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MAPS

Welcome to this episode of the Medical Affairs Professional Society podcast “Elevate”. The views expressed in this recording are those of the individuals, and do not necessarily reflect on the opinions of MAPS or the companies with which they are affiliated. This presentation is for informational purposes only and is not intended as legal or regulatory advice. And now for today’s “Elevate” episode.

00;00;33;09

Eddie Power

Welcome, everybody, to today’s podcast that’s going to cover marketing and sales fundamentals. My name is Eddie Power. I’m the Business Domain Lead for MAPS. And I’m also the CEO of emPower Medical, which is a consultancy focusing on Medical Affairs. I have over 25 years experience in pharma across six different companies, both large and small. And primarily my roles have been in Medical Affairs. And it’s my pleasure today to have Brenda Raphael as my guest. Brenda is the CEO of BLGR, LLC, a consultancy focused on business strategy and marketing. Brenda has over 20 years of business experience in pharma, including senior commercial positions at Pfizer, Bayer Consumer and Novartis. She’s led many portfolios, including a dozen launch brands, blockbusters, small brands, and she’s led strategy, commercial organization in sales, marketing and pricing reimbursements and managed full panels across multiple therapeutic areas both in the US and European companies. And more than that, she’s a classically trained marketer from Procter and Gamble and Coca-Cola earlier in her career. And I’ve had the privilege of working with Brenda and knowing her as a colleague and as a friend for over 15 years. And I really value her expertise and her perspectives, on marketing and how Medical Affairs can add value to the market in commercial organizations. So, Brenda, welcome to our podcast.

00;02;19;29

Brenda Raphael

Thank you very much. It’s a pleasure to be here with you. And, always a pleasure to be chatting with you, Eddie.

00;02;26;05

Eddie Power

Likewise. So why don’t we just kick off our conversation and first maybe get your thoughts on why you feel it’s important for medical professionals to understand marketing principles? And don’t we already have marketers who are responsible for that. Why should it matter to Medical Affairs?

00;02;46;09

Brenda Raphael

Great. Great question. To start with, don’t we have people for that? Is that what you said? There’s sort of this misperception that marketing is all about development of the materials. Right? So production of the visual aid, making of a television commercial, etc., like the production of the stuff, if you will. And that is some of what marketing does. But the most important thing that marketing does, or the commercial organization more broadly does, is develop the strategy around the product, around the brand, and that is developing a value proposition. So entering the market with something that the market can understand what its value is, is one of the more meaningful things that that we do, as marketing professionals. And if you think about it more broadly, marketing is really about how we are creating and communicating a value proposition to the market. The best value propositions really recognize both the medical need and the market need. Right? So coming together in a strategic way really requires medical professionals to have a great understanding of the foundations of marketing, right? Like how do we put a value proposition together? How do we view a marketplace? What creates value. And if you have that understanding and even that vernacular as a medical professional, you really end up with a fabulous partnership, a fabulous, strategic partnership between Medical Affairs and the commercial organization. And that’s, in my view, that is the most important reason why any Medical Affairs professional would want to engage in sort of a learning of what are the the basic marketing principles. What are the the business drivers behind something.

00;04;51;08

Eddie Power

We have the full, And I’d like some a couple of the areas that you touched upon there. You know, around that understanding that market need as well as the medical need. And how do you think that a Medical Affairs awareness of competitive market dynamics can elevate the partnership that you spoke about?

00;05;12;23

Brenda Raphael

You know, having an understanding of how the market works is hugely helpful. You know, there are some people that have this perception that you just go out and communicate your data, right? So you just share with the market what you know about your, your product or about your medicine and, and sort of magic happens and people make decisions and it’s all very logical. But, that’s not the way things work in reality. Right? So we’re humans and, people have choices, right? So people have choices when, you know, were making a decision around, which medicine to take, which order of medicines, which combination of medicines or whether to treat at all. So we have lots of, of choices and having an understanding of why people make the choices that they do is hugely helpful. Right? So if you, for example, know that, product A is better, right? We’ll put that in quotes, you know, “better.” But the market is choosing product. B more often.  Having an understanding of  why that is happening is very, very helpful. So if you can understand all the products that are in the marketplace, all the treatments that are in the marketplace, it may not even be a product. And even, you know, when, when, patients do or don’t get a medicine is incredibly helpful because you can develop your value proposition around that understanding. So, for example, in lots of categories, there are, quote, “better medicines”, newer medicines that are available. But almost always a physician will start with a generic medicine. That’s a very practical and real, consideration that they say “well let’s try the thing that’s $4 first.” Right. It’s a reasonable, conclusion based on  all the factors that go into something. And then if that doesn’t work or it does not have, the full effect that we want, then we’ll proceed to the next and potentially more expensive medicine or medicine with different side effect profile, for example. Having an understanding of all the dynamics in the marketplace are really incredibly helpful to developing strategy, but also to, you know, navigating the market.

00;07;42;28

Eddie Power

Thank you for that, Brenda. That’s very insightful. And, it leads me to a couple of trains of thought. One is you mentioned value proposition. And how do you think about that in terms of different stakeholders, you know, healthcare providers, payers, patients, caregivers, even in a system setting, like a hospital.

00;08;05;06

Brenda Raphael

Value proposition is, is just an articulation of, simply speaking, the value you offer to the marketplace. And it has a lot of components to it. Right. So it has a medical, or scientific, efficacy and safety profile, for example. That is the most basic of a value proposition. We do X, right? We, address these symptoms, or reduce this inflammatory marker, for example. This s the most basic of a value proposition. But there are all these other considerations, everything from how easy is it for the patient to use? Is it once a day? Is it three times a day? Is it an injectable? Do you have to measure it? Do you have to titrate it? All these practical components are part of the value proposition, as is price. Right. What  what value or what efficacy are you getting for the price that you’re paying? How easy is it integrate into your, into your system? So in a hospital, for example, we have most hospitals really working on standing orders and protocols, etc.. So if you have to redesign your entire IT system to accommodate a change, to accommodate the introduction of a medicine, then you’re saying, okay, is it really worth it? It’s going to take a lot of effort and a lot of time  to introduce that change in the protocol. So all these components make up a value proposition. It’s not really what do I want you to do for the patients. It is what is the value that I offer to the market. And it always has to be relative to what your other choices are, right? Including doing nothing. So your value has to be so strong that it makes you choose that over your alternatives. And it doesn’t have to be all the time. Right? So, you know, the value proposition isn’t always, you know, all things for all people. It may be a subset of people. Right. For these people with this, type of presentation, this would be a better choice. For example, if you have concerns with compliance, once a day medicines are significantly more valuable than ones that require you to time things out three times a day, for example. So, value propositions is something that we always start with? If you cannot articulate what value you offer to the market, how do you expect your customers, physicians,  health care professionals to pick up on that value and to use your medicine.

00;11;08;24

Eddie Power

It behooves us as Medical Affairs colleagues to think beyond efficacy and safety as, as you mentioned and think more of what I call applied Medical Affairs. You know, I’ve had experience, in the past, in my years, where sometimes it’s been a parent who cannot get a nasal spray in a toddler, right, or a geriatric, or elderly patient that tries who can’t open a blister pack. So, that goes beyond safety and efficacy to the point that you were making Brenda, around camp, a patient use of medicine properly. Right. And then the other picture you mentioned was around adopting, a new medicine. And what motivates people or prescribers, to make a change, in their health or lead them to adopt some new medicine or some new therapeutic intervention.

00;12;10;00

Brenda Raphael

What makes people do what they do? A really complicated question. And there is so much psychology that goes into why people make a change, right? Let’s take obesity, for example, like, a very, touchy subject for a lot of people. Why don’t they just diet, exercise, make lifestyle changes, take medicines that are supportive. Why don’t we just make these changes? And it’s it’s very complicated. Why? People make the decisions that they do, and they don’t always even know why they’re making the decisions that they do. But we do know some, some fundamental things. We do know that articulating the negative consequences of something tends not to work. I’ll say from years ago, we learned that if you tell people not to smoke because they’ll get all these terrible diseases lung cancer, COPD, etc., that they actually do not stop smoking. Right? There’s some evidence that the smoking rates go up when you talk about all the terrible consequences of, of smoking. It’s, counterintuitive. You don’t expect people to go, oh, you’re going to have these terrible consequences and not have them take an action. But that is human behavior. Right. So that is something we need to understand. And what is much more motivating tends to be things that create hope, optimism, a positive future, helping people envision a future that is either healthier, more mobile, happier, more healthy, more longevity, etc. is really much more motivating than scaring people. And it is, sort of counterintuitive, but it is one of those things that we’ve learned about human behavior. And in fact, I actually do a lot of work with not for profits. And I was in a seminar last week where they were talking about what motivates people to donate money to not for profits, and it’s much less about what are the, I will say, terrible circumstances that some people are in and much more about creating hope and optimism about the future. So if I give money to this cause, there is a more positive future for, the individuals we’re talking about, whatever that may be. So, we’ve learned it again and again. Everything from, you know, personal behavior to, philanthropic giving to medicines. Positivity sells and the sense that the future can be better than the past is much more motivating in getting people to make a change than anything else.

00;15;28;25

Eddie Power

You know, the way you frame that Brenda may lead to an moment for some medical colleagues where it’s not all about selling if you’re in marketing or commercial, but that there’s actually a science and a behavioral science, right, that, that drives a lot of what goes into that, that marketing thinking. And, you know, it strikes me that on the medical side, if you put on that mindset that it makes it much clearer where you could potentially add value. And you’ve had a lot of experience. You work with me, as one of your Medical Affairs colleagues and partners. But in your experience, where and how did Medical Affairs add most value from your perspective?

00;16;17;25

Brenda Raphael

Eddie. You know, there’s probably something that is, is maybe not intuitive, but one of the biggest values that medical affairs can add is in contributing to the insights. And by insights, I mean, why are healthcare professionals doing what they’re doing? We can see so much in the data, right? Like we know what people are doing, but we don’t always know why they’re doing it. And something that may be intuitive to a medical person may not be intuitive to a commercial person. And being able to lend that insight, whether that’s based on your training, like, you know, well, they do that because they were taught in medical school this or you know, practical reasons, etc. there’s so much understanding that can be lent to the situation that Medical Affairs professional can give, and it is something that is a dialogue. It’s a conversation. But really explaining why people do what they do is hugely helpful. And there’s probably one example I would point to is the the adoption of new anticoagulants. We saw in the data, for example, that that physicians were not abandoning warfarin with the speed that we had expected them to. Warfarin is just a very difficult drug. So, it’s a narrow therapeutic drug, and it has to be, really carefully monitored. And there’s a whole bunch of challenge that goes with using warfarin. And, and when there was a new option in the marketplace, more than one option, we were surprised that physicians were not abandoning it at the speed that we had expected and adopting the new technology, Which, by all factors seemed to be better. It was more efficacious, had a better side effect profile, etc.. But, it wasn’t being adopted at the rate that we had expected. And one of the insights that I learned actually, from my Medical Affairs colleagues and I asked the question why? Like, it just doesn’t make any sense to me. And somebody said to me, it was it was one of the physicians that said, well, because, you know, some doctors have gotten really good at administering warfarin. They take great pride in it. Right? They’re warfarin jockeys. They have mastered administration of this really difficult drug, and they take a lot of pride in it. Right. And so giving that up to adopt something that’s new and unproven is, you know, a complicated decision, right? So that’s an insight that I never would have gotten. And quite honestly, a physician who’s doing it isn’t going to articulate that themselves. So that is is hugely helpful. You know, the “ding ding ding”. The aha’s, the aha’s come out and then you’re like, oh, okay. Now let’s talk about that. Right. Like how do we manage that? How do we address that. How do we acknowledge that and take that into our strategic planning. So that’s one of the biggest values I see in Medical Affairs.  The more obvious one of, of course, is translating complex and complicated medical concepts to laypeople. You know, I would consider myself a professional, but very much a layperson when it comes to science and medicine and, and being able to translate those concepts in a way that is accurate but simplified to the point where we can say, okay, I understand how that works. Is, of course hugely valuable as well.

00;20;28;06

Eddie Power

Wonderful. And we’ve touched on motivation. You know, we’ve touched on medical professionals understanding the principles of marketing and value propositions. We’ve touched on some of this expertise that they can bring in. But beyond that, you know, one of the things that we’re trying to do at MAPS is, is to think about what qualities or competencies Medical Affairs professionals can, should bring to the table and what qualities in your mind actually make a great partner beyond those areas that we’ve touched upon.

00;21;05;26

Brenda Raphael

The first one is expertise. It’s an old fashioned idea, but please, please, please be the expert in the disease state that you’re working in. And that may be different than the one that you were trained in, or that you most recently worked in. But having somebody that you can rely on to really understand the condition or the disease state is, is very valuable. It’s very valuable from a training and a background perspective. But also as questions arise, knowing that you can rely on someone to ask a question of is helpful. And in the commercial organization, the people change relatively frequently and we rotate, you know, from product to product. But there’s, there’s a lot of movement in the commercial organization because it allows commercial people to have a fresh perspective as you’re evolving the strategies from year to year and executing. So we rotate more often. And so having that sense of institutional knowledge around the disease state is very helpful. The  second more strategic quality I think is really a willingness to engage in strategic conversation and being a strategic partner, adding value to the conversation, adding value to the strategy, and really engaging in healthy, constructive debate, voicing your opinion, using active listening to get a strong and aligned strategy are qualities that are somewhat unique. It’s not as common as I’d like to see in Medical Affairs professionals, particularly folks that are new to the industry. They’re reluctant to engage in that strategic conversation. And it’s sort of like, oh, “I’m going to stay in my lane. It’s not my area.” But that’s really not true. The best strategies are ones that are cross-functionally developed and aligned. And having an ability to say, hey, you know, have you thought about this or that doesn’t make sense to me because of this, you know, let’s talk that through. And you may not always be right. But it is always important to get that conversation going and pressure test things. Sometimes you pressure test things and you come out and go, yep, we are right, we’re on the right path. And other times you pressure test things and you’re like, whoa, yeah, that’s not working. Let’s revisit that. Let’s make some adjustments or go in another direction entirely. That is very valuable to the commercial organization, to me as a commercial leader.  And I have to conclude with this – having a sense of humor is really helpful. We work in sometimes very stressful organizations. There’s a lot of pressure, particularly if you’re working on a launch, and there’s a lot of work to be done and it’s hard work. If you can make it a little fun, it makes the day go faster. And an ability to laugh, I think, is always a good idea.

00;24;38;28

Eddie Power

Absolutely. I couldn’t agree more. Brenda, I always remembered, when we were together, just having,  that that sense of fun, that sense of togetherness,we were all in one team. We fostered each other’s teams to engage in that, in that diversity of thought. And then we were always able to celebrate together at the end, which I always took away with me as a as a wonderful and fantastic experience. You know, working with you. So thank you for that.

00;25;11;20

Brenda Raphael

Likewise. Eddie. It was a real pleasure talking with you today, and I hope our audience enjoyed it as well. And I hope we can get together again soon and do another one of these podcasts. I really enjoyed it. Thanks for having me.