There’s a New Slope in the Pharma Republic. And it seems that a little knowledge of history could help put current pharma mega-launches into perspective. Are you ready to rise to the challenge? If so, read on.
A long, long time ago. . . .
In the 1980s, Sir Ronald Halstead, former Chairman of Smith, Kline & French (SKF), purportedly declared that there would never again be another billion-dollar pharmaceutical.
SKF had introduced the first real anti-ulcer drug Tagamet, which eventually eclipsed the billion dollar sales mark. It is easy to laugh with the benefit of hindsight, but Sir Ronald's statement wasn't unreasonable.
At the time, the prevailing wisdom was that the first drug into the market that established an entirely new modality of treatment, in this case displacing the surgeon's scalpel, would be impossible to displace from dominating the indication.
This prevailing wisdom, along with the inherent assumption that the forces influencing the pharmaceutical market would remain the same, shaped the view of even the most knowledgeable industry insiders at the time.
These assumptions proved to be wrong and Sir Ronald’s prediction was quickly trounced.
The second-in-class drug, Zantac, quickly surpassed Tagamet in the same indication with sales of over $1 billion. Based on only a slightly better drug profile, Zantac was marketed with sheer brutal force.
In Pharma Galaxy far, far way. . . .
It was clear that the industry paradigm had shifted and that even well-established, recently-launched brands could come under threat from better treatments.
Within ten years, yet another antiulcer drug (Losec/Prilosec from Astra/Merck) would surpass the combined sales of both Tagamet and Zantac to become the world's biggest pharmaceutical with over $6 billion in peak sales.
Based on strong, consistent messaging and even establishing a new definition of the therapeutic area, it was a textbook example of the power of disciplined brand positioning and one of the first examples of “re-branding” a medical condition itself.
A bit later, at least one industry player saw the benefit of deploying substantially greater resources in drug launches. Epitomizing and shaping this era, Pfizer had the vision to double-down on its bet to grow the biggest sales force in the industry. This at a time when most competitors had initially downsized their field forces.
With sales reps moving in like storm troopers and a one-size-fits-all approach to their messaging, Pfizer embarked upon the most impressive sequence of pharma launches over a short period.
The blockbuster era was underway in earnest and it was all about launch scale and share of voice. But it was also about launch readiness and the importance of pre-launch marketing to maximize the potential of promising drugs coming through development, or very often licensed in.
In addition, most successful blockbuster launches built upon the lessons learned in earlier eras about the importance of brand positioning. The goal of a blockbuster launch was not just to maximize peak sales, but to minimize the time required to achieve it.
In this sense it represented a strategic paradigm shift.
A New Slope
For a period of less than ten years, it seemed like the sky was the limit for large-scale general medicine launches. But in fact, it was already time for the industry paradigm to shift yet again.
Whereas most of the blockbusters of that era were small molecules for use in large patient populations in primary care, cost-containment measures in many markets and patent expirations would narrow the opportunities for this model as it had been practiced up until then.
Even as Pfizer's Lipitor juggernaut cruised toward peak sales of nearly $14 billion, the era of biologicals and high-value, more narrow-indication drugs had dawned, typified initially by Novartis' Gleevec/Glivec.
And some of the most adept practitioners under the new paradigm would be players that didn't have all the excess baggage associated with the old blockbuster tradition. Baggage that would slow their adaptation to the new reality.
Perhaps most notable among these being AbbVie (formerly Abbott) and Novartis, along with a whole new cadre of biotech players.
Again, building on the successes of the past, these new launches would also maximize the value to prescribers, patients and increasingly to payers. The new focus: novel, highly specific medicines that could successfully treat conditions with a high disease burden.
Even as bio-brand franchises soared to new heights, patent expirations loomed, and there was uncertainty and pessimism within the industry. One could even hear whispers that we would never again see multi billion-dollar pharma brands.
Some of the same consultants who had so confidently sold the blockbuster model way beyond its expiration date in the previous era were now unable to envision a future that was anything different from the past as they had studied it.
Jedi Mind Games
It is time again for yet another paradigm shift as nimble players like Gilead open up a new era of ultra-rapid, ultra-high value drug launches.
The newest launch model ambitiously takes aim -- first in development and then in launch marketing -- at massive public health problems that have been hiding in plain sight and demonstrate value to all stakeholders.
Ironically, in some cases the very same health economic criteria that policymakers used to justify restrictions to access for earlier innovative biologicals now validate wide utilization of costly therapies.
Big pharma launches have always had political implications but now the launches themselves have become political. Clearly, new skills and capabilities are required of those who wish to succeed at this level in today's global market.
A New Galaxy?
But even now, as industry experts dissect the recent successes of new mega-blockbuster treatments, one has to wonder how much effort should be put into knee-jerk copy-catting other companies' approaches.
If history teaches us anything, we should know that once we are in the middle of yet another "new launch paradigm," it is already time to start preparing for the "next big thing."
With experiential learning, we at StratX foster an approach where leading pharma managers learn to think more intelligently about their launches in multidisciplinary teams. Understanding the past, without being bound to it.
It’s about learning and experiencing the impact of different strategic approaches and how to balance risk with return. Easy concepts to talk about, but trickier to put into practice.
Stayed tuned for the next installment – Episode V: The Payer Strikes Back
You can find our previous installments here:
- Episode I: The Multichannel Menace
- Episode II: Attack of Patient Centricity
- Episode III Episode: Revenge of the Net