32-33 - INDUSTRY: Cycle of life

The transformation of healthcare and the evolution of digital health are just two factors driving the need for new pharma commercialisation models. Cross-functional commercialisation teams are becoming key to identifying new opportunities earlier in patient pathways – and to harnessing the data that will drive innovative value propositions.

Most pharma organisations know and accept that commercialisation planning should start much earlier in the product development life-cycle. The pressure to be more forward-looking is increasing, given the growing sophistication of therapies and rising financial challenges facing healthcare systems.

So, how can companies deliver the shift that’s needed, going beyond traditional sales and marketing planning to create a commercialisation capability that will achieve greater success?

From our recent discussions with clients about the growing impetus for change, and the new ways with which brands must differentiate themselves in the market now, some strong themes have emerged.

The need for revised commercialisation models is being driven by:

The transformation of healthcare, desire to understand patient care delivery and scope to improve this through optimised pathways
The need to build a watertight economic case for products as therapies become more complex, targeted and expensive
The expanding opportunity presented by digital health to solve some pressing issues for patients and healthcare providers (e.g. by moving some aspects of care outside hospitals).

The companies that are successfully aligning their commercialisation strategies with accelerating healthcare transformation, through sufficiently early planning, are finding that they can differentiate their organisations and individual product brands in new and important ways. They are able to create and communicate richer value propositions that resonate across the different stakeholder groups, for instance.

They can also continue to build and enhance the economic case for their products with insightful data captured post-launch, through strategic real-world evidence capture. Harnessing digital diagnostic and monitoring tools, and co-creating digital patient support platforms are potential examples.

Adequate resourcing and the right capabilities across the cross-functional team are key to providing the platform. Having people with specific expertise in the right areas from across adjacent disciplines (medical affairs, clinical, market access), for instance, with capabilities and expertise – e.g. around digital health tools and intelligent data analytics – is becoming increasingly important.

Transformed commercialisation strategies, then, start with pooling resources, talent and know-how from across the key internal teams, and looking to plug any gaps in knowledge and capability through strategic hiring and targeted external partnerships.

Equipped with a greater appreciation of existing patient pathways and official guidance, the cross-functional team can start to explore how they can improve the uptake of a drug or therapy within that pathway.

By mapping out care pathways in hospitals and how patients flow through the system, gaps in care can be identified and improvement plans created.

Unless there is a physical hurdle, barriers may be addressable through improved, targeted value communication – not just about the efficacy of the therapy, for instance, but also about its known impact on patient quality of life, on the length of hospital stay, on reduced cost of care.

While the relative emphasis of the value proposition is likely to vary by stakeholder group (physician vs payer/insurer vs patient), the richer the data package that’s built as a drug is developed, put through trials and finessed for launch, the stronger the impact as commercialisation teams start to talk about the product in the market.

It highlights the criticality of early commercialisation planning – the design of clinical trials, planning for target indications and ensuring that the right data is being captured is clearly vital. This journey involves initial support and future market messaging, ongoing reimbursement cases and long-term pricing negotiations into the long term.

Communicating and potentially extending value proposition is hugely important in the age of more personalised treatments that are very costly to develop yet have only a finite market (e.g. in the case of very rare diseases, and sub-sectors of oncology where patient populations are small).

Opportunities here include designing phase 3 registrational studies with economic endpoints in mind, as well as pragmatic post-launch/phase 4 studies for real-world evidence generation, which support a compelling value proposition for all stakeholders (physicians, payers, patients, providers).

Real-world evidence is a powerful means of justifying the investment long after a new treatment has entered the market, not just as part of required pharmacovigilance/safety monitoring, but as a means of demonstrating and quantifying the value experienced by healthcare providers, payers and of course patients.

This is one area where digital health applications can play a strategically important role, simultaneously adding value for patients and healthcare providers by extending monitoring and support beyond a hospital setting and providing a vehicle for tracking how patients fare, feel and draw on healthcare resources over time.

The digital health intervention may itself be part of the solution (reducing dependency on in-person interventions), but even if it is purely a support platform it can play an important role in gaining feedback about how patients are responding to a drug, and how it is transforming their day-to-day life and mental well-being while reducing their dependency on health services.

The opportunities to harness digital platforms and apps are a subject in their own right and this scope will only grow over time. For now, it is vital to recognise these opportunities sufficiently early in the development cycle.

The good news is that leading pharma companies are already looking to smarter trial design, evidence positioning and value proposition building as new levers for differentiation, recognising that a shift in commercialisation strategy is paramount now.

There is a pressing need to nurture the right balance of skills and experience to do more early groundwork, well before the product launch. Ideally, strategic commercialisation activity should begin at the point of phase 3, or even phase 2b investment decisions, when a cross-functional team spanning market access, medical affairs, real-world evidence and commercial roles can help de-risk these decisions, by building the bigger market story around the overall value proposition of the product.

Pivotally, life sciences companies should be optimising market access plans, while pursuing fair pricing and reimbursement.