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Educating KOLs, Physicians, Patients
       and Payers to Support
   Successful Product Launches




Strategic Benchmarking Research, Analysis and Recommendations




                                                        BEST PRACTICES,
                                    1                                     ®
                     Copyright © Best Practices®, LLC                         LLC
Table of Contents
Background
             Summary of Key Insights, Findings and Lessons Learned p.4-7
             Universe of Learning: Research Participants, Launch Experience, and Therapeutic
             Area Demographics p.8-13
Market Entry Success Drivers
             1.1 Develop Integrated Continuous Thought Leader Strategies p.14-16
             1.2 Thought Leader Targeting p.17-21
             1.3 Thought Leader Relationship & Value Management p.22-29
             2.1 Manage Clinical Trials To Win Highly Regarded Thought Leaders &
             Investigators Into Your Clinical Trials p.30-38
             2.2 Managing Investigator-Initiated Studies p.39-47
             2.3 Early Access Programs: Helping Patients & Expanding Physicians Experience
             p.48-50
             2.4 Post-Approval Early Access Programs: Helping Patients, Physicians &
             Marketplace Buzz p.51-54
             3.1 - Data Disclosures: Inform Medical Community of Your Progress &
             Commitment p.55-60
             4.1 Communicate Clinical Science Through Journals & Congresses p.61-67
             4.2 - Using Scientific Publications: Marrying Productivity and Insights p.68-74
             5.1 - Use Multi-Channel Medical Education To Inform Health Care Providers p.75-77
             5.2 - Medical Education: Balancing the Mix of CME, Grants & Tools p.78-81

                                                                          BEST PRACTICES,
                                    2                                                          ®
                     Copyright © Best Practices®, LLC                                              LLC
Table of Contents
       6.1 - Inform Patients Through Education & Advocacy Group Collaborations p.82-90
       7.1 - Payer Education Starts Early; Focus On Cost and Outcomes p.91-101
       8.1 Use PR & New Technologies For Leveraged Reach to Patients, Physicians, &
      Payers p.102-118
       8.2 Use New Technologies For Educating & Informing Patients p.119-121
       9.1 - Orchestrate Medical Education Timing To Reach Right Constituencies At the
      Right Times (placeholder slide) p.122
       10.1 - Allocate Market Education Mix To Reflect Therapeutic Area Needs & the
      Competitive Landscape p.123-125
Lessons Learned
       Voices From the Field: Best Practices, Lessons Learned & Pitfalls To Consider
      p.126-129
       Future Trends & Issues p.130-133
       Appendix I - Orchestrate Medical Education Timing To Reach Right Constituencies
      At the Right Times p.134-138
About Best Practices




                                                                       BEST PRACTICES,
                                      3                                                  ®
                       Copyright © Best Practices®, LLC                                      LLC
Research Objective and Methodology
This study explores best practices in educating, informing and preparing the
marketplace for new products – through Physician, Patient, and Payer education,
publications, advocacy and communication strategies.


    Study Objective & Methodology                                    Key Study Objectives
 This field research and benchmarking                      •Identify key education tactics for
 study probed the broad array of medical                   thought leaders, physicians, patients,
 education and marketing practices                         and payers
 conducted two to three years prior to
                                                           •Assess key market-education
 launch that best inform and shape the
                                                           practices, including thought leader
 marketplace.                                              services, MedEd, scientific
 A quantitative survey harvested current                   publications, patient advocacy &
                                                           education, clinical trials & payer
 best practices and emerging trends in
                                                           education
 educating the marketplace to support
 successful product launches. In addition,                 •Identify key timing factors &
 deep-dive executive interviews were                       education mix
 conducted with selected participants to
 provide qualitative insights and emerging                 •Describe critical market entry pitfalls
 trends.                                                   and future trends

                                                                                   BEST PRACTICES,
                                                 4                                                    ®
                                  Copyright © Best Practices®, LLC                                        LLC
10 Steps To Excellence: Key Themes from Market Education Research
  Brand, medical and market education leaders describe various best practices for
  educating and shaping the market for new bio-pharma products. These practices can be
  distilled into 10 key areas that articulate a blueprint for market education excellence.

                           10. Allocate 1. Develop
                        Market Ed Mix To Integrated
                                                                                     “I think it's going to
                                                                                    “I think it's going to
                          Reflect T.A. & Continuous                                  boil down to being
                                                                                    boil down to being
                           Competitive   Thought Leader 2. Manage                    able to actually
           9. Orchestrate                                                           able to actually
           Med Ed Timing Landscape       Strategies    Clinical Trials To
                                                          Win Highly                 identify by individual
                                                                                    identify by individual
           To Reach Right
           Constituencies                                 Regarded                   customer what
                                                       Investigators &
                                                                                    customer what
           At Right Times                                                            channel they want
                                                                  TLs               channel they want
      8. Use PR & New
                               MARKET                                                information from and
                                                              3. Data Disclosures   information from and
     Technologies For         EDUCATION                        Inform Medical        how you're going to
    Leveraged Reach to                                       Community of Your
                                                                                    how you're going to
    Patients, Physicians,    EXCELLENCE                           Progress &         reach them most
                                                                                    reach them most
          & Payers                                               Commitment          efficiently, and almost
                                                                                    efficiently, and almost
            7. Start Payer                               4. Communicate             going through aa
                                                                                     going through
          Education Early;                               Clinical Science            decision tree that
           Focus On Cost
                                                                                    decision tree that
                                                         Thru Journals &             looks at effectiveness
               & Health         6. Inform  5. Use Multi- Congresses                 looks at effectiveness
              Outcomes Patients Thru Channel Med.                                   and cost . .. ...”
                                                                                     and cost ..”
                             Education &   Ed. To Inform                               -Senior Vice President, Marketing
                           Advocacy Group Health Care                                 -Senior Vice President, Marketing
                            Collaborations  Providers



                                                                                              BEST PRACTICES,
                                                            5                                                          ®
                                             Copyright © Best Practices®, LLC                                              LLC
Universe of Learning: 26 Companies Engaged
 Research participants included 34 executives and managers from 26
 leading pharmaceutical, biotech and medical device companies.

                         Participating Companies




                                                               BEST PRACTICES,
                                           6                                     ®
                            Copyright © Best Practices®, LLC                         LLC
Universe of Learning: Job Titles and Executive Interviews
Research participants’ roles ranged from senior leaders of commercial operations to managers of
brand teams and therapeutic franchise groups. “Lessons learned” executive interviews were
conducted across nine select companies.

                       Job Titles                                                Interview Class
   •   Senior VP, Commercial       •   Executive Director,
       Operations                      Global Marketing
   •   Senior VP, Marketing        •   Associate Brand
   •   Executive Director,             Director
       Commercial Operations       •   Senior Manager,
   •   Head Clinical & Medical         New Product
       Services                        Commercialization
   •   Vice President, Marketing   •   National Sales
   •   Senior Director, Oncology       Manager
   •   Director, Oncology          •   Manager, Clinical
       Commercial Analysis             Research
   •   Senior Manager, Marketing   •   Senior Product
   •   Manager, Oncology Market        Manager/Payer
       Research                        Marketing
   •   Senior Director, Diabetes   •   Senior Manager,
   •   Group Sales & Brand             Health Care
       Manager                         Solutions
   •   Senior Manager,             •   Medical Adviser
       Commercial Development

                                                                                            BEST PRACTICES,
                                                             7                                                ®
                                              Copyright © Best Practices®, LLC                                    LLC
A Third of Participants Have Launched more than Five Drugs

  Research participants were veterans of product launches, with 36 percent taking part
  in more than five launches.


     Q3. Number of New Product Launches Worked On: How many new product launches have you
                                participated in during your career?

                                      Total Benchmark Class

                                More than Ten,
                                     12%




                    Six to Ten, 24%




                                                                           Less than Five,
                                                                           65%




  (n=34)


                                                                                             BEST PRACTICES,
                                                       8                                                       ®
                                        Copyright © Best Practices®, LLC                                           LLC
1.1 Develop Integrated
Continuous Thought Leader
        Strategies:

Throughout Development and Market
   Entry, Thought Leaders Are A
Compass Guiding Market Insights and
             Education



                                        BEST PRACTICES,
                    9                                     ®
     Copyright © Best Practices®, LLC                         LLC
Start Early With Thought Leader Education & Services
Thought leaders are the bellwethers of market direction. They help companies understand where
therapeutic guidelines and practices are headed; they influence how practicing physicians respond to
new therapies. Not surprisingly, the largest response groups signaled Phase II as the kickoff to most
thought leader services. Some companies with robust pipelines and deep-standing commitment to their
therapeutic areas start thought leader services as early as pre-clinical research phases.
     Q6. Developing Thought Leaders: Please check when you should start each activity for
                                educating thought leaders.

          Total Benchmark
          Class
                                                                                      Engaging
                                                                                       Thought
                                                                        Providing                     Communicating
                                    Developing                                       Leaders &
                                                                         Medical                           Critical
                                    Integrated        Conducting                         Key
                                                                        Science                       Information and
                                  Thought Leader    Advisory Boards                 Investigators
                                                                         Liaison                     Sharing Research
                                    Strategies                                        in Clinical
                                                                        Services                          Insights
                                                                                    Trial Protocol
                                                                                    Development
                   Pre-Clinical        6%                18%               3%           18%                12%
                       Phase I         15%               12%              12%           24%                9%
                      Phase II         41%               26%               6%           47%                29%
              Phase III-3 Years        21%               24%              15%            6%                26%
              Phase III-2 Years        15%                6%              21%            3%                12%
               Phase III-1 Year        3%                12%              32%            0%                6%
          NDA thru Launch Year         0%                 3%              12%            3%                6%

(n=34)

                                                                                                         BEST PRACTICES,
                                                             10                                                            ®
                                               Copyright © Best Practices®, LLC                                                LLC
Market Entry Teams “Seed & Grow” MSL Pre-Launch Coverage
The overall benchmark class seeds Medical Science Liaisons (MSLs) at the start of Phase III clinical trials with
typically three liaisons to serve national thought leaders and clinical investigators. As Phase III trials
progress, this number of MSLs nearly doubles or triples each subsequent year. By launch year, the average
number of MSL has reached 26. This MSL seeding and growth pattern can be observed across most
therapeutic areas – although the staffing intensity varies somewhat across individual specialty areas.
           Q24. MSL Coverage: Estimate how many field-based medical science specialists or liaisons
           (MSLs) you assign during each year of the Phase III pre-launch period to a new product in a
                                            new therapeutic area?


                                                                                   26
             # MSLs Assigned




                                                                      15


                                                 8

                                   3


                               Phase III-3   Phase III-2        Phase III-1       Launch
                                 Years         Years              Year             Year
  (n=19)


                                                                                           BEST PRACTICES,
                                                             11                                              ®
                                               Copyright © Best Practices®, LLC                                  LLC
2.2 Managing Investigator-
       Initiated Studies:
Engaging Key Investigators in Developing
      Your Product’s Full Potential




                                           BEST PRACTICES,
                      12                                     ®
        Copyright © Best Practices®, LLC                         LLC
Oncology TA Tolerates Earlier Risk for IISs
Some organizations – particularly those working in Oncology, do investigator-initiated trials both early and
late in the development cycle. In Oncology, the life-threatening condition of many patients inspires
oncologists to conceive investigator initiated trials examining many tumor types and patient populations
that lie outside the first pivotal trials.
                                                                    “Once you have confidence that
                                                                    you've determined what your safety
                                                                    profile is, you can act strategically
                                                                    and build the right type of Phase
                                                                    One-type programs from an IIT
                                                                    perspective that'll allow you to
                                                                    understand how you perform in other
                                                                    diseases or in combination with other
                                                                    agents. I guess if I was developing
                                                                    an allergy medicine, that would be
                                                                    one thing. But I think in cancer it's
                                                                    very different. I think most oncology
                                                                    organizations are willing to take a
                                                                    calculated risk in some of these
                                                                    areas.”
                                                                    - Senior Vice President, Commercial
                                                                      http://deainfo.nci.nih.gov/advisory/bsa/bsa030
                                                                      8/presentations/Monday/1110am_Dorowshow1
                                                                      .ppt


                                                                                             BEST PRACTICES,
                                                      13                                                          ®
                                        Copyright © Best Practices®, LLC                                              LLC
4.1 Communicate
Clinical Science Through
 Journals & Congresses




                                        BEST PRACTICES,
                   14                                     ®
     Copyright © Best Practices®, LLC                         LLC
Primary Journals and Congresses Drive Publication Strategies
Benchmark partners place highest importance on publishing clinical research in primary journals and
secondary journals – along with presenting clinical research at both national and regional congresses,
and to a lesser degree on some online scientific publications. Online publications can also be important.
Some therapeutic areas place relatively greater importance on publishing in alternative channels.


       Q15. Please rate the importance of publishing your clinical results in various channels:

                             Scientific Publishing Channel Impact Map

                                                                           Highly Important     Important
          Major Congresses or Events (Int'l/Nat'l)                              83%               13%

                                 Primary Journal                                83%                17%

                   Online Scientific Publications       17%                     47%

                             Secondary Journals       10%                         72%

                                Alternative Media      4%     25%

                    Minor Congresses or Events                                    79%
                                                      4%
                               (Regional /Local)

                         Internet Self-publication    3% 17%
 (n=31)

                                                                                              BEST PRACTICES,
                                                           15                                                   ®
                                             Copyright © Best Practices®, LLC                                       LLC
4.2 - Using Scientific
 Publications: Marrying
Productivity and Insights




                                        BEST PRACTICES,
                   16                                     ®
     Copyright © Best Practices®, LLC                         LLC
Lower Wall Between Medical and Marketing
As the wall between Medical and Marketing has gotten higher, marketing groups no
longer understand the importance of scientific communication and how to work with
Medical to get that information published. Each group must have its autonomy – but
they must work together for the company’s benefit.


                                        “If you separate Medical and Marketing, then who's
                                        going to be the one basically saying whether or not
                                        you're getting what you need out of Medical? The
                                        reporting chain that goes all the way up through
                                        Medical doesn't look at things that way. We went in
                                        and Marketing did a gap analysis. They had one
                                        primary care study publication in the three years
                                        since launch. And they're saying, ‘Oh, we got this in
                                        JAMA.’ And we're like, great, isn't this a primary care
                                        drug? Yeah, well, how many primary care
                                        publications did you….one. Well, holy cow, guys. I
                                        think if you don't have that commercial lens…you
                                        need Commercial and Medical looking at it from
                                        different perspectives, and you need both. .” –
                                        Senior VP Commercial

                                                                             BEST PRACTICES,
                                             17                                                   ®
                               Copyright © Best Practices®, LLC                                       LLC
7.1 - Payer Education
Starts Early; Focus On
 Cost And Outcomes




                                      BEST PRACTICES,
                 18                                     ®
   Copyright © Best Practices®, LLC                         LLC
Engage Payers Early & Maintain Relations Through Launch
 The overall benchmark class reflects early and continuous involvement with payers and government
 agencies: They engage payers through clinical trial protocol design and needs assessment in Phase II.
 Commence outcome studies in early Phase III. Then conduct Ad Boards, agency meetings and payer
 pricing sensitivity in mid-Phase III. Payer education activities then accelerate late in Phase III.

Q12.Educating Payers & Government Agencies: Please check when you should start each activity for educating
                           payers & government agencies (Medicare/Medicaid).


                                                                                                                    Phase    Phase    NDA thru
                    Total Benchmark Class                                 Pre-                 Phase   Phase III-
                                                                                    Phase I                          III-2    III-1    Launch
                                                                         Clinical                II     3 Years
                                                                                                                    Years     Year      Year
                Conducting Advisory Boards with Payers / agencies          3%        0%        27%       15%        33%      18%        3%
         Conducting Clinical Meetings / Discussions with Payers /
                                                                           0%        6%        21%        9%        30%      24%        9%
                                                        Agencies
                                      Payer and Government Needs           0%        3%        36%       12%        24%      18%        6%
                        Conducting Early Payer Education Activities        0%        3%        21%       15%         9%      45%        6%
             Engaging Payers in Clinical Trial Protocol Development        6%        3%        38%       25%        16%       9%        3%
                               Conducting Health Outcomes Studies          3%        9%        27%       33%        21%       6%        0%
              Assessing Payers Efficacy / Safety / Pricing Sensitivity     0%        9%        18%       18%        33%      15%        6%
                                     Announcing Trade/Brand Name           0%        10%        6%        3%        13%      32%        35%
                                          Announcing Generic Name          6%        13%       13%       16%        23%      19%        10%


    (n=34)

                                                                                                                       BEST PRACTICES,
                                                                          19                                                                  ®
                                                            Copyright © Best Practices®, LLC                                                      LLC
About Best Practices, LLC
 Best Practices, LLC is a research and consulting firm that conducts work based on the simple yet
 profound principle that organizations can chart a course to superior economic performance by
 studying the best business practices, operating tactics and winning strategies of world-class
 companies.




                       Best Practices, LLC
                           6350 Quadrangle Drive, Suite 200,
                                 Chapel Hill, NC 27517
                                www.best-in-class.com
                                    Telephone: 919-403-0251




                                                                                BEST PRACTICES,
                                                    20                                              ®
                                      Copyright © Best Practices®, LLC                                  LLC

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Educating KOLs, Physicians, Patients and Payers to Support Successful Product Launches Report Summary

  • 1. Educating KOLs, Physicians, Patients and Payers to Support Successful Product Launches Strategic Benchmarking Research, Analysis and Recommendations BEST PRACTICES, 1 ® Copyright © Best Practices®, LLC LLC
  • 2. Table of Contents Background Summary of Key Insights, Findings and Lessons Learned p.4-7 Universe of Learning: Research Participants, Launch Experience, and Therapeutic Area Demographics p.8-13 Market Entry Success Drivers 1.1 Develop Integrated Continuous Thought Leader Strategies p.14-16 1.2 Thought Leader Targeting p.17-21 1.3 Thought Leader Relationship & Value Management p.22-29 2.1 Manage Clinical Trials To Win Highly Regarded Thought Leaders & Investigators Into Your Clinical Trials p.30-38 2.2 Managing Investigator-Initiated Studies p.39-47 2.3 Early Access Programs: Helping Patients & Expanding Physicians Experience p.48-50 2.4 Post-Approval Early Access Programs: Helping Patients, Physicians & Marketplace Buzz p.51-54 3.1 - Data Disclosures: Inform Medical Community of Your Progress & Commitment p.55-60 4.1 Communicate Clinical Science Through Journals & Congresses p.61-67 4.2 - Using Scientific Publications: Marrying Productivity and Insights p.68-74 5.1 - Use Multi-Channel Medical Education To Inform Health Care Providers p.75-77 5.2 - Medical Education: Balancing the Mix of CME, Grants & Tools p.78-81 BEST PRACTICES, 2 ® Copyright © Best Practices®, LLC LLC
  • 3. Table of Contents 6.1 - Inform Patients Through Education & Advocacy Group Collaborations p.82-90 7.1 - Payer Education Starts Early; Focus On Cost and Outcomes p.91-101 8.1 Use PR & New Technologies For Leveraged Reach to Patients, Physicians, & Payers p.102-118 8.2 Use New Technologies For Educating & Informing Patients p.119-121 9.1 - Orchestrate Medical Education Timing To Reach Right Constituencies At the Right Times (placeholder slide) p.122 10.1 - Allocate Market Education Mix To Reflect Therapeutic Area Needs & the Competitive Landscape p.123-125 Lessons Learned Voices From the Field: Best Practices, Lessons Learned & Pitfalls To Consider p.126-129 Future Trends & Issues p.130-133 Appendix I - Orchestrate Medical Education Timing To Reach Right Constituencies At the Right Times p.134-138 About Best Practices BEST PRACTICES, 3 ® Copyright © Best Practices®, LLC LLC
  • 4. Research Objective and Methodology This study explores best practices in educating, informing and preparing the marketplace for new products – through Physician, Patient, and Payer education, publications, advocacy and communication strategies. Study Objective & Methodology Key Study Objectives This field research and benchmarking •Identify key education tactics for study probed the broad array of medical thought leaders, physicians, patients, education and marketing practices and payers conducted two to three years prior to •Assess key market-education launch that best inform and shape the practices, including thought leader marketplace. services, MedEd, scientific A quantitative survey harvested current publications, patient advocacy & education, clinical trials & payer best practices and emerging trends in education educating the marketplace to support successful product launches. In addition, •Identify key timing factors & deep-dive executive interviews were education mix conducted with selected participants to provide qualitative insights and emerging •Describe critical market entry pitfalls trends. and future trends BEST PRACTICES, 4 ® Copyright © Best Practices®, LLC LLC
  • 5. 10 Steps To Excellence: Key Themes from Market Education Research Brand, medical and market education leaders describe various best practices for educating and shaping the market for new bio-pharma products. These practices can be distilled into 10 key areas that articulate a blueprint for market education excellence. 10. Allocate 1. Develop Market Ed Mix To Integrated “I think it's going to “I think it's going to Reflect T.A. & Continuous boil down to being boil down to being Competitive Thought Leader 2. Manage able to actually 9. Orchestrate able to actually Med Ed Timing Landscape Strategies Clinical Trials To Win Highly identify by individual identify by individual To Reach Right Constituencies Regarded customer what Investigators & customer what At Right Times channel they want TLs channel they want 8. Use PR & New MARKET information from and 3. Data Disclosures information from and Technologies For EDUCATION Inform Medical how you're going to Leveraged Reach to Community of Your how you're going to Patients, Physicians, EXCELLENCE Progress & reach them most reach them most & Payers Commitment efficiently, and almost efficiently, and almost 7. Start Payer 4. Communicate going through aa going through Education Early; Clinical Science decision tree that Focus On Cost decision tree that Thru Journals & looks at effectiveness & Health 6. Inform 5. Use Multi- Congresses looks at effectiveness Outcomes Patients Thru Channel Med. and cost . .. ...” and cost ..” Education & Ed. To Inform -Senior Vice President, Marketing Advocacy Group Health Care -Senior Vice President, Marketing Collaborations Providers BEST PRACTICES, 5 ® Copyright © Best Practices®, LLC LLC
  • 6. Universe of Learning: 26 Companies Engaged Research participants included 34 executives and managers from 26 leading pharmaceutical, biotech and medical device companies. Participating Companies BEST PRACTICES, 6 ® Copyright © Best Practices®, LLC LLC
  • 7. Universe of Learning: Job Titles and Executive Interviews Research participants’ roles ranged from senior leaders of commercial operations to managers of brand teams and therapeutic franchise groups. “Lessons learned” executive interviews were conducted across nine select companies. Job Titles Interview Class • Senior VP, Commercial • Executive Director, Operations Global Marketing • Senior VP, Marketing • Associate Brand • Executive Director, Director Commercial Operations • Senior Manager, • Head Clinical & Medical New Product Services Commercialization • Vice President, Marketing • National Sales • Senior Director, Oncology Manager • Director, Oncology • Manager, Clinical Commercial Analysis Research • Senior Manager, Marketing • Senior Product • Manager, Oncology Market Manager/Payer Research Marketing • Senior Director, Diabetes • Senior Manager, • Group Sales & Brand Health Care Manager Solutions • Senior Manager, • Medical Adviser Commercial Development BEST PRACTICES, 7 ® Copyright © Best Practices®, LLC LLC
  • 8. A Third of Participants Have Launched more than Five Drugs Research participants were veterans of product launches, with 36 percent taking part in more than five launches. Q3. Number of New Product Launches Worked On: How many new product launches have you participated in during your career? Total Benchmark Class More than Ten, 12% Six to Ten, 24% Less than Five, 65% (n=34) BEST PRACTICES, 8 ® Copyright © Best Practices®, LLC LLC
  • 9. 1.1 Develop Integrated Continuous Thought Leader Strategies: Throughout Development and Market Entry, Thought Leaders Are A Compass Guiding Market Insights and Education BEST PRACTICES, 9 ® Copyright © Best Practices®, LLC LLC
  • 10. Start Early With Thought Leader Education & Services Thought leaders are the bellwethers of market direction. They help companies understand where therapeutic guidelines and practices are headed; they influence how practicing physicians respond to new therapies. Not surprisingly, the largest response groups signaled Phase II as the kickoff to most thought leader services. Some companies with robust pipelines and deep-standing commitment to their therapeutic areas start thought leader services as early as pre-clinical research phases. Q6. Developing Thought Leaders: Please check when you should start each activity for educating thought leaders. Total Benchmark Class Engaging Thought Providing Communicating Developing Leaders & Medical Critical Integrated Conducting Key Science Information and Thought Leader Advisory Boards Investigators Liaison Sharing Research Strategies in Clinical Services Insights Trial Protocol Development Pre-Clinical 6% 18% 3% 18% 12% Phase I 15% 12% 12% 24% 9% Phase II 41% 26% 6% 47% 29% Phase III-3 Years 21% 24% 15% 6% 26% Phase III-2 Years 15% 6% 21% 3% 12% Phase III-1 Year 3% 12% 32% 0% 6% NDA thru Launch Year 0% 3% 12% 3% 6% (n=34) BEST PRACTICES, 10 ® Copyright © Best Practices®, LLC LLC
  • 11. Market Entry Teams “Seed & Grow” MSL Pre-Launch Coverage The overall benchmark class seeds Medical Science Liaisons (MSLs) at the start of Phase III clinical trials with typically three liaisons to serve national thought leaders and clinical investigators. As Phase III trials progress, this number of MSLs nearly doubles or triples each subsequent year. By launch year, the average number of MSL has reached 26. This MSL seeding and growth pattern can be observed across most therapeutic areas – although the staffing intensity varies somewhat across individual specialty areas. Q24. MSL Coverage: Estimate how many field-based medical science specialists or liaisons (MSLs) you assign during each year of the Phase III pre-launch period to a new product in a new therapeutic area? 26 # MSLs Assigned 15 8 3 Phase III-3 Phase III-2 Phase III-1 Launch Years Years Year Year (n=19) BEST PRACTICES, 11 ® Copyright © Best Practices®, LLC LLC
  • 12. 2.2 Managing Investigator- Initiated Studies: Engaging Key Investigators in Developing Your Product’s Full Potential BEST PRACTICES, 12 ® Copyright © Best Practices®, LLC LLC
  • 13. Oncology TA Tolerates Earlier Risk for IISs Some organizations – particularly those working in Oncology, do investigator-initiated trials both early and late in the development cycle. In Oncology, the life-threatening condition of many patients inspires oncologists to conceive investigator initiated trials examining many tumor types and patient populations that lie outside the first pivotal trials. “Once you have confidence that you've determined what your safety profile is, you can act strategically and build the right type of Phase One-type programs from an IIT perspective that'll allow you to understand how you perform in other diseases or in combination with other agents. I guess if I was developing an allergy medicine, that would be one thing. But I think in cancer it's very different. I think most oncology organizations are willing to take a calculated risk in some of these areas.” - Senior Vice President, Commercial http://deainfo.nci.nih.gov/advisory/bsa/bsa030 8/presentations/Monday/1110am_Dorowshow1 .ppt BEST PRACTICES, 13 ® Copyright © Best Practices®, LLC LLC
  • 14. 4.1 Communicate Clinical Science Through Journals & Congresses BEST PRACTICES, 14 ® Copyright © Best Practices®, LLC LLC
  • 15. Primary Journals and Congresses Drive Publication Strategies Benchmark partners place highest importance on publishing clinical research in primary journals and secondary journals – along with presenting clinical research at both national and regional congresses, and to a lesser degree on some online scientific publications. Online publications can also be important. Some therapeutic areas place relatively greater importance on publishing in alternative channels. Q15. Please rate the importance of publishing your clinical results in various channels: Scientific Publishing Channel Impact Map Highly Important Important Major Congresses or Events (Int'l/Nat'l) 83% 13% Primary Journal 83% 17% Online Scientific Publications 17% 47% Secondary Journals 10% 72% Alternative Media 4% 25% Minor Congresses or Events 79% 4% (Regional /Local) Internet Self-publication 3% 17% (n=31) BEST PRACTICES, 15 ® Copyright © Best Practices®, LLC LLC
  • 16. 4.2 - Using Scientific Publications: Marrying Productivity and Insights BEST PRACTICES, 16 ® Copyright © Best Practices®, LLC LLC
  • 17. Lower Wall Between Medical and Marketing As the wall between Medical and Marketing has gotten higher, marketing groups no longer understand the importance of scientific communication and how to work with Medical to get that information published. Each group must have its autonomy – but they must work together for the company’s benefit. “If you separate Medical and Marketing, then who's going to be the one basically saying whether or not you're getting what you need out of Medical? The reporting chain that goes all the way up through Medical doesn't look at things that way. We went in and Marketing did a gap analysis. They had one primary care study publication in the three years since launch. And they're saying, ‘Oh, we got this in JAMA.’ And we're like, great, isn't this a primary care drug? Yeah, well, how many primary care publications did you….one. Well, holy cow, guys. I think if you don't have that commercial lens…you need Commercial and Medical looking at it from different perspectives, and you need both. .” – Senior VP Commercial BEST PRACTICES, 17 ® Copyright © Best Practices®, LLC LLC
  • 18. 7.1 - Payer Education Starts Early; Focus On Cost And Outcomes BEST PRACTICES, 18 ® Copyright © Best Practices®, LLC LLC
  • 19. Engage Payers Early & Maintain Relations Through Launch The overall benchmark class reflects early and continuous involvement with payers and government agencies: They engage payers through clinical trial protocol design and needs assessment in Phase II. Commence outcome studies in early Phase III. Then conduct Ad Boards, agency meetings and payer pricing sensitivity in mid-Phase III. Payer education activities then accelerate late in Phase III. Q12.Educating Payers & Government Agencies: Please check when you should start each activity for educating payers & government agencies (Medicare/Medicaid). Phase Phase NDA thru Total Benchmark Class Pre- Phase Phase III- Phase I III-2 III-1 Launch Clinical II 3 Years Years Year Year Conducting Advisory Boards with Payers / agencies 3% 0% 27% 15% 33% 18% 3% Conducting Clinical Meetings / Discussions with Payers / 0% 6% 21% 9% 30% 24% 9% Agencies Payer and Government Needs 0% 3% 36% 12% 24% 18% 6% Conducting Early Payer Education Activities 0% 3% 21% 15% 9% 45% 6% Engaging Payers in Clinical Trial Protocol Development 6% 3% 38% 25% 16% 9% 3% Conducting Health Outcomes Studies 3% 9% 27% 33% 21% 6% 0% Assessing Payers Efficacy / Safety / Pricing Sensitivity 0% 9% 18% 18% 33% 15% 6% Announcing Trade/Brand Name 0% 10% 6% 3% 13% 32% 35% Announcing Generic Name 6% 13% 13% 16% 23% 19% 10% (n=34) BEST PRACTICES, 19 ® Copyright © Best Practices®, LLC LLC
  • 20. About Best Practices, LLC Best Practices, LLC is a research and consulting firm that conducts work based on the simple yet profound principle that organizations can chart a course to superior economic performance by studying the best business practices, operating tactics and winning strategies of world-class companies. Best Practices, LLC 6350 Quadrangle Drive, Suite 200, Chapel Hill, NC 27517 www.best-in-class.com Telephone: 919-403-0251 BEST PRACTICES, 20 ® Copyright © Best Practices®, LLC LLC