Patient Centric - Pharmaceutical Executive

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Patient Centric
Five years ago, in the race to deliver Gleevec, Novartis leaders glimpsed what a pharma company could be. Today, across the company, theyre putting that experience to work.


Pharmaceutical Executive


"In cases where there are well-established therapies you can model your new drug after, projections become much more accurate. But when there is no precedent, projections are very inaccurate. Gleevec was a bit easier for us to understand, based on our experience with Sandimmun [cyclosporine]. In the beginning, people projected that it would be a $100 million drug. It became a blockbuster, and transplantation medicine was revolutionized by it. But at first everybody laughed."

It's not hard to see experiences like these underlying the changes under way at Novartis: A company that has already taken large strides to integrate its global marketing is now turning to insight mining and other techniques drawn from the world of consumer products to better understand how patients feel. A research organization that produced one of pharma's strongest pipelines is adopting an approach to decision making that acknowledges the intrinsic uncertainty of projections.


We want a balance between specialty care and primary care. We don’t want to be a pure primary-care company. –Jörg Reinhardt, head of pharma development
Or, to put it another way, a company that got to live in the future is trying to find a way to get back there as quickly as it can.

Pure Marketing "My read on Novartis is that it is probably the purest marketing firm out there," says William Trombetta, professor of pharmaceutical strategy and marketing at St. Joseph's University. "A lot of people would name Pfizer—but that's just brute force with 12,000 reps. Novartis' CEO of pharmaceuticals, Thomas Ebeling, came over from PepsiCo. He's a packaged-goods guy with a PhD in psychology. A lot of people with that background worked on boring, dead products. How are you going to innovate detergent? What's the next innovation in syrup for soda? Ebeling is trained to think about the customer—not just physicians and managed care—but patients."

As Ebeling describes it, Novartis' marketing is in the midst of a multiphase evolution, the first phase of which was about global alignment. "You have to get the countries involved with development of the strategy," Ebeling explains. "You agree on the global agency, the key creators, and the key messages. You provide an infrastructure so countries can get the materials they need. But then you have to say, 'Look, guys, if you can prove to us that this campaign is not working, we'll discuss something else.' In the past, global marketing had to prove that a campaign was working in a country; now countries have to prove that the global campaign is not working."


Looking Eastward
Phase two is about customer information. "We learned there is often a disconnect between patients and physicians," Ebeling says. "So we launched a new process for all our brands in all our countries. It starts with an intensive period of insight creation: How do patients treat themselves? What do they fear? How do they interact with caregivers and physicians? We do the same with the physician. Then we identify overlaps, where patients and physicians have identical views, and disconnects. We try to eliminate disconnects."

The classic example of this process in action is Novartis' campaign for Lamisil (terbinafine) for onychomycosis—toenail fungus. "Patients are motivated by cosmetic benefits," says Ebeling. "Physicians are not. But once we learned patients and physicians are equally concerned about infections, we positioned Lamisil as a drug that is treating an infection, not addressing cosmetic concerns."

Another example came in launching Zelnorm (tegaserod) the company's treatment for irritable bowel syndrome (IBS). Novartis conducted research on 10,000 patients and more than 1,000 physicians and again discovered a disconnect. IBS has multiple symptoms, but for patients, pain is overwhelmingly the most important. When they talk to doctors, patients often neglect to mention other symptoms. As a result, the physician can fail to diagnose IBS.


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