Marketing Strategies for Specialty Care Marketing Strategies for Specialty Care Products: Why change the model?Products: Why change the model?

Touchpad Question:Touchpad Question:Which Market Segment Grew Faster Which Market Segment Grew Faster in 2009?in 2009?

1. Branded Primary Care

2. Biotech

3. Oncology

4. Generics

Touchpad Question:Touchpad Question:Which Market Segment Grew Faster Which Market Segment Grew Faster in 2009?in 2009?

1. Branded Primary Care + 1.6%

2. Biotech + 16.1%

3. Oncology + 10.4%

4. Generics + 11.6%

Strategy: Strategy:

“a plan of action designed to achieve a particular goal or overall aim ” noun (plural strategies)

Oxford English Dictionary

Goals Are SimilarGoals Are Similar

Primary Care

Sell your productGain market shareDisplace your competition

Specialty

Sell your productGain market shareDisplace your competition

What is a “Specialty” Market / Product?What is a “Specialty” Market / Product?

1. Expensive, complex therapy.o e.g. Avastin, Fabrazyme, Remicade, Tsabri, Atripla

2. Small number of target customers.o e.g. 200 key prescribers in Canadian HIV market place.

3. Highly knowledgeable and sophisticated prescriber base.

4. Rapidly advancing base of scientific knowledge.o Driven by key conferences (e.g. ASCO, CROI, ASN, ACC).

5. Increasingly becoming a chronic care market.o e.g. transplant immunosuppressives, MS-therapy, HIV antiretrovirals,,

targeted anti-neoplastics.

6. Often a small patient base.

Major DifferencesMajor Differences

1. Sales force deployment

2. Science and data are the drivers

3. Patient Advocacy Groups

4. Reimbursement hurdles are high

5. Marketing Mix

6. Communication Channels and Media

Target Audience:Target Audience:General MD vs. SpecialistGeneral MD vs. Specialist

GP / FP

Solo practice,

Limited staff,

Wide range of diseases

Limited access

Specialist

Group, department practice.

Influence on guidelines, reimbursement, education,

Research requirement / interest

Single disease focus

Frequent access

Limited clinical time

1. The Sales Force1. The Sales Force

Highly technical knowledge requirements Not driven by reach & frequency Project based activities Must be able to sell the science Must be able to work as part of a team High access to Customers (part of the team)

Few customers to target /Few customers to target /Higher value per customerHigher value per customer

Small audience relative to other therapy areas

High relative value per prescriber

Example:o 6 HIV representatives.o $20.0 M per

representative in revenue.

Relatively little variation in value per prescriber (all are high prescribers).

0

10000

20000

30000

40000

Onc Urol Neur CV OBG

# Oncs vs. Other Specialties

2. Science and data are the Drivers2. Science and data are the Drivers

Conferences can change practice Face to face influence (role of a good medical

director) Medical Information as a communication

channel MSL’s

Publish Or Perish:Publish Or Perish:Topo Inhibitor - Publications & SalesTopo Inhibitor - Publications & Sales

0

50

100

150

200

250

94 95 96 97 98 99 00 01

To

tal P

ub

licat

ion

s

$0

$200

$400

$600

$800

U.S

. Sal

es (m

illio

ns)

Irino Pubs Topo Pubs Irino Sales Topo Sales

3. Patient advocacy 3. Patient advocacy

Patient groups are often very educated regarding the disease / condition

Small, vocal groups that can influence approvals, reimbursement

Very involved in the treatment and availability of treatment

These groups can affect patient opinion as well.

4. Reimbursement4. Reimbursement

Hurdles are high due to relatively high price QOL data is essential to success Again, a data driven world Expect provincial variability Expect variability in criteria for reimbursement

Large Differences Between Health Canada Indication and “Payor Indications”

BC AB ON QC

Treatment Naïve Patients

Cirrhotic pts with:HBV DNA >1M copies/ml

Or

HBV DNA >10K copies/ml

& ALT >3x ULN

All pts with chronic HBV

(restricted benefit listing for use by specialist in

internal medicine)

Pts. with HBV DNA >106

IU/ml, any age, >F4 upon biopsy or confirmed diagnosis of cirrhosis

All pts with chronic HBV

(open listing on RAMQ formulary)

Treatment Experienced Patients

Not Listed LAM pts who have evidence of:

1) inadequate response

2) Viral breakthrough

3) LAM resistancePu

blic

Pay

or

“In

dic

atio

ns”

HC

Ind

icat

ion

Viread® is indicated for the treatment of chronic hepatitis B infection in patients 18 years of age and older

Key Areas of Strategic FocusKey Areas of Strategic Focus

Regulatory Strategy

Product Label

New Indications

Funding Strategy

Reimbursement

Guidelines

Communications

Sales Force

Promotional Strategy

Conferences

Stakeholder Strategy

Patient Groups

Advocacy

Medical Strategy

Advisory Boards

MSL’s

Med Info

IIT’s

Marketing Mix Allocation ComparisonMarketing Mix Allocation Comparison

30%

20%

10%

10%

5%

15%

10%

Journal Ads Detail AidsReprints SamplesAd Boards Market ResearchKOL Development

Primary Care Product10%

5%

15%

0%

25%

15%

30%

Journal Ads Detail AidsReprints SamplesAd Boards Market ResearchKOL Development

Specialty Care Product

What’s The Ideal Communication Medium?

• Detail Aid

• Sales Force Messages

• Clinically oriented communications

• Guidelines, conference coverage, slide decks

• Sales and Medical delivered Messages

•Customer forums

Product Slide Set

Speaker Name

Title

Insitution

Date

Specialty Marketing:Specialty Marketing:8 Strategies for Specialty Success8 Strategies for Specialty Success

1. Gain key opinion leader support early in the development process.

2. Develop evidence of the health gain and value for money of therapy.

3. Develop a clearly defined patient profile for the brand based on the evidence.

4. Plan for variation in reimbursement criteria, guidelines, product positioning and product uptake.

5. Invest in advancing the science– guidelines, review articles, IIT’s.

6. Be Nimble: Medical practice Changes Quickly in these Markets

7. Ensure enough resources are allocated to “non-traditional” channels – Medical Strategy, MSL’s,

8. Ensure sufficient conference coverage and presence is implemented.