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Earlier this week, my team and I were meeting with a client preparing to launch a new therapy into an increasingly mature rare chronic autoimmune marketplace. Like many commercial teams facing a similar launch challenge, they are wrestling with a superficially simple question: Where will the patients come from?
Some will be newly diagnosed. Others will have failed existing therapies, and those patients will probably represent the most obvious early opportunity. But a meaningful portion of the market will depend on something considerably more difficult: persuading patients who are already being treated -- and who may consider themselves reasonably satisfied -- to make a switch.
At one point in the conversation, one of my ThinkGen colleagues proffered an analogy that I loved and immediately scribbled onto one of the 3x5 cards I still use to take notes. What if many patients describe themselves as satisfied because, over time, they have simply grown accustomed to a B-minus treatment experience? And what if our client's new therapy actually could offer something closer to an A?
That distinction gets to the heart of a perennial launch challenge. It isn't enough to demonstrate that A is better than B-minus. Before a switch is even contemplated, patients, and often their HCPs, need to recognize the limitations of the current treatment experience in the first place.
And therein lies the difficulty. Patients can be remarkably good at accommodating imperfection.
Any marketing researcher who has spent enough time interviewing patients with chronic disease has encountered some version of this phenomenon. Ask someone how satisfied they are with their medication and they may tell you, quite sincerely, that they're doing pretty well. The treatment works. They've learned to manage the side effects, accommodate the regimen, travel with it, and anticipate what it will, and won't, do. Over time, it has simply become part of life.
Probe a little deeper to get below the surface, however, and a more interesting portrait often emerges.
Perhaps the patient can work, but she arrives home exhausted with little energy left for anything else. Perhaps he still declines invitations to go out with friends because he isn't confident about how he'll feel that evening. Travel may require elaborate prior planning and/or some special containers or other equipment. Exercise has fallen away. Certain household responsibilities have migrated to a spouse. A symptom that once seemed unacceptable has gradually been recast as "just something I live with."
All of this can occur despite the fact that, on paper or according to some disease-specific clinical metric, the patient might be seen as, or feel, "controlled."
And none of this means the patient was being inaccurate when she described herself as satisfied. Human beings are extraordinarily adept at adapting to constraints. Expectations recalibrate. Compromises become routine. Over time, accommodation can become almost indistinguishable from satisfaction.
And that can be a formidable competitor for any new medicine.
Switching, after all, means exchanging the familiar for the uncertain. The existing therapy may be imperfect, but those imperfections are known. A new product profile may elicit real enthusiasm around the prospect of better efficacy, greater convenience, or improved tolerability. At the same time, it introduces another set of questions -- some vocalized, others not -- about new side effects, loss of disease control, and whether disrupting something that is "working" is worth the gamble. Loss aversion doesn't disappear simply because the alternative appears superior on paper.
This is where I think marketing research can become particularly valuable.
A satisfaction survey sounds straightforward until you start thinking carefully about what satisfaction actually means. Asking patients to rate their current medication on a ten-point scale may be useful, but it doesn't necessarily inform us whether that treatment is allowing them to live the life they want.
The academic literature on disease burden makes essentially the same point. Traditional measures have evolved considerably beyond mortality and morbidity toward health-related quality of life, functioning and economic burden. Even then, aggregate measures can miss important aspects of individual experience, including effects on careers, education, relationships, families and caregivers.
That's why the construction of an unmet-needs survey requires considerably more thought than simply compiling a list of symptoms.
Depending on the disease, as a researcher I want to know whether patients can work the hours they want to (or need to) work. Whether they can exercise. Travel spontaneously. Sleep through the night. Attend their children's activities. Socialize without planning around their condition. Date. Maintain intimacy. Leave the house without worrying about what might happen. We may want to understand absenteeism and productivity, but also confidence, a sense of predictability, risk of embarrassment, ability to maintain relationships, as well as the myriad compromises patients have gradually stopped noticing.
The right variables will be different in rheumatoid arthritis than in migraine, inflammatory bowel disease, COPD, or atopic dermatitis. And that's my point.
A recent Economist article about the impact of GLP-1s provides a fascinating example of how broadly we might think about these questions. (https://www.economist.com/graphic-detail/2026/07/26/how-big-is-americas-obesity-penalty)The research it described didn't stop at weight, blood glucose, mobility or conventional QoL measures. It examined what happened to women's employment and romantic prospects after substantial weight loss.
The findings were remarkable. Among previously unemployed women taking GLP-1s, employment increased considerably relative to comparable women who wanted the drugs but hadn't yet started them. Single women who lost weight were also substantially more likely to marry or begin living with a partner.
Whatever one makes of the mechanisms behind those findings, I love the breadth of the question. It asks us to think beyond, "Did the treatment improve the disease?" toward something more human: "What did improvement allow this person to do that she couldn't, or didn't, do before?"
That is often where unmet need is hiding.
Most marketing research is commissioned because someone within the company needs to know something. We conduct research to understand an internal business question, to size an opportunity, to test a positioning, establish a customer segmentation, explore a patient journey or forecast demand. That's all what I would call "research to know."
But there is another category of research that I think deserves more attention, and which can be useful to spotlight unmet need: research to show.
A carefully constructed, representative study of treatment satisfaction and residual unmet need can certainly help a launch team understand where existing therapies are falling short. And when designed appropriately from the outset, it can potentially do more. Before launch, the findings can help educate internal and external audiences about the continuing (and specific) burdens of disease despite available treatments. After approval, and subject of course to the appropriate medical, legal and regulatory requirements, elements of that evidence may also help support external communication.
The important point is that this cannot be an afterthought. If research may ultimately have a life outside of the walls of the sponsoring company, rigor matters from the beginning: the sample, questionnaire, measures, analytic plan and documentation all need to withstand considerably more scrutiny than an ordinary piece of marketing research conducted for internal purposes.
And intellectually, the study has to be allowed to discover what is actually there. The objective isn't to manufacture dissatisfaction. It's to determine whether apparent satisfaction is masking meaningful residual burden. A great example of this is seen in the following YouTube video (https://www.youtube.com/watch?v=_KxMxdjKaiE&t=439s) right around the 4:55 timestamp.
This brings me back to the launch discussion that started all of this.
A new therapy entering an established category isn't competing against an abstract standard of perfection. It's competing against treatments that patients know, physicians understand, payers cover and healthcare systems already know how to deliver. In many cases, it's competing against years of adaptation.
That's why simply demonstrating superiority on a product attribute may not be enough to drive switching. The more interesting question may be whether patients and physicians have come to accept limitations that no longer need to be accepted.
Sometimes the answer will be no. A B-plus really is a B-plus, and patients are genuinely doing well. But sometimes "I'm satisfied" means something closer to "I've figured out how to make this work."
For those of us who spend our time intently listening to patients and their care partners, that's an important distinction. When someone tells me they're satisfied with treatment, I've learned not to regard it as the end of the conversation.
Usually, that's when the conversation starts getting interesting.
