Those of us living in the UK are going through a huge change as we negotiate Brexit and leave the EU. Like any massive, fundamental change this will require time and skillful planning and change management. After decades within a system, and a certain status quo, we as a country now need to change and adapt. It will bring challenges but also opportunities. Similarly the pharmaceutical industry is going through a huge change, with its own challenges and opportunities.
In particular the the pharmaceutical industry has seen a significant change in the last decade, with the 2010s seeing the industry face a huge patent cliff, with blockbusters like Lipitor, Nexium, and Plavix losing patent. The 2010s also saw the emergence of the biosimilar industry, driven by biologic patent expiries such as Enbrel. This patent cliff and increased scrutiny on budgets increased the shift towards the use of generics, increasing the competitive pressure traditional pharmaceutical and biotech companies faced.
At the same time as these commercial pressures, the environment that the industry worked in shifted, driven by technology. Thanks to the internet, the industry’s primary customers, physicians, were no longer so dependent on sales reps or text books for their information. Through the internet they had access to far more information, as well as greater access to peer opinions and input, that was not restricted geographically. This coupled with the growth in generics and competition meant that more choice, and therefore power, shifted into the hands of physicians. These customers were no longer happy to accept the trumpet blowing, sometimes low value, communication that the industry traditionally shared. They still wanted medical and product information, but they expected it to be high quality, robust and accessible via the channel of their choice, be that face to face or online, and in the format that suited their needs.
Technology has also driven another major power shift, namely in the hands of patients. Traditionally for patients the only source of health information was via their access to healthcare providers (HCPs). This left them very dependent on what their doctor or nurse said and decided. There was in some cases the option to get second opinions but again the patient’s outcomes lay largely in the hands of HCPs, and their geographical access to these. The internet and social media however shifted this. It allowed patients to access far more information, from anywhere in the world, and from multiple stakeholders, including other patients. All of a sudden patients no longer had to accept the word of their local doctor as absolute.
My own experience is a great example of this. Prior to my Hashimoto’s diagnosis I was extremely ill and on some days virtually bed-ridden. Upon seeking help from a specialist I was horrified to be told it was all in my head. In my case I turned to social media for support and, thanks to this support and information found online, I refused to accept this “diagnosis” and sought help from another specialist (in my case in a different country). It is this access not only to information but also that moral support that has led to far more empowered patients, who refuse to accept the status quo and are forging ahead in getting answers and better outcomes. This goes so far as to patients even driving medical innovation, for example through the launch of the first artificial pancreas system by type 1 diabetics, years before Medtronic launched its version, or driving clinical trials and access to medicines through funding and lobbying.
All of these seismic changes in the external environment have meant the industry has needed to go through some huge changes internally. There has been a move towards improved marketing – shifting towards being customer centric and communicating across multiple channels. Besides structural changes in the industry, in the form of merger and acquisitions, there have been changes internally to companies. Digital departments sprung up to try to drive the shift away from traditional channels to internet enabled channels. There has been much talk of the need to change, of the need to be agile and the need to be customer centric.
However the reality often falls short. It has now been a decade that we have been going through change and yet the industry to this day remains incredibly self-focused. Whilst all companies are now active across channels, there is still a strong focus on the face to face channels, still suboptimal channel integration, and many process are far from being agile. Despite being able to do segmentation, and personas, on a much more granular level, many marketing plans still target large segments (e.g. cardiologists) and these are still often driven a great deal by traditional segmentation (e.g. number of prescriptions), as opposed to insight based behavioural segmentation. Despite acknowledging the importance of patients, they remain woefully ignored and under-served, with patient advocacy teams still minute compared to HCP facing roles.
I have often compared the industry to a super tanker, that is incredibly slow to change direction, but today we need to be a speed boat, with the ability to change and adapt rapidly. Just as the UK cannot wait years to slowly implement Brexit driven change, so too the pharmaceutical industry needs to speed up the change – we do not have another decade to adapt to the realities of today.