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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 Copyright Notice Copyright by Advanstar Communications Inc. Advanstar Communications Inc. retains all rights to this article. This article may only be viewed or printed (1) for personal use. User may not actively save
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