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Brand "A" INERTIA PRESENTATION
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Most industries have a specific “Market Leader” (e.g. Apple, Facebook, Google etc), while I wouldn’t necessarily say these are “inertia” brand products, their popularity coupled with heavy ...

Most industries have a specific “Market Leader” (e.g. Apple, Facebook, Google etc), while I wouldn’t necessarily say these are “inertia” brand products, their popularity coupled with heavy utilization can later on move them into that category. This presentation focuses on the “Life Sciences” industry where you have a number of brands in that “inertia” space and pretty much are market leaders based on years of use and reputation (e.g. Lipitor, Fentanyl, Warfarin etc). These products don’t require much “Marketing Muscle”….yet they are utilized almost exclusively.
If you are a newer entry to the market how do you un-seat an “inertia” brand? I’ll attempt to explain how in this example presentation, the “inertia” product is BRAND “A”

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Brand "A" INERTIA PRESENTATION Presentation Transcript

  • 1. (Example Presentation) Brand “A” INERTIA Key factors contributing towards Brand “A” ‘inertia’ and competing against it globally and per market Presentation By Andre’ Harrell
  • 2. Background Most industries have a specific “Market Leader” (e.g. Apple, Facebook, Google etc), while I wouldn’t necessarily say these are “inertia” brand products, their popularity coupled with heavy utilization can later on move them into that category. This presentation focuses on the “Life Sciences” industry where you have a number of brands in that “inertia” space and pretty much are market leaders based on years of use and reputation (e.g. Lipitor, Fentanyl, Warfarin etc). These products don’t require much “Marketing Muscle”….yet they are utilized almost exclusively. If you are a newer entry to the market how do you un-seat an “inertia” brand? I’ll attempt to explain how in this example presentation, the “inertia” product is BRAND “A” 2
  • 3. Agenda Objectives Methodology and sample Research findings
  • 4. Objectives Identify factors contributing towards “inertia” when Moving away from Brand “A” Globally Market differentiators
  • 5. Agenda Objectives Methodology and sample Research findings
  • 6. • The below research categories are just fictitious examples: Methodology (EXAMPLE) Previous Market Research (Example)  Re-analysis of the Phase 2 Product X Message Research involving: - 7 countries (US, EU5, Japan) - 23 x 2.5h group discussions - total of 125 respondents - in the time period Jan – Feb 2014 Global Market Research (Example)  On global trends in the treatment of - patients with spinal injury - and neurology more generally
  • 7. Agenda Objectives Methodology and sample Research findings − Global level − Market differentiators
  • 8. Evidence of different stages of market evolution ANESTHESIA primary reference Sophistication of unmet needs Launch of NOVEL OPIOIDS Initial experiences with NOPs Broad brush Refined Product W only Product Y Product W Product Y Additional information on new and existing products Influence extent to which HCP's have moved away from Brand “A” are reluctant to move away
  • 9. Current behaviour and future use intentions for pain management Overview  Aging global populations means that demand for pain management products will continue to increase  In USA, Germany and Japan, Product W has been available for some time – some HCP's, though not all, have had bad experiences – in Germany and US some HCP's are putting new patients on Product Y because of its OD dosage and the negative experiences with Product W  In the other markets, use is of Product W is less established and Product Y is not yet launched for “Craniotomies”  Product A is expected to decline and level around 50% 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Avg % in evolved markets (US, DE, JP) Avg % in less evolved markets (UK, IT, FR, ES) Brand “A” / Pain Management may stabilise beyond 2 years Brand “A” / Pain Management may stabilise beyond 2 years
  • 10. Across all countries, Brand “A” use will stabilize at around 40% of eligible patients within 2 years 10 25% 50% 75% 100% 6 months ago now in 2 years US Japan UK Italy Spain Germany France Current and future use behaviour* (n=125 respondents, 7 countries, July 2014)%ofPatientsRequiring PainManagement  All markets predict steady decline in Brand “A” use in two years time  Brand “A” use will stabilize at around 40% of neurology patient population  The rate of decline is greatest in the US * Product set includes Product A, IV Opioids, IV PCA, Epidural/PCEA
  • 11. Product A ‘Brand “A” inertia’ is driven by satisfaction/security there’s no reason to risk ‘uncertainty’ without good reason • No good reason to change – If patient is stable don’t change • ‘Know where you are with Product A’ • Patient satisfaction / demand • Fear of side effects with new class of opioids • Unsure of what to do with certain patient types • Cost • Regulations / guidance Pain Management Devices • Effective Patient Controlled Analgesia • Lower Opioid Consumption • Removes delay in analgesic delivery/gaps • Freedom from the hassles – Monitoring • Can be customized for each patient • Robust clinical trial data / compelling reasons to use Product W • Invasive (IV access required) • Potential Programming Errors • Need qualified personnel to administer Product Y • Flexibility (dosage, duration, basal) • Nursing preference: (No repeated needle sticks, reduce time requirements for staff & patients • Others expect problems to be less than with Product W CONFIDENCE UN-CONFIDENT
  • 12. Comfort and Security Desire to be free of safety issues surrounding post-op analgesic selection is countered by degree of clinical comfort it brings vs uncertainty with newer products MONITORING BENEFITS  Provides security  Tried and tested / familiar  Staff & Patient in control of pain management  Lower opioid consumption Uncertainty and Doubt CONCERNS CAUSED BY ITS ABSENCE  Potential for programming errors  Need qualified personnel to administer  Involves multiple departments in hospital to coordinate and deliver care
  • 13. Surgeons and HCP's appear to have a high interest in using Brand “A”, however have a high interest in post launch safety issues  Broad audience with differing needs  Several factors effect post-op analgesic selection  Multiple modalities used based upon patient surgical processes  Increasing scrutiny of IV PCA safety issues  Current pump advancements focused on safety features  Continual monitoring of Product A impact Cautious usage in the early years of practice Watching and waiting
  • 14. Level of Brand “A” inertia is expected to vary between landscape/patient types – consistent across all markets Patient wishes ultimately influences therapy choice regardless of patient type Patient Landscape Medical History Renal/Hepatic Function Elderly Pain Management Cost Issue Stable Pain Management Control Patient Types Young (65 yrs & under) Unstable Pain Management Control Opioid Intolerant Affluence Some may consider home healthcare monitoring Level of Brand “A” inertia
  • 15. Agenda Objectives Methodology and sample Research findings − Global level − Market differentiators
  • 16. Brand “A” usage expected to decline quickly, though HCP's often lack interest on new options due to safety concerns  Overall, Newer Options are seen as more convenient and cheaper than Brand “A”  However, there’s a clear concern regarding : - Safety Concerns - Potential for programming errors - Need qualified personnel to administer  In this context, HCP's feel that there will be a move from Product W to Product Y: - Product W seen as having higher risk of safety issues and higher incidence of programming errors 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (US only) %ofPatientsRequiring PainManagement
  • 17. Initial usage of Newer Options has brought some concern but won’t prevent its growth – at the expense of Brand “A” - if cost- effective  HCP's believe Newer Option usage will increase - convenience, easier dosage and efficacy - First, in patients not effectively treated with Brand “A” and provided to other patients as long as they are affordable and can be proven cost effective  Though initial usage of Newer Options has highlighted some issues that may slow their uptake: - Safety concerns - Programming errors - Regulatory training issues associated with complex dosing 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (Germany only) %ofPatientsRequiring PainManagement
  • 18. Cost is seen as key barrier to the uptake of Newer Options  Very cost conscious market where guidelines are key to product uptake  High emphasis on cost and safety concerns  Conservative approach to treatment. Newer Options are seen as an inevitability but the uptake will be slow due to: - Safety concerns - Country regulations concerns - Programming potential errors - Lack of monitoring: ‘you don’t know where you are and there’s no reversal’(UK, HC) 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (UK only) %ofPatientsRequiring PainManagement
  • 19. Some initial experiences in JP have prompted concern and do not encourage a shift to Newer Options  An aging population means that demand for these types of products will continue to increase  In Japan, Product W has been available for some time – Some HCP's, though not all, have had sobering experiences – Concern at the level of programming errors – High level of press coverage of safety concerns, which may have been disproportionate in incidence compared with the incidence in trials – Concerned with higher opioid consumption – Concerns re litigation with regulatory issues that comes with dose selection – Concerns re high costs of Newer Options vs low cost of Brand “A”  HCP's generally expect Brand “A” to decline and level around 50% in 2 years’ time 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (JP only) Brand "A" use may stabilise beyond 2 years %ofPatientsRequiring PainManagement
  • 20. Brand “A” usage is expected to reduce significantly, though view is mixed on which Newer Option will be the preferred replacement  Newer Options currently are only used in private practices and the current usage levels are low. There are concerns regarding: - Safety and the lack of safety guidelines - Use in elderly patients, patients with artificial valves and risk of heart abnomalities  HCP's predict an increase in usage of both Product W and Product Y as long as the cost is competitive  There are mixed views regarding the preferred Newer Option: - Product W has good efficacy data and the dosing is simple compared to Brand "A" - Product Y seems easier to manage than Product W and is FDA recommended 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (Italy only) %ofPatientsRequiring PainManagement
  • 21. Cost issues prevent higher usage of Newer Options in Spanish NHS  The usage of Brand "A" is currently very high in Spain  While respondents foresee an increase of the Newer Options, they believe that the current economic climate and Spain’s thorough guidelines will restrict its growing usage  Perceptions and experiences of Product W are mixed - HCP's are positive about the simpler dosage and superior efficacy at lower doses than Brand "A" - its usage is slowly increasing but: - they are worried about safety and the lack of safety monitoring - only indicated for patients badly controlled on Brand "A" - due to economic constraints, it is used mainly in private healthcare - usage largely restricted to private practice 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (Spain only) %ofPatientsRequiring PainManagement
  • 22. Little experience on usage of Newer Options but expect good uptake when approved for reimbursement  HCP's anticipate an increase in Newer Option usage once they’re approved for reimbursement  Newer Options are seen positively: - efficacious and easier dosage: - they will give the patient comfort and peace of mind  However, they do have some concerns about safety and lack of safety monitoring which could slow the process  There are doubts about the value of Newer Options on high risk patients 0% 25% 50% 75% 100% 6 months ago now in 2 years Product A Product B Product C Product D Current and future usage behaviour (France only) %ofPatientsRequiring PainManagement
  • 23. The ability to tailor safety to the patient is countered to some extent by the lack of supporting data or guidelines Detailed guidance on dose adjustment for all patient populations is critical for alleviating fears • The ability to tailor “Safety” patient characteristics that resonates strongly • Considered critical for treatment subpopulations (renally impaired, elderly, abuse potential, …) • BUT presents HCP's with a new challenge “Safety Claims” with limited scientific evidence “I don’t have a guideline value to tell me whether the product is safe or not” “There is no clear guidance for which patient should receive which product” “What happens if I get sued? How can I justify my rationale”? “I don’t have a safety mechanism to help me decide on the safety of a product.... what if I choose the wrong one”?
  • 24. Convenience of dosing regimen is countered to some extent by uncertainties over programming errors Level of efficacy provided by convenient dosing remains an unresolved issue and will need to be evaluated in clinical practice • Convenience of dosing regimen is generally welcomed • Expected to improve compliance, particularly among the HCP’s BUT … Convenience Of Dosing Unique Technology Easy to Administer Inability to titrate or adjust dosing Non-inferior efficacy results in clinical trials “Product Y has turned out to be effective in control of pain management…but still the data for Product Y suggest that it has comparable efficacy to other products..” (HCP) “The risk for using [Product Y] based on convenient dosing has is not yet been addressed.” (HCP)
  • 25. Uncertainty over treatment outcomes in numerous subpopulations contributes to Brand "A" inertia • Recognition of numerous patient characteristics influencing treatment outcomes is leading to a more fragmented view of the Brand "A" patient population • HCP's require more studies to fully explore the effects of Newer Options in these subpopulations Pain Management Cost Issue Opioid Intolerance Elderly (over 75)Renally impaired Asian subpopulation studies Patients with artificial valves Medical History
  • 26. Verbatim quotes highlight the disparity between the comfort with Brand "A" vs uncertainties with Newer Options Brand "A" / Product A Newer Options “I think I am more conservative and I think for me the shift will be slower. I think a lot of the patients who see me are elderly and don’t have the timing issue to come into the office.” (HCP) “I make recommendations based on my comfort zone. I essentially pick the plane I am most comfortable flying. As a surgeon I pretty much let the anaesthesiologist make the call, I don’t like to tell them how to do their job”. (HCP) “Now I’ve become a little more hesitant to start Product W. Part of it is the legal concern, not that I think it is a bad product.” (HCP) “Good anaesthesiologists are not using non Brand "A" alternatives because of the fear of what is going to happen in post-op or if the patient is hypo ventilating. How are we going to stop this?” (HCP) “It is a good product [Product Y] but it is complex. There is no superior clinical data.” (HCP)
  • 27. Verbatim quotes highlight the disparity between the comfort with Brand "A" vs uncertainties with Newer Options Brand "A" / Product A Newer Options “Monitoring allows us to determine whether the dose being used is too high or not. So if a patient on Brand "A" experiences hypo ventilation, we can monitor the pump and adjust the dose. With the Newer Options, however, if the dose were to be reduced, we would likely be accused of doing so without having any fundamental rationales and are likely to loose a lawsuit.” (HCP) “Without smart pump technology, monitoring the efficacy of drugs and dosing cannot be assessed directly.” (HCP) “Brand "A" is cheap and I personally like Brand "A" the best.” (HCP) “We have considered using Product Y in ENT cases because pain is only during the procedure and we need a short, potent agent without post-op pain”. (HCP) “Each Newer Option has varying degrees of patient unsuitability.” (HCP “I haven’t personally been able to differentiate between these recently available pain management products myself.” (HCP) “I use Product Y in neuro cases where I need to routinely monitor the patient”. (HCP)
  • 28. Verbatim quotes highlight the disparity between the comfort with Brand "A" vs uncertainties with Newer Options Brand "A" / Product A Newer Options “I think I will still use Brand "A" and use Product W on those patients who have difficulty with needles or susceptible to needle site infections. Also I will use Product W if some of my patients have problems with Brand "A".” (UK, HCP) “I think if my patients are stable/pain controlled I’m likely to leave them on Brand "A".” (UK, HCP) “I think there have been some concerns around the safety of Product Y which has put people off...” (UK, HCP) “I am personally sceptical about the cost benefit of Newer Options as our hospital will still be running” (UK, HCP) “I am not that concerned with the newer options. I will more likely use a drip during inpatient procedures anywayt”. (UK, HCP) “Part of the problem is that we only have limited information about the dosing with some of the pain management products.” (UK, HCP)
  • 29. Verbatim quotes highlight the disparity between the comfort with Brand "A" vs uncertainties with Newer Options Brand "A" / Product A Newer Options “Those pts who manage fine with Brand "A" I will keep on it” (IT, HCP) “The advantages are that Product W is effective in high risk situations, but it has not shown to reduce the number of hypo ventilation events compared to Brand "A", so it’s sort of bitter sweet.” (IT, HCP) “I don’t think these newer products will be indicated for pts who have had spinal cord surgery” (IT, HCP) “The problem is the risk of hypo ventilation limits the use of these newer options, we can’t use them in the very elderly, and there are more and more of these pts.” (IT, HCP) “Some of these newer options are contra-indicated in certain levels of renal failure, when clearance is under a certain level.” (IT, HCP)
  • 30. Verbatim quotes highlight the disparity between the comfort with Brand "A" vs uncertainties with Newer Options Brand "A" / Product A Newer Options “HCP’s are discouraged with wondering how they can fit them into a treatment algorithm. We want to use them, but nothing is right; we cannot monitor whether they are effective, because we cannot measure the pain intensity scores.” (DE, HCP) “I think stable pain control are more likely to stay on Brand "A".” (UK, HCP) “A problem is that the newer options are difficult and complicated to measure dosing.” (DE, HCP) “The long-term effect – who knows what can happen if it has been taken for 5 years.” (DE, HCP) “I don’t believe that, because Brand "A" has been on the market far too long for that and we have the longest experience with it. Brand "A"’s lead will narrow, but I think an awful lot of patients will still be treated with Brand "A".” (DE, HCP)
  • 31. Positive experiences with and convenience of Product Y will drive its use • Negative experiences and bad press may deter Product W use – evidence of decline in Product W use • Dosing monitoring for Product W is confusing for some – guidance on most appropriate not clear • Product Y use increasing – convenience and easy dosing parameters – awareness of positive results in first launch markets – familiarity and experience may be key in early launch markets
  • 32. Expectations of new comer Product Z are high due to belief in superiority in efficacy / safety Positive Negative  Superior vs Product A/Brand "A" demonstrated in trials − provides strong argument to use the product − gradually considered a cost of entry  Superior safety profile  2nd trial vs Product Y showed superior efficacy  Less problematic for renally impaired  Lack of safety monitoring requirements because of its excellent safety performance  Some anticipation of the ‘best new agent’ − ‘waiting for this to replace Product A’  Lack of flexibility in dosing regimen  Later market entrant − greater experience / familiarity with Product Y in the interim  Trial includes low risk patients with renal impairment  Restricted usage regarding body weight and very old age  Not a great deal of KOL support due to its early entry  Some anticipation of another ‘me too’ product  Earliest reports suggest it’s going to be a very expensive product “The differences are relatively subtle but I think what Product Z may have is that in the Trial comparing Product Z with Brand "A"/Product A there was a small efficacy benefit which was not significant in the Product W trial.” (US, KOL)
  • 33. “INERTIA” (Lack of movement or activity especially when movement or activity is wanted or needed) “BRAND INERTIA” (When consumers just buy products without any real attachment to the brand)
  • 34. Checkout my presentation on “Resuscitating A Failed Brand”! http://www.slideshare.net/aharrell2000/resuscitating-a-failed-brand-32157556 You can also checkout my background/work by clicking on the following links: http://www.slideshare.net/aharrell2000 www.linkedin.com/pub/andre-d-harrell/5/13/382/ www.ah2andbeyond.com https://www.facebook.com/pages/Sales-Marketing-Management- Consulting/267898536570725 https://www.linkedin.com/company/5177160?trk=tyah&trkInfo=tarId%3A1399 667573768%2Ctas%3Aah2%2Cidx%3A1-1-1
  • 35. Andre’ Harrell AH2 & Beyond Consulting www.ah2andbeyond.com 267-221-8529