Feeling their pain

Launching a new pharmaceutical product across several European markets simultaneously requires marketing and communications precision. It isn't always sufficient simply to develop and distribute a superior product and take heed of diverse regulatory guidelines; in some cases the market also has to be made aware of its need for this specific product and prepared for its uptake.

One such example of a pan-European pharmaceutical launch is that of Targin (oral oxycodone/naloxone prolonged-release tablet), which is also registered as Targinact and Targiniq. Targin, made by Mundipharma, is a medication for the control of severe chronic pain.

Chronic pain is a widespread problem across Europe, with an estimated one in 15 adults affected by severe chronic pain. In real terms, that statistic translates to almost 30 million sufferers across the continent.

Chronic pain is classified as pain that persists or progresses over long periods of time (usually defined as longer than three months). It includes back pain, arthritis and osteoarthritis, among others, and has an impact on every aspect of patients' daily lives, extending from their personal to their working lives.

As well as persistence, intensity is also a significant issue — some people report that their pain is sometimes so bad they want to die.

Treatment options
Current treatment options, which aim to enable people with pain to live full and rewarding lives, include non-pharmacological treatments, such as acupuncture and transcutaneous electrical nerve stimulation (TENS), and pharmacological treatments, such as over-the-counter (OTC) medications, analgesics, anti-convulsants, anti-depressants and opioid pain relief medications.

Of the various treatment options available, one of the most commonly employed is opioids, which reduce the patient's sensation of pain by acting on the central nervous system. Although highly effective in the control of pain, up to 90 per cent of patients who are treated with opioids suffer from constipation, a severe side effect that can cause more distress than the pain itself.

Targin is an opioid (oxycodone) combined with an opioid antagonist (naloxone). This combination dramatically decreases the risk of opioid-induced constipation.

Reducing, and in many cases eliminating, this severe side effect represents a significant step forward in the treatment of chronic pain.

Pre-launch planning
In preparation for the launch of Targin, Mundipharma commissioned the Pain Study Tracking Ongoing Responses for a Year (PainSTORY), which was a survey designed to provide in-depth information of how chronic pain impacts the lives of sufferers over the course of one year. The study was initiated in April 2008 and, after completion, results were presented at a meeting of the European Federation of IASP (International Association for the Study of Pain) Chapters (EFIC) in September 2009.

With the benefit of these study results, the January 2009 launch of Targin to medical media was able to focus on the patient and his/her emotional view of pain.

Launching Targin
The launch event, Bringing Pain To Life, comprised two elements – an interactive journey through a pain exhibition and a media briefing.

Mundipharma chose to include an interactive element in the launch event to provide medical journalists with a first-person insight into the realities of living with severe chronic pain and its side effects on a daily basis.

Three exhibition rooms — labelled 'pain', 'brain' and 'effects' — combined elements of experience and interactivity with factual information. This information was designed clearly and simply to explain the mechanisms at work in chronic pain, how pain treatments take effect in the body and the distressing side effects of traditional pain management.

Journey through pain
The 'pain' room attempted the impossible task of simulating the effects of chronic pain. It was filled with jagged edges, different textures and unpleasant, painful noises, as well as words flashing around the room, which were taken from descriptions patients had given of their pain and their emotional reaction to  it. These words included 'trapped', 'defeated', 'ashamed', 'embarrassed', 'burning' and 'stabbing'.

The 'brain' room was used to communicate the scientific aspects of pain — how pain-inducing messages are picked up by receptors in the body and carried via sensory nerves to the spinal cord, where they are transmitted to the brain, which causes the sensation of pain. Opioids block the perception of pain by breaking the connection to the brain.

This information was conveyed through animated footage accompanied by text.

The final room, 'effects', demonstrated treatment side effects and the feelings these cause. This was achieved by making journalists walk through a winding narrow corridor plastered with words associated with opioid-induced constipation, such as 'bloating', 'abdominal pain', 'cramps', 'sickness', 'nausea', 'dizziness', 'tiredness' and 'fatigue', and words describing associated feelings, such as 'depressed', 'embarrassed', 'irritable', 'trapped' and 'despair'.

When asked after the event, journalists confirmed that this interactive journey helped them understand what it is like to suffer from and cope with chronic pain on a daily basis.

Media success
At the accompanying media briefing, speakers discussed the necessity of reducing the burdens of both pain itself and its treatment, the clinical evidence of treating chronic pain, the need for sustaining the quality of life and the novel approach of Targin.

Diversity was achieved by using a combination of presentations from European Key Opinion Leaders and Mundipharma's R&D experts. In addition, a filmed patient case study was shown. The case study described Sheila, a middle-aged woman who had been housebound for four years, suffering chronic pain as a result of her osteoarthritis. Targin treatment changed her life, giving her a new sense of optimism.

"The pain is now under control," she said in the video, "and finally I no longer have to deal with the bowel problems that used to spoil my life."

The speakers emphasised that 'they are not treating pain, but treating patients' and highlighted the key product messages, which were subsequently taken up 100 per cent in the media coverage.

A total of 17 medical and consumer journalists from nine strategic markets attended the briefing, representing a total readership of 140,127. Their attendance resulted in over 50 pieces of media coverage, including 11 in target medical media and 34 in consumer media across eight European countries. Over 560 views of the multimedia news release and 450 file downloads of supporting materials further demonstrated the success of this media briefing. Coverage appeared in Hospital Doctor, FTOR Finance Community, Scrip, Euro Investor, Gastrointestinal Nursing, APM Health and Gazet van Antwerpen.

Post-launch
The success of this launch campaign was consolidated by the presentation of the PainSTORY results, nine months after the product launch. This study helped Mundipharma to establish contact with and generate further endorsement for the campaign from patient advocacy and professional organisations.

Bringing Pain to Life constitutes a unique example of a product launch campaign that not only reached all of its agreed objectives, but surpassed them through building a continuous information and education flow far beyond the initial event. The media briefing and interactive exhibition were just the start; once the PainSTORY study was finalised nine months later, it was also used to support other events and its results were presented at a variety of major pain congresses, highlighting again the enormous impact of pain on patients' daily lives.

The Author
Lara Dow is head of European communications and congress at Mundipharma International

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