tested jointly with patients). Through positioning work, pharmaceutical marketers may identify persuasive messages to promote adoption/uptake of their product(s) and often the emphasis has been placed on prescribers. Moving forward, we must explore messages that resonate with both physicians and patients. We must identify messages that impress the patients and their families while ensuring that they are messages that can and will be delivered by the health care professional. Pharmaceutical marketers and their advertising/creative agencies must now satisfy two masters. It’s been long known that physicians respond better with scientific claims and data while patients look for emotionally connecting messages. Developing a message that resonates with both audiences can be, even modestly put, challenging. Further, marketers must face the challenge of training physicians to convey the intended message to patients. Even when we identify the ideal messages that resonate with patients, without the cooperation/buy-in of the messengers (i.e., physicians,) the message will never be heard. As such, positioning/messaging studies now must be designed to build a credible story that resonates with both audiences at once. As with any positioning work, we believe it’s still meaningful to understand what messages resonate with each of these audiences individually. The challenge becomes harder when we tackle the task of marrying the two: to find messages that resonate clinically and appeal emotionally without one side shunning the other. Unfortunately, there does not appear to a simple way. Positioning work may require one additional step in the research program to identify messages that are not only persuasive but deliverable by physicians. As an example, a marker may have to consider a multiphase research program. For the initial phase of message development, we still feel two GfK HealthCare approaches – Customer Driven Positioning (or CDP, a bottom-up process that allows respondents to build the positioning statement themselves) coupled with Information Architecture (revolutionary approach to message development, typically conducted after CDP, in which respondents build positioning in the form of a persuasive story) – are most effective. We push the envelop further with this challenge by recommending that once both rounds of messaging work have been done, we flip the table by having one cohort (i.e., physicians) critique the winning messages chosen by patients as payers, and vice versa. By having critical review of these messages, we ensure that they resonate with the payers (patients) as well as the messengers (physicians). Only through this cooperation can a marketer ensure the growth and success of her premium product outside the U.S., where the increase in wealth among patients and families can be the next frontier. |
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