How to Make Rx-Dx Alliances Work - Pharmaceutical Executive

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How to Make Rx-Dx Alliances Work
There are big differences between pharma and diagnostic companies-and big rewards for the players who learn to cope with them.


Pharmaceutical Executive


Dx-only push/medical community pull. The third scenario involves creating a strong demand in the medical community from key opinion leaders, clinicians, and patient advocacy groups. If the Dx company is solely responsible for promotional efforts with little or no marketing and sales support from the Rx company, the test may take three to five years from regulatory approval to achieve market acceptance. This scenario tends to play out in cases in which a test is developed to fulfill an unmet medical need or when it is designed to diagnose a disease or monitor treatment efficacy of a relatively new drug. (See "Getting Everyone on Board," page 58.)

Rx and Dx push/medical community pull. The ideal scenario for achieving rapid market uptake of a new diagnostic is to combine Rx and Dx push with medical community pull. Under those conditions, a new test could be accepted within two to three years after regulatory approval. However, such a scenario requires near-perfect planning by the two companies.

It also means Rx and Dx teams must begin to work closely together as early as the pre-clinical stage of development and throughout the alliance's course-whether it is a loose agreement or a formal contractual one. (See "Working Hand in Glove," page 58.)

To create the ideal scenario, pharma companies must be prepared to promote new diagnostic concepts and their accompanying usage guidelines. Diagnostic companies recognize that most pharma sales and marketing executives hesitate to shift any portion of their product selling time with physicians to educate them about a diagnostic test. However, when the use of a diagnostic test can affect the acceptance and use of a drug, it is beneficial to co-promote both the test and drug and to educate physicians about both. In fact, pharma sales reps can often lengthen their visits with physicians by introducing and educating them on the test's uses and the diagnostic's ability to guide a specific treatment.

The use of pharma industry resources-including their comparatively large promotional budgets and large direct sales forces-to market a new diagnostic test can dramatically increase the speed with which that test is accepted in the market. But because that is not always feasible, pharma executives may consider selecting diagnostic partners who are prepared to invest in a direct sales force to take the lead in promoting their own product. In that case, the Dx company relies on the Rx sales force only to help create awareness of the test. To date, however, only a handful of point-of-care diagnostic companies in the United States have been willing to bear that responsibility.

Impact Predictors A simple technique developed by Diagnology can help measure the potential success of partnerships between diagnostic and pharmaceutical companies. A patient flow schematic can help assess the value of working together and selling the Rx Dx partnership notion to senior management. (See "Proving the Case," page 60.)

Take, for example, a currently preferred office-based diagnostic test used by a primary care physician that yields 40 50 percent accuracy in diagnosing all patients (Segment C). If a new diagnostic test eliminates significant levels of misdiagnosis or identifies patients with atypical symptoms that were previously missed, it may increase diagnostic accuracy to 80 percent. The improved test will diagnose almost twice as many people as the current technology, resulting in twice as many patients getting treatment (Segment D). If the pharma partner has a 50 percent share of the market for that disease's treatment, it can expect to gain prescriptions for at least half of the patients in Segment D.

Another way to look at the partnership's value is to demonstrate the impact a new diagnostic might have on improving patients' awareness of a disease. Studies show that patients frequently seek diagnostic information before exploring treatment options. If they could be encouraged to request a specific diagnostic test from their doctor through awareness and education programs in disease areas in which there is significant under-diagnosis, or misdiagnosis, then more patients would eventually seek treatment. That is a win win situation for both partners. (See"Humor+Celebrity=Awareness.")

Finally, it is essential to consider a partnership's value with regard to customer retention. A point-of-care diagnostic test, when supported by new standards of accuracy and effectiveness, is likely to become embedded as a "test of choice" for office-based physicians. Evidence from point-of-care marketing campaigns directed at physicians demonstrate that doctors tend to support well endorsed brand-name tests and are therefore unlikely to switch to alternatives without similar support. A joint campaign, coupling the diagnostic with a given medication, may create a halo effect that makes the physician more committed to the pharma product. That creates a significant increase in customer retention or brand loyalty, which in turn generates a measurable sales impact for the Rx partner that the company can track as a benefit of the alliance.


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