So how do you get doctors to adopt new drugs more quickly? Some say it's impossible—just as some bought the iPhone as soon
as it was released and others are still waiting for a better-generation product. There will always be physicians who take
a watch-and-wait approach.
But there's reason to believe that by providing the necessary evidence, more physicians will become "early adopters." Diagnostic
tests help provide that evidence in the prognosis and monitoring of patients, and by eliminating skepticism on behalf of prescribers
typically slower to adopt new technologies. Plus, clinical trials based on genetically stratified patient populations mean
there will be less potential for adverse events, easing physicians' concern. With this, there will be a wider base of early
adopters, which will speed adoption and increase usage in the rest of the physician population.
Branding the value proposition The evolution of pharmaceutical markets has now become almost standardized. First-in-class drugs set the rules. Second generation
therapies are primarily differentiated relative to where in the class they are launched. As follow-on generations expand the
market, they are differentiated from the first-in-class entrant by means of a different mode of action, fewer side effects,
or new data on cost effectiveness. Finally, drugs will come onto the market with twice-a-day dosing or novel delivery mechanisms
(e.g. nasal sprays, patches) to further differentiate new entrants from products already within the class.
But with personalized medicine, there is potential for a much richer promotional landscape than what's currently seen using
the standard approach to differentiation. Diaceutics worked with a leading UK advertising agency to understand how it works.
One surprising finding was that, unlike the traditional empirical paradigm, the "test and treat" protocol contributes toward
building in physicians' minds the concept of a "consistent standard of care." Specifically, diagnostic tests offer the opportunity
to manage genetically identified patients in the same way, every time, without letting empirical observations get in the way.
Embedding a therapy-response test may appeal to the physician's desire to adhere to the highest of clinical standards long
before treatment guidelines have been fully established.
The Way Forward
At day's end, the value proposition of a therapy and companion diagnostic combination is very different from that of a one-size-fits-all,
standalone therapy. That personalization means the research and development model is no longer being debated; that it further
enables the pharmaceutical marketing model should be debated more actively and with the bias toward change rather than retaining
the status quo.
In their review of the capabilities required to enable personalized medicine, Lara and De Mesa suggest that pharmaceutical
and diagnostic companies that address the lack of appropriate marketing capabilities for personalized medicines could gain
a competitive advantage by enhancing relationship marketing with consumers. Similarly, newer education and sales management
will also need to be adopted and the industry will need to move away from its traditional reach and frequency metrics that
it depended on for the blockbuster model.
The installation of an appropriate, evidence-based method to manage the personalized medicine approach is likely to require
longer but fewer details, and doctors and reps working closer together. Interestingly, this trend is already witnessed in
the launch of oncology products, so it is not entirely alien to pharma's business model. Moving that approach out of specialty
medicines into mainstream diseases like diabetes or cardiovascular disease may be where the greatest savings and efficiencies
Of course, change is not easy. The convergence between the pharmaceutical and diagnostic industries, with their disparate
business models and cultures, brings a host of difficulties and likely errors before we reach significant signposts toward
success. For this reason, the marketing power of personalization may first be pioneered in mature therapy areas where entrants
previously considered fourth or fifth in class can be recast and repositioned as first in a genetically targeted subgroup.
However the life sciences community gets there ultimately, a more thorough exploration of the market-shaping benefits of personalization
will increase the current momentum already building for personalized drugs within the pharmaceutical and diagnostic industries.
Peter Keeling is CEO of Diaceutics and can be reached at firstname.lastname@example.org
Mollie Roth is Corporate Counsel and Vice President of Business Development for Diaceutics and can be reached at email@example.com