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Position,Position,Position… The “weekender,” the “doughnut hole,” and the secret art of “bathroom mapping”: How pharma marketers are learning to tell new stories for every phase of a drug’s lifecycle. BY RICHARD B. VANDERVEER WITH EACH PASSING YEAR, PHARMA- done. But circumstances may change substantially in the com- CEUTICAL product positioning begins
petitive environment, so where we want the product to be in
the minds of our customer may not remain a constant.
tinues longer, and responds to moremarket variables than ever before. Starting Early
Pharmaceutical marketers are beginning to focus on product
(KOLs) in the early development stage, to the ad campaigns
positioning earlier in the clinical development stages. In cancer
that mark an expired patent’s over-the-counter debut, prod-
therapy and central nervous system treatments, for example,
ucts must fit tightly defined niches in complex markets.
where compounds frequently have multiple indications, mar-
Strategies in each new phase in the positioning process depend
keting research can determine which indications will lead to
on factors like cost (really, the availability through HMOs
the most prescriptions based on current need.
and Medicare), similar drugs in a manufacturer’s portfolio,
Knowing where the positioning strategy is headed can help
and the self-image of patients, among others.
manufacturers prioritize their clinical trials. GlaxoSmithKline’s
But for everything new in product positioning, some ele-
Paxil (paroxetine), for example, started life as an antidepres-
ments remain as important now as they were decades ago.
sant, but has sequentially added social anxiety disorder and
Then and now, positioning has more to do with consumers’
panic disorder as indications. Pfizer’s Geodon (ziprasidone)
attitudes toward a product than with the product itself. The
was launched as an antipsychotic, and more recently gained an
basic ideas of product positioning were developed more than
indication for bipolar mania. When chemotherapeutic agents
30 years ago by marketing consultants Al Ries and Jack Trout.
effectively treat different types of cancer, marketing research
Regarded as pioneers today, they coined the modern notion of
can help with tumor prioritization, which yields important
marketing “warfare” and, in the 1970s, began thinking about
information about the most profitable order in which to con-
product positioning as “the battle for your mind.”
How target customers think and feel about a product, Ries
For a drug facing established competitors, early positioning
and Trout maintained, will determine their behavior—what
research might suggest a non-intrinsic product enhancement as a
they buy and consume, and ultimately the kind of market
competitive advantage. When Ciba-Geigy introduced Lotensin
share the brand wins. Because positioning drives strategy and
(benazepril), an angiotensin-converting enzyme (ACE) inhibitor,
helps determine what communications materials are created, it
it had no clinical benefit to set it apart from the myriad other
is central to the success of the brand. Positioning couples the
ACEs being introduced at about the same time. With some cre-
understanding of the marketplace (including customers and
ative marketing, supported by appropriate marketing research,
customer segments) with the appreciation of the product
the manufacturer found a position for the product based on a
(including its competitors) and guides the development of the
unique lifetime price guarantee to the patient.
Historically, the “positioning” of a pharmaceutical product
No Tabula Rosa
was a fairly simple one-shot deal. Approximately 12 to 18
Just as family therapists say that each child in a household
months before the introduction of a new product, a team
grows up in a different family, so too will each new product
involving product management, the advertising agency, and
enter a different market than its predecessors. The launch of
the marketing research specialists would decide what aspects
the first product in a market will be very different from the
of a product were most likely to be perceived positively by
launch of the fourth or fifth, which emerges into a competitive
physicians. They framed these claims into concept statements,
world of older siblings. In the urinary incontinence/overactive
and tested the statements with doctors to find which resonated
bladder market (OAB), for example, several new products are
best. The winner was then chosen as the brand’s positioning
joining the venerable Ditropan XL (oxybutynin) and Detrol
and used as the integrating theme for the product launch and
LA (tolterodine) in that treatment area. Product managers will
need to keep up-to-date on the positions of the previously
pharmaceutical companies produced a constant
awareness into the positioning messaging for the
stream of genuinely new chemical compounds. positioning
But these days, drugs with genuinely different
chemical structures are extremely rare. Worse
strategies
launches. The product’s positioning does not
yet for marketers, the pharmaceutical promo-
often fail when
change, but the story used to communicate the
tional channels jangle with a confusing clamor
positioning does. Rather than starting anew—as
doctors learn
of competing products, while third-party payers
repositioning often errantly attempts to do—
exert a growing influence on drug selection.
that a prescribed
each new story must build upon the foundation
Cutting through this confusion starts with a
established by previous versions of the story. product isn’t
return to basics, the orthodox Ries and Trout
This is often called the “stair step” model. on a patient’s
definition of product positioning: literally,
At different stages in a product’s life cycle,
where we want the product to be placed in the
managed care
new marketing research builds upon previous
minds of our customers, after all is said and
research to support a product’s positioning (see
formulary. Patent Expiration
(tadalafil) benefited from catchy terms like “weekender,” a
Climbing Stories After key opinion leaders
wonderful shorthand for patients to use in discussing what in
Competitive Launch
drier, more clinical terms, would have been known as “dura-
tion of action.” Conversely, Levitra (vardenafil) failed to
New Indication
develop a public relations shorthand for its own positioning
Pre-Launch
and suffered in the marketplace as a consequence.
launch story. As marketersbattle for the minds of the
Clinical Development Positioning a Portfolio PRESCRIBERS
Sometimes a pharmaceutical company markets two or more
products for the same indication. If each product is posi-
PRESCRIBERS
tioned individually, without considering the market niche of
AKE HOLDERS
the other(s), the total revenue value of the portfolio will suf-
PHYSICIAN
fer. To maintain an overall positioning strategy, senior man-
agers must assume the responsibility for product positioning,which has traditionally been left up to product managers. A PharmExec Graphic
Management may be tempted to allow each product manage-
“Climbing Stories”). As the brand goes through early stages of
ment team to position its offering individually, so that stable
development, for example, the perspective of KOLs shapes the
mates have to duke it out. But managers generally find it best
product positioning process. Prior to launch, the input of
to position the portfolio of products as an integrated whole.
physician stakeholders is most important. When a new indica-
Not only does this approach yield promotional efficiencies, it
tion is added, marketing research often focuses on doctors who
is also more responsive to the holistic viewpoint of physicians
When a competitive brand launches, input from current pre-
Pfizer did an excellent job marketing Celebrex (ccelecoxib)
scribers again begins to reshape the positioning story of the
and Bextra (valdecoxib) as a portfolio. The company presented
incumbent product. Finally, if prescription drugs go over-the-
Celebrex to treat chronic anti-inflammatory conditions, and
counter at patent expiry, the feedback from patients and con-
positioned Bextra as the drug with more “punch” in acute
sumers typically steers research. At each stage of positioning
pain. Not coincidentally, positioning Bextra this way put it in
research, the new story picks up where the old one left off. Once
direct competition with Merck’s Vioxx (rofecoxib). On the
a product has been introduced into the marketplace, marketers
other hand, in a notorious portfolio-positioning failure, Bayer
can never again begin with a blank slate.
positioned Avelox (moxifloxacin) to compete with its ownolder stable mate, Cipro (ciprofloxacin). The overall position-
Cost: the New Strategy Shaper
ing strategy confused physicians, and simply diverted business
A medication’s cost plays an increasingly important role in a
product’s positioning story. In 2005, cost issues determinewhether a pharmaceutical brand is included on formularies ofmanaged care plans and, if it is, the tier on which the product
finds itself. For many drugs, an otherwise elegant product posi-tioning strategy fails when a pharmacist calls to inform the
Global Positioning Strategies Fail
doctor that a prescribed product is not on the patient’s man-
THE PHARMACEUTICAL INDUSTRY talks about “global marketing” and
aged care formular and that patient agrees to take a generic, or
“global branding,” but marketers do not yet agree on what these conceptsmean, or what implications they have for product positioning.
when a patient reports that the purchase of the product at the
Global positioning inevitably results in compromises. Marketplaces vary
pharmacy required an out-of-pocket expenditure of $45—
around the globe, so positioning tends to be market specific. Therefore, any
money the patient had previously earmarked for groceries—
attempt to hold positioning completely constant across the globe is likely to
fail. Competition, regulation, formularies, and medical practices—all of which
In the near future, many pharmaceutical marketers expect
influence positioning—vary from one country to the next. Even so, the
Medicare Part D, private drug plans (PDPs), “doughnut
essence of the product must be held constant across the marketplaces in
holes,” and similar cost factors to move to the forefront of
The fact that the United States constitutes more than 60 percent of the
the product positioning process. Whether a drug is covered
market for most pharmaceuticals means new agents are typically positioned
on the formulary of remodeled healthcare plans will soon
here first. The domestic message is then modified to reflect the culture of the
outrank the importance of even the effects of tiered co-pays
foreign market. If a product is introduced abroad, the initial positioning work is
The company’s global headquarters may attempt to coordinate global
Public Relations
positioning. But the local operating company must be given a voice in theprocess. Local operating companies typically know more about regional
Another key consideration in a pharmaceutical product’s posi-
issues than headquarters does, and they need to be actively involved if they
tioning strategy is its potential to create buzz in the market-
are to buy into a positioning strategy.
place. A well-known example of this phenomenon arose in theerectile dysfunction (ED) market, in which Lilly’s Cialis
Positioning the Competition
room. This insight helped them develop a story for the new
Sometimes companies must actually position a competitor’s
product as a pre-emptive strike. Frequently, competitive intel-
Pfizer succeeded in developing an ED condition where pre-
ligence can determine potential weaknesses in the competing
product, even before it is launched. War Gaming, a dueling-details research methodology that pits two products against
Facts vs. Feelings
one another, helps marketers attack new products’ soft spots.
For most pharma marketers, it is easiest to recount facts about
A classic example of such an approach was Lilly’s pre-emp-
efficacy, side effects, and dosage. But blending facts and feelings is
tive strike against Pfizer’s Geodon. Lilly successfully posi-
one of the most challenging, creative, and rewarding aspects of
tioned the forthcoming competition as a drug with higher
cardiovascular risk, which in turn blunted Geodon’s initial
In the ED market, a lifestyle category in which physicians
and patients determine together whether to treat, Cialis’
Companies must also remember to inoculate the market
positioning needed to speak to both groups alike. In devel-
against negative perceptions of their own products that might
oping that dual message, the product’s ability to work “up
be induced by competitive efforts. It isn’t enough to persuade
to 36 hours” was a statement of fact. That the product sepa-
physicians about the benefits. If you don’t address serious con-
rated “the pill from the pillow” and helped patients feel less
cerns about your product, your competitors certainly will.
“rushed and medical” addressed complaints about Viagra,the incumbent ED product, which had to be carefully timed.
Positioning a Condition
With pharmaceuticals, unlike shampoos, cars, cereals, and so
Some marketers find it effective to develop a position for the
on, feelings are not typically the primary driver of a product’s
condition. Pharmacia, for example, developed OAB as a con-
positioning. In this highly regulated industry,
dition, because women found it hard to identify with urinary
facts form the backbone of a product’s story.
But feelings, as the Cialis and other cases
Understanding the attitudes, feelings, and behaviors of
show, often interpret and contextualize facts,
patients helps create white space, the redefined treatment areas
that give marketers an opportunity to tell a new positioning
story. Many become ethnographers, observing patients in theirnatural surroundings for extended periods of time. The makers
Richard B. Vanderveer is CEO of GfK V2, a global
of Detrol, for example, noted that some patients practiced
pharmaceutical marketing research and consulting
“bathroom mapping”—in other words, they planned their
firm. He can be reached at 215-283-3200 x303 or
daily activities in such a way as to ensure ready access to a rest-
Richard B. Vanderveer
Reprinted from PHARMACEUTICAL EXECUTIVE, August 2005
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