Pharma marketers are increasingly confident that the 'brand value proposition' is a key tool in engaging stakeholders. This is true not just for payers, but also for physicians, policy makers and patients. The trend towards global marketing creates pressure to build global value propositions that will direct the brand strategically, while at the same time being relevant to localised communication.
It has always been essential to demonstrate clearly why a brand offers incremental value over existing therapies. Changing the ingrained habits of clinicians is particularly challenging where they feel they know what works for their patients and now have to justify decisions that have financial impact. As healthcare systems face increasing financial pressure, the role of the value proposition has evolved. Of course, it is still important to communicate the clinical benefit of brands, but for a payer, the concept of value is a different matter.
The challenges are complex. National endorsement does not necessarily imply widespread local access: just because a product makes health economic sense in given patient cohorts does not mean that local payers will not challenge access based on the question of affordability. These stakeholders must weigh the benefits of a new intervention for their population against the cost of all the other things on which they need to spend scarce resources.
At each level, different stakeholders have different value drivers that affect the reasons behind their decisions. So any successful value proposition must resonate with each of the clinical or payer audiences it is designed to address.
Many clinicians make decisions as part of a formal or informal peer hierarchy. The key opinion leader model allows marketers to use these pre-existing patterns of influence to support their brands. While this is effective with clinicians, it does not translate well to the payer community, which makes its decisions on a different basis. Payers may look to key clinical influencers and peer payers for guidance, but they tend to retain a certain independence of thought, heavily influenced by their local financial context.
Pharma still seems to view payers as a single audience. But it is increasingly clear that from pure clinician to pure payer there are a number of different customers with varying needs and blends of clinical and financial value drivers. To be successful, these must be addressed in different ways.
Unfortunately, payer job titles only represent a vague guide to the specific nature of the role. Even within one organisation, there may be one commissioner with a pharmacy or clinical background and another whose training and orientation draws his or her decision-making more towards the financial. To segment effectively, it is essential to start with the most fundamental value drivers and to base the segmentation on an understanding of variations in needs and attitudes, rather than the function that seems apparent from the job title.
One message for all
As the customer base becomes more fragmented, it might be attractive to 'alter' the value proposition and flex brand positioning to address different stakeholder concerns. There have been examples where products have been positioned to payer audiences as second-line therapies for situations where current treatment fails and yet promoted to clinicians as a first-line alternative to the standard of care.
Such promotional strategies should be considered with caution; payers who have agreed to fund a product based on specific positioning tend not to take kindly to finding the product is being prescribed to patients outside the agreed cohort. This may result in future products, or indeed portfolios, being blocked from formulary inclusion.
Co-creatively working with customers is a reliable way to generate value propositions and value messages that really meet their needs and achieve the commercial objectives for the brand. Such collaboration requires transparency and trust and can both support the creation of effective communications platforms and assist in developing long-term partnerships with key customers.
Having one core value proposition that resonates with common stakeholders' needs and drivers will engender trust between the industry and a customer base that has seldom welcomed its pharmaceutical suppliers with open arms. However, this needs to be based on more than the lowest common denominator.
A core proposition that encapsulates the essence of the brand and its value can then serve as a platform from which messages can be tailored to meet the needs identified for each customer segment. Identifying these segments and their sometimes common, but often disparate, needs relies upon local market insights into the decision-making process, the influences and influencers involved.
Developing a global value proposition built on a foundation of meeting customer needs and reflecting individual market dynamics will ensure it is implementable. Early local team involvement in developing the core brand proposition is essential to inform clinical platform development and guide evidence generation to support local market access messages in addition to traditional licensing requirements.
A localised approach to commercialisation may also have an impact on launch decisions. If a brand proposition is unable to meet the local market needs that must be addressed to gain access to funding, is promotional investment wise? Examples already exist of brands not launched in some cost-constrained markets.
Building the value suite
Generating in-depth understanding of market dynamics and individual stakeholder value drivers facilitates the development of messages to communicate the core value proposition. The creation of a suite of value messages, and flexible approaches to their communication, allows for local adaptation and application of the value proposition, tailored to different customers, their needs and their local market dynamics.
Local teams can use their local knowledge to map customers' needs and value drivers to the value messages so that they will resonate with their customers and then use them to communicate the value proposition effectively.
The brand value proposition is more than a value dossier or a package of evidence that supports a health economic argument; it is the very essence of the brand, what generates belief in it and what it offers over anything else available to improve patient outcomes.
Convincing cash-constrained stakeholders of the value of the brand requires them to be considered as individuals who have needs and beliefs that drive their decision-making. This means moving away from packaging available evidence in those traditional media considered attractive by the industry.
A new approach of engaging with customers based on their needs and motivations will allow marketers to generate customer belief in products and a desire to give patients access to them.
An emerging approach
The key to the successful communication of brand value in an environment which is ever-changing and in markets with a plethora of decision makers, each with different needs, priorities and aspirations, is about knowing what to say, to whom, as well as when and in what language.
Developing one core value proposition and a suite of associated value messages that resonate with all stakeholders is essential in generating market access and driving product uptake, both at launch and beyond.
Understanding how the application of that suite of messages needs to be undertaken to genuinely match the needs of all types of customers requires global marketers to engage with local teams early on. Only by doing this can they use the local team's knowledge of their market to inform the launch strategy.
Stakeholder segmentation based on needs rather than job role will clarify the similarities and differences between customers both within and across markets, as well as streamlining the number of messages required to communicate the core proposition across the piece.
Cassandra Rix is head of market access at The MSI Consultancy
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