As anyone who has seen any of the CSI shows is well aware, forensics is the science used to detect and better understand a crime. But what if you could use it in marketing? Instead of trying to uncover how someone died, what if you could discover why a brand launch did not live up to expectations? What went wrong? Where could the brand strategy have been better? What can you as a marketer learn from this failure to ensure your brand doesn’t suffer the same fate?
For 10 years, Neal Wolff, MBA, Vice President, Marketing at Vyluma, has been using his own approach of “forensic marketing” to evaluate historical launches and analogs, to better hone his own brand strategies by identifying potential pitfalls and opportunities that can help ensure success.
“Some very smart companies develop some very good brand plans, and yet they don’t perform as expected. What I like to know is why didn’t things go to plan,” Wolff explains. “But forensic marketing is not a criticism. Marketing is the science of changing human behavior, and a lot of things happen when you try to change human behavior—it’s not easy. My approach is to look at the science of marketing. To dig a little deeper into brand strategy, market assumptions, customer segmentation, etc. and see what could have been done better. For me, forensic marketing is as much of an art as it is a science. It’s learning from the past to build a better strategy for the future.”
While the use of historical analogs to build sales forecasts and other predictive models is not new, Wolff’s goal is to uncover the reasons behind a brand’s underperformance. Often, these reasons can provide insights into what is actually required for a successful brand launch. One of the most important insights Wolff has discovered in his use of forensic marketing is the need to understand as early in the brand process as possible: What is your brand’s value to customers?
Uncovering the Value of a Brand
“If you wait until launch to try to build value, then it’s too late,” Wolff explains. “There are examples of brands that have launched with potentially a great product, but the value was not seen until much later in the launch, when that value could have been delivered much earlier had they understood what value the brand was creating in the marketplace.”
For example, Wolff points to PCSK9 inhibitors which launched at a price of ~$14,000 per patient per year. However, the clinical trial endpoint data they used to support this price only showed their ability to lower low-density lipoprotein (LDL) cholesterol. A much more important endpoint for payers at the time would have been the ability to reduce cardiac events. However, the PCSK9 inhibitors only had meta-analysis that showed their potential to achieve those results in aggregate without any data from specific studies. When ICER analyzed the appropriate price for these endpoints, they concluded that they should have been priced much lower, around $5,000 per patient per year. Payers limited formulary uptake until the companies changed their pricing strategy and lowered their prices, which were more in line with ICER and consequently what payers were willing to pay for the endpoints they were delivering.
“Unfortunately, many brands start thinking about the payer too late in the process,” Wolff says. “Start looking at the payer even before you design your Phase 3 trial. When a room full of payers were asked what their most important endpoint was for heart failure programs, they said it was 30-day rehospitalization because when a patient returns to the hospital after discharge, it was significantly impacting their budgets. This important insight regarding a key endpoint for a new drug for heart failure would be important as you design your Phase 3 studies.”
When you have a proper understanding of a brand’s value, then you can be successful even at a high price point. Wolff says a perfect example of that are Gilead’s Harvoni and Sovaldi, which are cures for Hepatitis C. When they came out, everybody thought their price of $84,000 to $120,000 was very expensive, but it turns out they valued the products appropriately. As Wolff explains, they understood the cure of Hepatitis C could be priced much higher than the current standard of care, which was just a treatment that did not eliminate the disease.
Know Your Target—And What They Want
Another key insight that Wolff has discovered through his forensic marketing work is the importance of targeting the right audience. The case of Entresto proved this point. While the product is now very successful, at launch it severely underperformed company expectations and analyst expectations, according to Wolff. When he wanted to find out why, he determined that it wasn’t a smart strategy to target both cardiologists and primary care physicians (PCPs) at launch.
“One of the things we’ve learned over the years regarding an important cardiology product is cardiologists are the primary prescribers, and the PCPs will refill those prescriptions, but they’re not going to change what the cardiologist initiated,” Wolff explains. “So I would’ve focused exclusively on cardiologists at launch, and then started to educate PCPs only after the cardiologists were on board with the new therapy and prescribing it.”
But that is not all. At launch, the Entresto team also underappreciated how hard it would be to get cardiologists to switch their standard of care. Most cardiologists had developed an emotional attachment to the angiotensin receptor blockers (ARBs) they prescribed their patients and grew to trust, so it was not an easy switch to get them to prescribe Entresto even though the product tested positively head-to-head versus ARBs.
Additionally, Entresto was a more potent therapy and prescribers had to be careful with how they put patients on the treatment. Wolff says based on his learnings, he does not think they did enough to help prepare physicians to talk to patients to start them on therapy. Of course, now Entresto is part of the heart failure guidelines that provide recommendations and evidence for doctors on the treatment of these patients, but Wolff says the team underappreciated the importance of these guidelines and how long it would take to become part of them.
Another learning Wolff uncovered is that Entresto may have initiated their direct-to-consumer (DTC) campaign too early.
“They had developed a very powerful DTC campaign, however, patients were going to their physicians and asking for Entresto before the doctors were sold on the product,” Wolff says “So the timing of the DTC was off because you have to make sure your primary prescribers are on board before engaging with patients. With that said, all of this is based on my belief from looking at this launch as an outsider. So, while I am not saying I am 100% correct about my assessment of what Entresto did wrong, I would apply these types of learnings to the launches that I will be working on in the future.”
Don’t Lose Sight of the End Goal
Other observations that Wolff is willing to share from his work include the importance of doing good pricing work, especially since pricing is some of the hardest market research to get right.
“Pricing research is critical and it’s one of those things that you don’t want to cut costs for,” Wolff suggests. “There are not many companies that can do truly insightful pricing research, so find a company that can help you understand your price sensitivity in the market, all the economics around the prescription, the cost to the patient, how to avoid abandonment, the role of copay assistance, the economics of Medicaid or Medicare patients, and how to accelerate the process to land on formularies.”
Understanding the patient journey early on is another key learning that Wolff discovered.
“You have to understand what patients care about and what physicians care about,” Wolff says. “You need to know how the disease is currently being treated. Where do you want to focus your attention? What is the change you’re trying to target so that your product is prescribed? And you have to decide how hard a switch it will be. For instance, is there a lot of education involved or is it pretty straightforward and you just need to get to the right targeted customers and educate them.”
In the end, the right strategy doesn’t just mean success for your brand, but better outcomes for both the patients and physicians.
“It’s incumbent on us to learn from our mistakes and continue to get better at launching products because the pressure is high since the benefit to patients is so important,” Wolff says. “Our industry is doing great work developing treatments, so it’s imperative that we as marketers do our job right so that the right medications can get to the right patients to help them as much as possible. A failed launch means good drugs aren’t getting to patients because we failed to build a proper strategy. Prevent that by using forensic marketing, doing your homework, and learning from the past to unlock the true value that your brand can bring to patients and providers.”