For a drug facing established competitors, early positioning research might suggest a non-intrinsic product enhancement as
a competitive advantage. When Ciba-Geigy introduced Lotensin (benazepril), an angiotensin-converting enzyme (ACE) inhibitor,
it had no clinical benefit to set it apart from the myriad other ACEs being introduced at about the same time. With some creative
marketing, supported by appropriate marketing research, the manufacturer found a position for the product based on a unique
lifetime price guarantee to the patient.
No Tabula Rosa
Just as family therapists say that each child in a household grows up in a different family, so too will each new product
enter a different market than its predecessors. The launch of the first product in a market will be very different from the
launch of the fourth or fifth, which emerges into a competitive world of older siblings. In the urinary incontinence/overactive
bladder market (OAB), for example, several new products are joining the venerable Ditropan XL (oxybutynin) and Detrol LA
(tolterodine) in that treatment area. Product managers will need to keep up-to-date on the positions of the previously introduced
products and incorporate this awareness into the positioning messaging for the next product launched.
Positioning issues survive after a drug launches. The product's positioning does not change, but the story used to communicate
the positioning does. Rather than starting anew—as repositioning often errantly attempts to do—each new story must build upon
the foundation established by previous versions of the story. This is often called the "stair step" model.
At different stages in a product's life cycle, new marketing research builds upon previous research to support a product's
positioning (see "Climbing Stories"). As the brand goes through early stages of development, for example, the perspective
of KOLs shapes the product positioning process. Prior to launch, the input of physician stakeholders is most important. When
a new indication is added, marketing research often focuses on doctors who are already prescribing the drug.
When a competitive brand launches, input from current prescribers again begins to reshape the positioning story of the incumbent
product. Finally, if prescription drugs go over-the-counter at patent expiry, the feedback from patients and consumers typically
steers research. At each stage of positioning research, the new story picks up where the old one left off. Once a product
has been introduced into the marketplace, marketers can never again begin with a blank slate.
Cost: the New Strategy Shaper
A medication's cost plays an increasingly important role in a product's positioning story. In 2005, cost issues determine
whether a pharmaceutical brand is included on formularies of managed care plans and, if it is, the tier on which the product
finds itself. For many drugs, an otherwise elegant product positioning strategy fails when a pharmacist calls to inform the
doctor that a prescribed product is not on the patient's managed care formular and that patient agrees to take a generic,
or when a patient reports that the purchase of the product at the pharmacy required an out-of-pocket expenditure of $45—money
the patient had previously earmarked for groceries—and simply does without treatment.
In the near future, many pharmaceutical marketers expect Medicare Part D, private drug plans (PDPs), "doughnut holes," and
similar cost factors to move to the forefront of the product positioning process. Whether a drug is covered on the formulary
of remodeled healthcare plans will soon outrank the importance of even the effects of tiered co-pays in positioning strategy.
Another key consideration in a pharmaceutical product's positioning strategy is its potential to create buzz in the marketplace.
A well-known example of this phenomenon arose in the erectile dysfunction (ED) market, in which Lilly's Cialis (tadalafil)
benefited from catchy terms like "weekender," a wonderful shorthand for patients to use in discussing what in drier, more
clinical terms, would have been known as "duration of action." Conversely, Levitra (vardenafil) failed to develop a public
relations shorthand for its own positioning and suffered in the marketplace as a consequence.