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Marketing/Promotion Stern. The great thing about marketing today is that we have more methods to choose from to get our messages out to our customers: patients and healthcare providers. As marketers, though, the challenge is to use the methods in ways that the strengths can be advantageous. It seems clear now that DTC advertising on TV is not as powerful as it was when it first appeared in 1997. Today, fewer physicians are willing to prescribe the drug that patients ask for, simply because they have seen a commercial on TV. The power of DTC TV advertising is that it has created much higher disease awareness, and it can be used to deliver compliance and adherence messages. The Internet can be a very powerful tool, but too many marketers are still using it to deliver static messages to patients and healthcare providers. The beauty of the Internet is the ability to use its interactive properties to create better and stronger relationships with people. SAUNDERS. We have adopted the PhRMA code as a company but we also have supplemented the PhRMA code with our own internal additional requirements. And we’re building the processes and support mechanisms throughout the company to ensure our compliance with these standards. With regard to GCP, we’re looking at ensuring that we have the right internal controls in place to comply with the good clinical practices throughout the world. Rosenberg. The largest challenges will be around how products are marketed, especially products that fall under the specialty diseases category, such as psychotropic drugs or products used to treat moderate-to-severe pain. The FDA will be scrutinizing heavily the use of clinical reprints and articles used to support product claims. The days when companies could push the envelope and use animal studies, patient-case studies, or open-label studies to support product claims are gone. The FDA will be looking for well-controlled clinical studies to support any marketing claims made to healthcare providers. This more closely matches what has been done from a regulatory standpoint in Europe and Japan for several years. Shanahan. More and more companies will need to distribute not just scientific papers and brochures to doctors but actual systems biology models that describe therapies and enable the doctor to have a deeper understanding of the products they are considering. Without these interactive tools for instruction and guidance for products, which can be highly regulated, little will change in drug promotion. r.levy. Gaining access to the target audience is, and will continue to be, our biggest challenge. With the increased competition and noise, gaining access is tougher — and more critical — than ever. Smart marketers have to use every tool in their toolbox to find ways to be in the right place at the right time. We have to use every avenue available — both direct and indirect — to make sure we are communicating effectively to get our message across. Perlotto. Unquestionably, the challenge is the constant pressure to do more with fewer marketing dollars. Some of this is a result of the growth of the continuing salesforce arms race. There is a tendency for organizations to force marketers to look at salesforce costs as a fixed cost and all other marketing expenditures as variable costs and therefore the first place to cut when profits dip. Given that the productivity of salesforces on a dollar-generated-per-rep basis has consistently declined in recent years, this approach just doesn’t make sense. Representatives remain one of the most effective tools marketers have to deliver a deep or complex message, but they are also one of the most expensive tools in the marketing toolbox. Taking one component of the toolbox and holding it sacred from cuts throws off the smart marketer’s balanced marketing mix. Salesforces and marketing budgets need to be right-sized to meet the needs of the brand(s) they are designed to support. The culture of the pharmaceutical industry, along with the technology industry, is one of the last great frontiers of the sales-driven culture. It is slowly changing to be both more customer-centric and marketing-centric, but cultures change slowly. Cottone. One of the biggest challenges of marketing today is simply breaking through the high level of competition within the pharmaceutical industry. Research and development efforts over the last several years have led to a plethora of new drugs to treat a variety of illnesses. Additionally, DTC marketing is more prevalent than ever. There is an abundance of information on new treatments available through a variety of mediums for physicians and patients to review. This makes it increasingly important to develop and deliver clear and concise messages that will resonate with customers by defining the benefits and advantages a product or therapy offers. Karczewski. Five years ago things were quite different. Clients, in general, had more to spend on promotion and were less budget conscious. The economy was good, dollars were more available, and communications companies were expanding at a rapid rate. There seemed to be plethora of new products on the market, and we could see no end in sight. Today, there is a general upheaval across the board; marketers, agencies, and suppliers in all facets of the business are trying to forecast the direction of the market and determine where the industry is going. Many are trying to reinvent themselves to take advantage of changes in the market. On the agency side, companies are trying to put together different models in an attempt to catch the next wave. Many are hoping to create efficiencies to save money externally and internally. Kempisty. Product marketing today is more challenging than ever for several reasons. The first reason is that fewer blockbuster drugs have meant more second, third, and fourth product introductions to the market, leading to fierce competition for minute fractions of share and volume. The second reason is probably the success of consumer advertising and the innovations surrounding it. DTC revolutionized pharmaceutical marketing, but over time it has become commonplace, and in many instances it has become stale and somewhat more difficult to execute effectively. Simple consumer awareness campaigns are no longer sufficient to drive patient-directed conversations regarding specific brands and conditions. Finding ways to integrate and leverage evidence-based education that helps patients overcome barriers to assessment, diagnosis, treatment, and adherence — and deliver this behavior-changing content through traditional marketing channels — represents the next true frontier. Lastly, permission-based marketing initiatives that promise true integrated and customized messaging are seen as the Holy Grail. And while their potential is tremendous, what happens when permission is not given or is unattainable? How then do we create materials and messages that meet the needs of the greatest possible audience without the luxury data-driven solutions? Copromotion/Comarketing of Pharmaceuticals Copromotion and comarketing continue to be used widely in global pharmaceutical markets. More than 350 of these accords were signed in United States, Europe, and Japan in the last five years. In the United States and Europe, copromotion is far more commonly used than comarketing. Cardiovascular drugs and CNS products are the two categories recording the highest number of deals in all three regions. “Significant changes have taken place in benchmarks of financial terms since Rowin’s last study on this topic in 1998,” says Dilip Phadnis, president of the Rowin Group. “For one, up-front payments have skyrocketed. Also, substantial global codevelopment/cocommercialization accords are growing in number. Furthermore, deal making is moving to earlier in the development cycle because of the competition for new molecules.” GlaxoSmithKline, Pfizer, and Bristol-Myers Squibb are the three most prolific joint-marketers in the triad markets of the United States, Europe, and Japan. Large U.S. subsidiaries of Japanese companies are beginning to be used as copromotion partners in the United States. Similarly, large Western subsidiaries in Japan are acting as copromotion partners in Japan. Source: The Rowin Group, Maywood, N.J. For more information, visit rowingroup.com. Deal making is moving to earlier in the development cycle because of the competition for new molecules. What’s Your Opinion? 2005 — A look ahead What are the most significant business challenges you believe the industry will face in 2005? Three key issues Although the industry is facing a number of key issues, three stand out as particularly critical. First, creating the most effective promotional mix is an increasingly expensive effort, often with little proof of which activities actually generate the greatest ROI. Companies need to be sure they’re putting their money where it will yield the highest return. Understanding true ROI is most visible when we examine salesforce numbers. Today, there are 94,000-plus reps in the United States; this is a staggering 75% increase in just the last seven years. Have we seen productivity and results rise at the same rate? The answer is clearly no; yet the race for salesforce growth continues. Salesforces cost the industry $30 billion a year. And incremental costs are being added by new approaches, such as e-detailing, DTC/DTP, and brand Websites. Soaring promotional costs are negatively affecting profitability. Second, is the changing customer mix. Although DTC is no longer in its infancy, uncertainty remains around its effective implementation and accurate measurement. Our data show that the vast majority of DTC responders are already diagnosed and in treatment. How do we reach untreated or undertreated patients, who make up 50% or more of the total sufferer population in some classes? We need to examine new segmentation models that help us reach consumers who’ve remained beyond our grasp. Third, we face a corporate-reputation crisis. We are under attack in the media on multiple fronts. We are strong contributors to the health of this nation and the world. It’s time for us to respond forcefully and to tell our story in a way that reaches all of our audiences or we will face a growing tide of media criticism and government regulation. Barry Zimmerman CEO NOP World Health Today, there is a general upheaval across the board; marketers, agencies, and suppliers in all facets of the business are trying to forecast the direction of the market and determine where the industry is going. Many are trying to reinvent themselves to take advantage of changes in the market. The Internet can be a very powerful tool, but too many marketers are still using it to deliver static messages to patients and healthcare providers. The beauty of the Internet is the ability to use its interactive properties to create better and stronger relationships with people. David Stern Serono Inc. Dr. Marcus Wilson HealthCore Inc. In 2005, I predict that we’ll experience increasing pressure to improve postmarketing insights and enhance our ability to ensure patient safety in the real-world setting.