How to Turn Around a Flagging Brand: A Real Life Case Study

The glamour end of pharma marketing is undoubtedly around the launch of a new product.  Everyone is excited and optimistic, you certainly hope that what you are launching represents a step forward in treatment, and that clinicians will be intrigued and eager to try your new medicine.  Much gets written about how to make the launch a success, and rightly, because a solid platform for growth is crucial to achieving a return on the investment made in getting the drug to market.

For most marketers, of course, the more routine activity revolves around keeping that launch momentum going.  You can’t achieve that return in months, you needs several years of strong sales to succeed.  So what do you do if your product, even after a strong launch, starts to falter?  What should you do to arrest a slowdown in growth?  In short, how do you turnaround a flagging brand?

This is not an academic question.  With decreasing points of differentiation and increasing competition, this is a situation which pharma marketers will face more and more.  Of course, each case will be different; but there will be some common factors, and hence there are lessons we can learn from any given example.

So I’d like to introduce to you a real life case study, which in the interests of discretion I am going to call Brand X.  The name doesn’t matter; the case study provides an illuminating insight into the value of a strategic, hypothesis-driven, investigative approach to research over more traditional, broad market research – and the lessons that can be learnt in how pharma uses research to drive decision making.

Brand X was a new treatment for a specific type of cancer launched in a European market, and which 18 months post-launch was showing the symptoms of sub-optimal strategy and execution, both in terms of flattening growth and a high variance in the success that reps were experiencing.

Turning around a situation like this requires knowledge and insight into what is happening, why the brand is faltering, from which a strategy can be developed that will tackle the genuine issues, not just the ones which senior management’s ‘gut feeling’ says are causing the problems.  The difference, as we will see, can be significant.

So there are four stages to this kind of task.  First, we had to diagnose the issues holding back Brand X.  Then, we had to develop strategies to overcome those challenges.  Next comes the need to value the strategy uplift that is possible and the resource commitment required.  Finally, it is vital to present an evidence-based business case and ensure the seamless execution of the strategy.

Brand X had got their product to market a little quicker than a competitor’s product, but when the competitor did launch, they were better organised in coming to market.  So Brand X had the opportunity to be seen as first mover, but unless customers were both aware of them and had a positive view of them, they ran the danger of becoming the Betamax to their competitor’s VHS; and anyone over 40 will remember that although Betamax came first and was the better format, VHS achieved a critical mass and market ubiquity by putting effective marketing behind the product.

So what was going wrong?  The key to finding out was effective and insightful research.  Naturally, we started off with an internal workshop where we developed a number of hypotheses as to why the brand was flagging.  But that view was bound to be skewed, so we then went out into the field and attempted to validate those hypotheses by talking to current and former reps, urologists and key opinion leaders.

What became very clear was that the issues identified in the internal workshop were not validated by the field research, and that issues that senior management thought were holding the brand back did not seem to be the same ones that customers regarded as important.

Senior management seemed convinced that the failings were down to two main issues: ineffective execution in the field, and price.  Through the research, we were able to disprove some of the potential issues, for example value per patient not being maximised, compliance issues or simply not getting first patients on the product.

In the end the research uncovered a raft of key issues to address, and we categorised them into four sections: product  perception, organisation, market and strategy & execution.  This approach gave us a whole shopping list of factors to tackle.  Some of the organisational issues were particularly telling, and in many cases it was these which had not been identified internally.

Insufficient centrally-driven activity, poor communications, a too short-term mindset and a lack of investment in becoming a ‘urologists’ company’ all pointed to some key failings which had little to do with rep performance itself – giving the lie to the MD’s initial assertion that “the problem is in the field!”

That said, there were some issues with the product itself.  Not fatal ones, but ones which required a different approach in order to play to the product’s real strengths.

One perceived disadvantage is that Brand X has a more regular depot.  Because of this, the only urologists who liked Brand X were those who liked to see certain types of patients more regularly anyway – others saw it as an unnecessary strain on resources in the surgery and an inconvenience for the patient, who is reminded of their cancer monthly.  The answer to this is to identify the kind of patients who need to be seen monthly, such as newly-diagnosed patients requiring more advice, or anxious patients requiring more support, as well as those who visit the surgery more regularly for  other treatments.  Equally, identifying doctors who are more holistic-type treaters, the kind of doctors who like to keep a close eye on their patients anyway.  In this way, you start to turn a perceived inconvenience into a competitive advantage.

Conversely, one of what the company saw as the product’s big advantage – that it could be used straight away without the need for pre-treatment agents – turned out not to be much of an advantage, simply because the health system in Brand X’s market moved so slowly in any case.  So selling to this supposed advantage was not going to be effective.

So if the product itself was neither the cause of flagging sales nor presenting a particular point of competitive differentiation, what of the market?  This is a market where not much had changed in a long time, so doctors’ choice was amongst products which were pretty much all the same.  It became clear that they were most likely to use the one sold by the rep they liked most.

This meant that the company had to own the reps who owned the relationships, and particularly those who had existing relationships with high prescribers.  This would require consistent and continuous contact, and support for training, seminars and congresses.  In this way, relationships could then be leveraged to get business with new clients.

Again, the research had identified a potential problem in achieving this: because of limited investment and a lack of consistent effort, the company was not viewed as a urology partner, driven by poor geographical coverage of reps, frequently changing personnel both in the front line and at HQ, and the absence of a centrally-driven strategy.

As a company, they were failing to gain traction.  They were not seen as a long-term partner, but rather as people who were there to make a quick buck – that phrase was actually used, unprompted, by one of the urologists the research targeted.  And that rather suggested that the whole culture of the organisation was awry, something which inevitably had not come out in the internal workshop!

Lack of communication aggravated the problem.  The reps felt ignored and unrecognised, in truth they didn’t really believe in the product proposition and especially not in their company – a situation not helped by the fact that two sales managers had been fired within 18 months, again focusing on the symptom of the underlying problems in the organisations attitude to investment in the area and lacking a credible proposition in the market.

A study of the adoption ladder backed up the fact that an unmotivated sales force was not performing.  Nearly 30% of doctors visited were not able to remember the product (!), and then 50% of doctors who did try the product in a small number of patients did not end up using again.  A lot of that was down to the reps not getting them to try the product with the right patients.  In essence, it was being used as a last resort, and it is hard to win in that situation.  Being positioned as last resort means that when your product is used, it’s probably not going to work.

So a key task was to get the drug prescribed for the right kind of patients, playing to its strengths, so that doctors would see the benefit of using it.  The company had been obsessed with pushing benefits such as the fact there was no need for multi-therapy, price, and the reputation of the company; but the research showed that these were either of little importance, or not areas in which Brand X could effectively compete.  By concentrating on control, the level and speed of testosterone reduction, and the good side effect profile, the company would be able to present compelling arguments which actually mattered to the clinicians in certain patient management situations. They could win a valuable segment if they would only give-up trying to change behaviours to win the whole market off an attribute that was of little significance in most situations.

Perhaps the most serious shortcoming that the research identified was a lack of investment, which meant that resources were being stretched too thinly to build relationships that could deliver.  Although this had been a fundamental weakness which had allowed a competitor to muscle in on the market, it wasn’t necessarily simply a question of throwing new resource, but rather of marshalling what resources could be afforded more effectively on the segment they were credible to win in.

We recommended targeting urologists who wanted to ‘make a difference’ to patients, who should be seen more frequently anyway, by giving them rapid control of the disease. Recommendations included building regional centres of excellence (we called them ‘strongholds’), where Brand X could make itself impenetrable to the competition.  Built around KOLs who would support the brand, these specialist strongholds could then be used as a base to ‘fight out’ of into other hospitals.

Coupled with this was the recommendation to allow investment to be correctly directed locally around a global agreed positioning strategy. Included in this was to create Regional Development Directors, who would have the autonomy and the authority to make sweeping changes locally.  This way, if  something out of the ordinary was required in the field, rather than the normal delay while the investment decision went right back up the chain, it could be made quickly by someone holding a local kitty to support the stronghold.

The lesson here for any pharma marketer is that you should never assume that your hypothesis about why a brand is flagging are correct.  In Brand X’s case, the original hypothesis was that the price was too high, and therefore competition was causing them to struggle.  Whilst there were some elements of truth in that, it was missing the vital truth: the corporate strategy was undermining the business.

Serious organisational issues can be missed in the early months of launch when you have no competition, however once competitor did come along the brand’s success was compromised.  Their survival had been due to lack of competition, which had blinded the company to ongoing failings.

At the very top level there was a need for some serious investment, to get solid structures in place, and a constant viable strategy – which they needed to keep to – which played to the strengths of the product, and recognised that they couldn’t have every patient.

All of this only became clear because we challenged the company’s own hypotheses, and then tested and validated them with quality research.  Trying to put together an action plan to turn around a brand without having that kind of insight into the issues is a sure-fire route to failure – without objective evidence you would just be another voice in a room.

Too often decision making in pharma is driven by hunches, wishful thinking or just plain guesswork.  It doesn’t need to be like this; the best decisions are always taken on the basis of testing those hunches, gaining fresh insight and letting the evidence decide.

About The Author

Alex Blyth is a Managing Consultant and Head of Marketing Sciences.

Originally published in Pharmafocus, February 2011