Have You Hit A Wall (After Launch)?

Sanofi Zaltrap

Very quickly, Sanofi slashed the price in half. It’s still making a profit, but it will never outrun the bad publicity that emanated from this story, a story in which it appeared that Sanofi was getting rich on the back of dying cancer patients. Clearly the pricing and payer strategy employed by Sanofi was not well thought out. It was predicted the brand would make strong sales but it has failed to live up to expectations and is widely considered a failed launch due to its sales compared to its forecasts.

This is not the only failing launch Sanofi have had to endure. The company had challenges with their launch of their anti-arrhythmia drug, Multaq, which Morgan Stanley predicted could garner sales of $3 billion a year. The drug, however, was linked with a higher risk of liver, cardiovascular and lung disease. On top of those conditions, patients with atrial fibrillation were also advised by the FDA against using it. Payers backed off pretty quickly and very low reimbursement prices were set when it was included. By the end of 2012, sales stagnated at $570m, leaving it falling far short of the billions the company had banked on.

Let’s leave poor Sanofi alone for now and turn to AstraZeneca and its oral anticoagulant, Brillinta, which is a widely discussed example of a launch failure. Analysts expected a big uptake given its more positive efficacy and safety profiles compared with the cheaper generic drugs. The FDA then asked for more data, adding another six months to the launch date and trashing the optimism that it could quickly reap market share before Plavix went generic. No such luck.

Sales started off slow and went downhill from there (although sales did improve in 2012 and 2013). Sales of $2.7 billion by 2015 were predicted; however, it has only achieved sales of $71 million since approval. These are just a handful of the stories I could tell. My point is that even the big guys fail. These failures were all largely due to poor payer and pricing strategies as well as a failure to communicate the value of the products to the payers and physicians. Even if it becomes clear that your payer strategy is not optimal, there are many options available to you. You can change it after careful analytic analysis. You can negotiate creative pricing approaches set around how much the company will discount from the list price for specific conditions. You can agree a risk-share approach where the company will reimburse the payer if the real-world effectiveness does not measure up to pre-registration trial data, or you can simply not put the drug on that market (as Boehringer Ingelheim did with Trajenta in Germany)…and these are only a few of the options available.

However, in all of these case studies, the problems could be minimized by utilizing Eularis artificial intelligence powered bespoke analytics that can identify and highlight the key issues in advance and allow effective remedial action to be taken. It’s not just about developing a great launch strategy, but continually evaluating the post-launch efforts and tweaking them to ensure success. Did you achieve what you had hoped for? Did you achieve what the CEO and CFO had hoped you would? What mistakes were made? What new developments do you need to integrate into your post-launch plans to satisfy customers and drive revenue?

Other Case

Let’s look at a case study of a drug we worked on in the US Pharmaceutical market. This client came to us two years after launch in a crowded, mature market – with generics already available in that market – and the product was failing to grow. The analysis was conducted to reveal three major areas inhibiting growth:
    •    a wrong message focus
    •    poor managed care coverage
    •    a sub-population that had been ignored but would provide strong benefits if targeted

Notwithstanding these, the brand was generally doing everything else right. Their activity channels and mix were fine and some minor tweaking of allocation was required. However, without the right message focus, they were all essentially wasting their budget. The messages of their unique differentiator that they were focused on were well received and strong but they were not drivers for this category and, therefore, not impacting prescribing behavior at all.

They had done what we have seen many times i.e. focused on the unique differentiator messages without taking care of the basic drivers first. You could think of this in simple terms, like a washing powder advertisement. Think of a washing powder that focuses only on the lovely smell but ignores the core message that it washes clothes clean and makes them whiter than white. They would be wondering why they are not getting the sales they expected despite being very strong on the core message; but this is because the core message is not driving sales as it’s being ignored as a ‘given’.

In the case of the Pharmaceutical brand we mentioned, the core messages around efficacy – that they had the data to support – were not even mentioned; however, what should have been a secondary message was their core message. So, for the message they focused on, if you overlaid high prescriber data with non-prescribers, both saw them as superior on that message but it was not driving their prescribing at all.

In terms of the managed care coverage, they told us it was around 80%. If that were true, the physicians were not aware of it. However, we suspected it was not true and the physicians knew that. To test our hypothesis, the company conducted extensive analysis of their coverage and discovered it was nowhere near as great as they had thought it was. This definitely needed to be rectified.

Our clients then changed their message focus according to the analytics, did some tweaking of their budget allocation and focused heavily on their managed care coverage. When we reran the analysis 6 months later, the brand had more than doubled in market share and the managed care coverage had improved dramatically, although there was still work to be done in that area. The overall sales increase, without any increase of sales and marketing budget, was $249 million. Not too shabby!