Achieving Pharmaceutical Launch Excellence in the Asia-Pacific Region


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Anthony Morton-Small, IMS Asia-Pacific Practice Leader for Commercial Effectiveness, lays out the benchmarks for launch excellence in Asia Pacific – maximizing opportunity, market share leadership, and promotion out-performance – and why so few launches reach this pinnacle. Morton-Small defines the Launch Readiness framework and explains how this approach will bolster launch preparations.

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Achieving Pharmaceutical Launch Excellence in the Asia-Pacific Region

  1. 1. 30 Launch. The new realities in Asia-Pacific by Anthony Morton-Small, Practice Leader, Commercial Effectiveness, Asia-Pacific The new realities • Launches are achieving lower market shares • First six months are the most critical • Small dynamic market • A shift in the power of stakeholders away from prescribers • Growth contributions of launches deteriorating
  2. 2. 31 Despite widespread poverty, trouble- some overpopulation, and residual political complexity, India is in the midst of a remarkable evolution. A consumer-oriented middle class is on the rise. Improved patent protection, an expanding health care infrastruc- ture, and changing demographics and disease profiles are all conspiring to open this once-overlooked market to a broader range of pharma prod- ucts—and investment options. In China, meanwhile, some 90% of the population will soon be covered by universal medical insurance—giv- ing some 1.7 bil people access to a growing number of primary and sec- ondary care centers and raising the ante for better medicines for a grow- ing number of diagnosed conditions. Similar dynamics are currently being played out in countries as diverse as Vietnam and Taiwan. It’s all proof of the emerging pos- sibilities in a part of the world that continues to shrug off the global economic malaise and trend toward growth. It is no wonder, then, that far-flung pharmaceutical companies are increasingly focused on the Asia Pacific region—seeking entre, build- ing bridges, launching products. But those that are serious about making a lasting impact in this re- gion must consider this: One doesn’t succeed by merely introducing prod- ucts to the APAC marketplace. One succeeds by launching them within the framework of true excellence. Defining the term What, in the end, is true excellence? At IMS, we have defined the phe- nomenon according to three quanti- fiable measures: MAXIMIZING OPPORTUNITY Steep penetration curves within the first six months, with no subsequent drop in market share for the two years post launch. MARKET SHARE LEADERSHIP Taking either first or second in mar- ket share within two years, thereby establishing a long-term, market- leading position. PROMOTION OUT-PERFORMANCE Achieving a high or low relationship between market share and cumula- tive promotional share at two years post launch. We have also tried to understand just what percent of the pharmaceuti- cal industry actually achieves such excellence— canvassing more than 8,500 products launched in eight study countries between 1997 and 2008 and identifying those launches that actually met all three excellence criteria. The results? A mere 61 out of the more than 8,500 products we studied met our criteria for excel- lence. Our survey results unequivo- cally demonstrated that MNCs were failing, in most cases, to realize their greater ambitions and to capitalize on standing opportunities. When launches go wrong In many cases, launches were com- promised early on by the failure of companies to develop and apply a deep understanding of the indig- enous economies, historical trends, cultural predilections, and public policy of the launch country. We found that companies had failed to think, as well, both about how lo- cal environments differ and about how western approaches to pharma marketing are often simply irrelevant in APAC countries. Strategies that spark success in Belgium, for exam- ple, are not necessarily on point in India or South Korea. Despite our findings—and warn- ings—we continue to see multi- nationals relying on western-style launch strategies. We see them ig- noring the very pressing fact that Asia’s emerging markets are far less homogenous than the mature regions of the world.And we seem them fail- ing to wisely negotiate the absence of clear forecasting data and the dif- ficult reality that the vast majority of patients remain underdiagnosed, un- dercompliant, and underserved. All of these failures are ultimately com- pounded by a lack of locally available information and knowledge from re- sources such as disease registries, not to mention a poor understanding of the incidence and prevalence and the burden of disease. Awareness. Accessibility. Affordability. And more. Accordingly, we recommend that MNCs honor the three As of phar- ma marketing in Asia – “Awareness,” “Accessibility,” and “Affordability,” in addition to the standard five As of successful launch uptake – “Approv- al,” “Access,” “Advocacy,” “Adop- tion,” and “Adherence.” When we talk about Awareness, we’re talking about MNCs actually priming the markets for the drugs in their portfolios. We’re talking about educating patients and physicians. We’re talking about establishing a thorough understanding of disease states, therapeutic options, and the potential fall-out of non-compliance. We’re talking about operating effec- tively in environments that do not offer access to traditional direct-to- consumer campaigns or established patient advocacy groups. Innova- tive outreach mechanisms includ- ing collaboration with NGOs, the provision of language translation for basic communications, and, where appropriate, the sponsorship of fam-
  3. 3. 32 ily networking support systems and tele-counseling are all tried and of- ten true solutions. At the same time, MNCs must take a very smart approach to combating prevailing access to medicines chal- lenges. “Accessibility” to medical treatment is simply not on par with the mature markets, nor is it consist- ent within geographic borders. At IMS, we see substantial variation be- tween top-tier urban markets, lower- tier cities, and rural environments in terms of the quality of health care infrastructure, the distances patients must travel for care, and the availabil- ity of the physical treatment centers. We see a need, therefore, to pay at- tention, and to act with knowledge, to prioritize target markets carefully, and to consider how pharma can work with distribution channels and the healthcare system to maximize reach. Further, MNCs must be willing to accept that relationship selling, so key to western success, be bal- anced alongside the power of selling through science—of demonstrat- ing a product’s therapeutic benefits through clinical trial data. Local pharmaceutical companies typically have the corner on relationship sell- ing. Scientific selling, in countries such as Thailand, China, and India, provides MNCs with a competitive advantage over the extremely strong local players. This may well require investment and expertise in phase IV trials and registry studies to generate local data. Around the world, price matters. But it matters even more in the APAC region, where inflation rates, GDP growth rates, rising patient incomes, and elevated expectations combine to make “Affordability” a crucial de- cision point for those who need the products, not to mention those in a position to prescribe them.Thus, we are seeing an increasing number of cases—GlaxoSmithKline in India is a prime example—where companies leverage a local pricing strategy across the portfolio. In China, we are see- ing companies pursue price points in the top urban cities that are different to those implemented in outlying cities. At the same time, we’re see- ing MNCs take smart approaches to improving the affordability of their products through such tactics as the forging of local manufacturing and supply relationships, the establish- ment of differential pricing within geographies, and the search for pos- sible tax exemptions. It goes without saying that global and regional forecasting and pricing models need to reflect local sensi- tivities regarding both the ability and willingness to pay. In emerging mar- kets especially, pricing and position- ing count, and both challenge estab- lished norms of traditional launch approaches, stretching the ingenuity of MNCs. Finally, there’s this: Mature markets represent a highly restrictive mode of operation, not just in terms of payer constraints surrounding re-imburse- ment and pricing decisions, but also in regard to clinical constraints sur- rounding indications and labeling. Emerging markets,on the other hand, are often less fettered with regulato- ry constraints and offer substantially more choice throughout the launch process. In out-of-pocket environ- ments, pricing considerations are usually oriented around ability and willingness to pay. But in the absence of tight guideline restrictions, MNCs have more opportunity to optimize messaging and positioning around the patient needs and to maximize the potential source of business. Achieving excellence through Foundational Success Factors Every day, we’re talking to clients who are intent upon investing in the emergent and wholly dynamic APAC region—clients who, despite numerous potential pitfalls and hur- dles, believe, as we do, that the risks are worth taking. We’re helping them build proven strategic frame- works. Often, we’re helping them create a regional or local nerve cent- er—essentially an on-the-ground operation or network—that will en- able the company to orchestrate and manage the launch planning process in Asia-Pacific. (See figure 1). At the same time, we’re focusing our clients on what we call the Founda- tional Success Factors. We’re help- ing them, for example, to become an Aligned and Prepared Organi- zation—one that understands the product’s potential and builds effec- tive launch plans replete with readi- ness assessments, contingency plans, and underlying support processes and systems. We call the second Foundational Success Factor Powerful the Perti- nent Value Proposition, and through it, we ask our clients to create a proposition that incorporates an op- timized target product profile, gener- ates an evidence base, solidifies prod- uct positioning, sets the right price, and facilitates access. We call the final foundational factor Effective and Efficient Stakeholder Engagement Strategy. Here our focus is on helping organizations develop the means by which they might map and segment key stakeholders, op-
  4. 4. 33 timize resource allocation to maxi- mize message impact, and monitor and drive performance. Taken in total, these foundational factors don’t just predict launch suc- cess; they ensure that it happens—if and only if clients are fully engaged and not merely substituting a gener- ic checklist of activities that leaves them lacking alignment, impeded by poor organizational visibility, and deficient in terms of timeliness and precision. We know—we daily see—that suc- cess depends as much if not more on how MNCs prepare for launch as on what actual activities they un- dertake. We’re serious about helping our clients prepare for launches that achieve the gold standard—launches that align strategic objectives with launch success factors, prioritize key activities, establish best-in-class qual- ity standards, and map critical time- lines and interdependencies. It’s our job, across the APAC region, to help see the process through. Launch Readiness – key challenges can be addressed using a launch readiness framework Launch Readiness Framework What are the strategic objectives & the critical activities for delivering them? What are the best-in-class quality standards for carrying out each activity? What are the critical timelines & interdependencies across activities? Launch Readiness Framework Part 1: Alignment with strategic objectives Launch Readiness Framework Part 2: Prioritised critical activities Launch Readiness Framework Part 3: Best-in-class quality standards Launch Readiness Framework Part 4: Critical timelines & interdependencies 1 2 3 4 Figure 1