PM360 March 2010
MARKET DRILL-DOWN

As is often the case, it’s not a single driver that shapes a trend but rather a confluence of many. Market Drill-Down takes current market data and slices it in new ways to reveal what’s really driving the market.

IF YOU CAN’T SEE THE FOREST, TRY LOOKING AT THE TREES
By Paula Fullman, Wolters Kluwer Pharma Solutions

Q: Can you help us understand the forces slowing uptake of a branded drug recently approved for a new indication?

A: A successful brand—on the market for more than five years—is experiencing slower-than-expected uptake into a new market. The drug, which we’ll call Brand X, is approved for two indications in related therapeutic areas. Recently, Brand X was approved for a third indication also in a related area.

When Brand X was approved for the second indication a couple of years after the first, all went smoothly and patient uptake was highly successful. After some initial research, the company anticipated the leap to the third indication would reap similar results. Unfortunately, things didn’t turn out that way. Preliminary data examining source of business and patient growth showed that the newest indication was not growing as quickly as forecasted. Although the company was armed with research and experience, it still could not make sense of the nuances of the new market.

So if you can’t see the big picture of what is causing the issue in your market—the proverbial “missing the forest for the trees”—you may need to take a closer look at the “trees.” In other words, it’s time to dive deep into the details of the patient data. To start our investigation, we examined what was really happening to Brand X at the pharmacy counter. Is the opportunity being lost due to patient refusal of product, switching, or is it something else? Also, how do patients of the original indication (Indication I) differ from those of the second indication (Indication II), versus those of the new, third indication (Indication III)?

Double Whammy
After culling through recent Wolters Kluwer Pharma Solutions market data for Brand X, we uncovered an immediate hurdle to sales. Compared to the first two indications, patients being treated with Brand X for Indication III are more likely to abandon prescriptions at the pharmacy counter. This means that many of these patients are submitting prescriptions for Brand X to the pharmacy but are refusing to pick them up and pay for them.

As we drilled deeper, we found something equally disconcerting: Brand X patients for Indication III who do pick up their first prescription tend to discontinue therapy after the initial fill (see Bar Chart, opposite). In both cases, patient behavior is contributing to slower sales.

Although patient drop-off could be attributed to a confluence of factors, we zeroed in on a likely candidate: price sensitivity. We found Brand X patients being treated for Indication III are more price sensitive than those for Indications I and II. Patients for Indication III began significantly refusing prescriptions when co-pays reached around the $45 mark compared to $65 for Indication I and $75 for Indication II, suggesting that price sensitivity is different for each indication (see Graph, above).

Grasp Your Patient
Understanding that there are differences in each of these three patient groups, the company needs a better grasp of the Brand X Indication III patient group to effectively manage the drop-off problem. Using longitudinal patient data to track demographics and purchasing history, we came to understand some of the differences that make Brand X Indication III patients, well, different.

First, we looked at the overall Indication III treatment market, that is, patients being treated across all brands approved for Indication III. Brand X patients are similar to the overall group with respect to age and geographic location—both patient segments show an average age around 40 and nearly 6 in 10 live in urban areas. However, there are some key differences. Proportionately, Brand X patients within the Indication III group tend to have lower household incomes, are less likely to be female, less likely to have been treated previously for the condition of interest, but are more likely to have graduated from college.

On the other hand, when comparing only Brand X patients across each of the three indications, the Indication III population relative to the Indication I and II populations is older, more likely to be female, more likely to live in urban areas, much less likely to have been treated previously, and much more likely to have graduated from college.

Knowing the Trees
As for Brand X, its product managers now can focus on turning around the discontinuation and abandonment issues. For example, as a means to combat abandonment due to price sensitivity, they can target physicians who have a greater proportion of patients who would respond to a voucher program. They also can delve into the causes of discontinuation, try to understand what experience the patient is having in the first 30 days of therapy, and perhaps create different educational aids for this patient segment that we now know is much less likely to have had prior therapy. Further, they can begin targeting patients with messages about the importance of remaining on therapy for a period of time in order to
realize the full benefits.

To download Market Drill-Down Tools for this issue’s topic, go to www.PM360online.com/tools

GET THE MARKET DRILL-DOWN EXPERTS WORKING FOR YOU! Submit your marketing question to Wolters Kluwer Pharma Solutions for deep analysis. All queries will be considered for a future column. Email Paula Fullman at Paula.Fullman@source.wolterskluwer.com

Paula Fullman is a Practice Lead with Wolters Kluwer Pharma Solutions, focused on patient analytics. She can be reached at Paula.Fullman@source.wolterskluwer.com