In 2009, marketing partners Eli Lilly and Daichii Sankyo were preparing to launch their new blood thinner Effient (prasugrel) which appeared to have greater efficacy than the market leader Plavix, the world's second best selling product, sold by Bristol-Myers Squibb and Sanofi. EvaluatePharma predicted "Effient's sales would reach $1.42B by 2014 and be the biggest growth driver at Eli Lilly over the next seven years." Lilly and Daichii
Sankyo were preparing a traditional blockbuster-style launch.
Unbeknownst to Lilly and Daichii Sankyo, BMS had assembled a multi-disciplinary internal counter-launch team nearly two years
before prasugrel's approval to preempt its rival's launch. The team's primary strategy was to pre-position prasugrel as a
"niche product" with "bleeding concerns" by consistently communicating this four-word positioning to highly influential, prioritized
stakeholders. For example, one and half years before the FDA approval of Effient, Sanford Bernstein analyst Dr. Tim Anderson told the Boston Globe, "Prasugrel might get approved, but I see it as more of a niche-type product. Better efficacy but with higher bleeding, including
fatal bleeding." During July 2008 conference call, a BMS COO Lamberto Andreotti told analysts: "The way I see it, if and when
it is approved, [prasugrel] will be a niche product." Seven months before prasugrel's approval, thought leader Dr. Sanjay
Kaul of LA's Cedars Sinai Heart Institute told Reuters that "[prasugrel] is likely to be a 'niche product.' I don't think
it will be widely used based on the bleeding concerns.'" Similar opinions were voiced by Leerink Swann analyst Seamus Fernandez,
who told the New York Times that prasugrel "may end up as a niche product, not a blockbuster," and by Decision Resources market analyst Michael Latwis:
"We think it's going to initially be very much a niche product."
When Effient was approved by the FDA in July, 2009, the die was cast. BMS had effectively pre-positioned its rival Effient as a niche product with bleeding concerns, thus undermining its launch. Effient achieved less than one-tenth of its projected $400 million first year U.S. sales. A Pink Sheet analysis of consensus forecast projections for 13 U.S. products launched in 2009-10 revealed that Effient represented the year's single biggest launch failure.
What's the message here? Pre-positioning of Effient by its rival BMS underscores how dramatically pharmaceutical product positioning has changed over the past 15 years. Marketing
professionals must adopt radically different positioning approaches.
Three fundamental factors have driven this change. In the late 1990's, the pharma industry transitioned from the growing Commercial
Stage ("Pharma 1.0") to the mature Competitive Stage ("Pharma 2.0") of the industry's lifecycle (See Figure 2) This resulted
in markedly more competitors and competitive noise in the market, creating communication challenges for product positioning.
In addition, this transition changed the timing of product positioning. Aggressive rivals now often attack launch products
in the Pre-Launch Phase when they are most vulnerable, forcing launch companies to position their new agents months or years
prior to launch to avoid being pre-positioned.
This evolutionary industry transition paralleled a larger market transition to a digital world dominated by the Internet and
other information technologies. This new digital environment is characterized by shorter attention spans; faster, shorter,
and more concise information bites ("i-bites"); and accelerated uptake and repetition of digital reports and communications.
These two transitions in turn accelerated the development of a new pharma stakeholder ecosystem – beyond the traditional triad
of physicians, patients, and payers – which holds increasing power over the access, utilization, and perception of pharmaceutical
products. Pharma marketers now must position their products across a myriad of influencers, including powerful Pre-Launch