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Oncology is a major focus of new drug development. Characterized by its dynamic pace, oncology data on new therapies, new combinations, and rapid advancements in technology are rapidly coming to fruition.
Physicians express excitement as they hear about potential novel therapies for the first time. Patients across many tumor types are living longer.
And yet, as the onslaught of new data accelerates, Old Guard regimens are surprisingly sticky.
Why do new therapies with evidence outperforming the standard of care take so long to become part of routine practice?
Despite compelling studies favoring new regimens, the barriers to uptake have not changed – in fact, they seem to get more entrenched.
These include:
• Oncologists’ bandwidth to absorb new information. Time and again, we have observed oncologists struggling to drink from the fire hose of new data. The bar for gaining their attention is high and getting higher.
• Decreased access to oncologists and their staff. If they’re on your target list, they’re on everyone’s target list. There is intense competition for limited spots for promotional visits.
• Logistical challenges. This is particularly acute for precision therapies, which require extra testing and steps.
• Perceptions of high cost. To the practice, to patients, and to the healthcare system.
As a result, oncologists and oncology practices default to their tried-and-true ways of doing things (i.e. habits).
How do you and your colleagues navigate this? You need to know where to focus your efforts.
We understand the pressure you’re working under. Launch planning timelines are now measured in days and months, not years.
The greater the unmet need, the less time you have. Under these conditions, it’s challenging to pressure-test the assumptions driving your brand plan sufficiently – and yet, the stakes are high for the customers you serve.
There are certain phrases we hear in our conversations with oncologists that cue us to “mind the gap.” When we hear these phrases, we know we need to bridge the gap between stated intentions and actual behavior. Additional related reading: Uncovering the Truth: Bridging the Gap Between Stated Intentions and Actual Behavior to Generate Deeper Qualitative Insights
As your thought partners, we have identified three key assumptions in your plan that warrant additional scrutiny. These are the assumptions that we’ve seen cause launches to go sideways.
Oncologists say this:
“New options are always welcome.”
“There is an unmet need for this product. This is better for patients.”
But, you know too many options can be confusing.
The context for your new data or launch is foundational. How well do you understand the broader context for your evidence?
• We define context as the broader landscape in which your product resides – a landscape that centers your customers (not your product).
• When products are centered in the context of the launch, the associated launch strategy tends to be generic – i.e., one-size-fits-all.
• For example, take a moment to review the product attributes that came forward as most important in your market research studies. Your review will likely show efficacy endpoints (OS, PFS, ORR) dominate the list of most important attributes. But, at this point, efficacy is the cost of entry. What are you doing differently with this information? This is the essence of launch strategy. Your lower ranked attributes (such as side effect profile) likely matter more in the transition from trial to usage than your market research shows. Quality of survival matters; bothersome or difficult-to-manage adverse effects can overshadow other product features. Barriers to access and other logistical challenges – for example, an oral medication that competes with easily available injectable alternatives -can play an enormous role in product choice.
Fully understand how long-standing habits impact product adoption.
• We have written extensively about ThinkGen’s Habit LensSM – (see Figure 1 below) our framework to help you understand the decisions that oncologists have already made.
• Oncologists are under pressure; they simply don’t have the bandwidth to re-think their treatment approaches.
• A cornerstone of your launch plan is convincing oncologists and their practices to re-evaluate and re-make these often long-standing, well-entrenched decisions in light of your new data.
• Apply ThinkGen’s Habit LensSM to what oncologists say in your advisory board meetings and in market research to ensure you rigorously understand the context for your evidence/product and the cues that are likely drive trial and uptake.
• Ask yourself: Can any of your competitors adopt your strategic imperatives and succeed? If yes, go back to the drawing board and challenge yourself to re-think your imperatives. How can your imperatives truly be customized to your brand and the unique context for your launch?
“The product profile looks great; I will definitely start prescribing this for my indicated patients”
“I saw this presented at a conference. I just need a rep to come in and tell us how to prescribe it.”
But, you’ve worked on launches with a lag in uptake, despite pre-launch excitement.
Challenge yourself on barriers to adoption and expansion, and go as deep as possible. We encourage you to scuba, not snorkel.
• Your buying process/customer journey has likely identified different drivers of adoption, unmet needs, and product advantages.
• But, have you systematically broken down the barriers and reviewed them by category?
• Have you identified the moments of truth for your brand – and have you determined how you will influence those moments to drive awareness, trial, and, ultimately, adoption?
Place your brand’s inflection points under the spotlight of your scrutiny.
• Pre-launch, no one is better positioned to subject your brand’s inflection points to the glare of a spotlight than you.
• This is your opportunity to work collaboratively with cross-functional teams to rigorously examine and reduce or eliminate barriers to uptake.
• Work with your cross-functional teams to think critically about the barriers to adoption that exist.
• Use Figure 2 to put yourself in the shoes of your customers; use a “Choose Your Own Adventure” format to fully capture the scenarios they may face as they try to adopt your product.
• What initiatives can you put in place to remove barriers and facilitate the path to purchase?
“I see patients like this in my practice all the time.”
“This patient profile reminds me of [product].”
But, you know that intention to prescribe is not the same as actually prescribing.
• Your patient profiles help oncologists identify the right patient for your product, but patient identification simply gets you to the starting line. What happens next?
• After you’ve identified barriers to trial, we encourage you to think strategically and systematically about product adoption. How will you advance oncologists from awareness, through adoption, and ultimately through expansion?
• Is your promotional message the same for each of the groups? If so, bring on a trusted colleague and pressure-test your thinking.
• Is your launch dashboard set up to identify and size these distinct groups of oncologists based on their behavior? You will need to track oncologists as they advance through this continuum.
• Use Figure 3 to identify the stage gates for product adoption and the corresponding information needs within each stage.
• Ensure your narrative and message testing includes clear, simple messages to address these information needs.
• Customize your sales call to where a physician is in the adoption continuum.
• To help prevent your product from being niched, establish a plan for expansion at the outset. Include making it as easy as possible for physicians and their staff to obtain and use your product. We strongly recommend including non-oncologists in your market research for a truly comprehensive market landscape assessment.
If you work in oncology, you’ve likely just returned from a conference, you’re planning to go to a conference, or you’re in the throes of brand planning and execution. You need to make the most of the time that you have.
In that spirit, we’ve offered you three areas in your brand plan that warrant scrutiny. Focusing your critical thinking on these three areas will help facilitate uptake of your product.
We very much hope this is helpful to you. We are happy to talk further with you and your colleagues about how these frameworks apply specifically to your product and evidence situation. We would love to hear what you think!
