Engaging with your opinion leaders

At launch, do you want to have a cohort of advocates who are authoritative, knowledgeable, and genuinely engaged in educating their peers on your products' benefits? Of course you do. Are your company's KOL engagement processes conducive to this? On the evidence of audits performed by Kendle Healthcare for clients large and small, not nearly as much as they might be. 

A drug's most effective spokespeople are external experts who know the wider therapeutic class inside out, and understand your product's place within it. They are more likely to be motivated to give presentations, write articles and talk to the media if they have had a long association with the company; and their communications will be the more credible if they have had experience of using the drug, particularly as investigators.

R&D and medical considerations
In setting up the study programme for a developing product it therefore makes sense for R&D and medical teams to consider the need for speakers, media spokespeople and advocates, at launch and beyond. Do they? Again, according to our experience, not as often as they might.

Why is that? Quite rightly the things uppermost in the development team's thinking are getting both the planning and the execution of trial programme right. There will be some external experts among the investigators and most companies will also involve some as advisors for the planning of the programme overall and the design of the study protocols. There will, therefore, be KOLs involved with the product from early on. However, the number and types of KOL will, in most cases, be chosen exclusively to meet the immediate needs of the trial programme, and not from any consideration of the longer term needs of marketing.

Yet meeting the needs of the trial programme does not preclude giving some early thought to future business objectives. At this stage you can still ensure the mix of investigators includes sufficient opinion leaders who can communicate authoritatively about the product and will be prepared to do so. Most companies leave that to chance. But while the big name opinion leaders may be happy to present at international symposia, for example, they may be not so enthused about less high profile roles or supporting the local affiliate. There are sensitivities for sure, and sometimes compliance issues, in bringing this sort of commercial thinking into the medical programme but we would argue that the mix of investigators should include lesser names and up-and-coming experts to broaden the number and range of people who can be called on for a range of activities.

Enlisting future opinion leaders at the trials stage can pay huge dividends later across a range of vital launch activities

An added complication is that widespread dissemination of information about a product may not be undertaken until six, seven or eight years after the start of the trial programme and five years, say, after the start of phase III studies by which time the opinion leader landscape may have changed considerably. This makes it all the more important that sufficient thought is given early on to the mix of investigators.

Investing in intelligence
It is paradoxical, given the vast expense and high stakes attached to any trial programme, that development teams invest so little in good opinion leader intelligence and rely on informal, and often less than objective, opinion leader lists. There is some evidence that this is changing, but even now we, as providers of KOL intelligence, are most often called in, not by the development team, but by marketing or medical affairs in the run-up to launch, and commissioned to deliver the first KOL mapping the company has undertaken. A good KOL mapping is both extensive and forward-looking: identifying the opinion leaders of tomorrow allows a company to develop valuable working relationships with talented and motivated clinicians in the earlier stages of their careers.

It makes sense not to leave to chance whether you have sufficient advocates of the right type, and in the right place for launch. Enlisting future opinion leaders at the trials stage can pay huge dividends later across a range of vital launch activities. Ensuring a spread of different types of opinion leaders within the investigator mix will make communicating about the product much more effective. These need be only a small number of the total investigator pool but some thought about the longer term needs of the company at this early stage could be invaluable at launch and beyond.

Neil Kendle is
 managing director of Kendle Healthcare.
Contact him via email neil@kendlehealthcare.com
 or visit www.kendlehealthcare.com