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

Touchpad Question: Which Market Segment Grew Faster in 2009?

1. 2. 3. 4. Branded Primary Care Biotech Oncology Generics

Touchpad Question: Which Market Segment Grew Faster in 2009?

1. 2. 3. 4. Branded Primary Care Biotech Oncology Generics + 1.6% + 16.1% + 10.4% + 11.6%

Strategy:

a plan of action designed to achieve a particular goal or overall aim noun (plural strategies) Oxford English Dictionary

Goals Are Similar

Primary Care Sell your product Gain market share Displace your competition Specialty Sell your product Gain market share Displace your competition

What is a Specialty Market / Product?

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

1. Small number of target customers.

o e.g. 200 key prescribers in Canadian HIV market place.

1. Highly knowledgeable and sophisticated prescriber base. 2. Rapidly advancing base of scientific knowledge.
o Driven by key conferences (e.g. ASCO, CROI, ASN, ACC).

1. Increasingly becoming a chronic care market.

o e.g. transplant immunosuppressives, MS-therapy, HIV antiretrovirals,, targeted anti-neoplastics.

1. Often a small patient base.

Major Differences
1. 2. 3. 4. 5. 6. Sales force deployment Science and data are the drivers Patient Advocacy Groups Reimbursement hurdles are high Marketing Mix Communication Channels and Media

Target Audience: General 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 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 / Higher 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).
40000 30000 20000 10000 0

#On vs Ot er cs . h S pecialt ies

On c

U ol r

N r eu

CV

OB G

2. 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 MSLs

Publish Or Perish: Topo Inhibitor - Publications & Sales

250 200
Total Publications

$800

150 $400 100 50 0 $200

$0

94

95
Irino Pubs

96

97
Topo Pubs

98

99

00

01

Irino Sales

Topo Sales

U.S. Sales (millions)

$600

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. 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

HC Indication

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

BC

AB

ON
biopsy or confirmed diagnosis of cirrhosis

QC
All pts with chronic HBV
(open listing on RAMQ formulary)

Public Payor Indications

Treatment Nave Cirrhotic pts with: HBV DNA >1M copies/ml Patients
Or HBV DNA >10K copies/ml & ALT >3x ULN

All pts with chronic Pts. with HBV DNA >106 IU/ml, any age, >F4 upon HBV
(restricted benefit listing for use by specialist in internal medicine)

Treatment Experienced Patients

Not Listed

LAM pts who have evidence of:

1) inadequate response 2) Viral breakthrough 3) LAM resistance

Key Areas of Strategic Focus

Regulatory Strategy
Product Label New Indications

Funding Strategy
Reimbursement Guidelines

Medical Strategy
Advisory Boards MSLs Med Info IITs

Stakeholder Strategy
Patient Groups Advocacy

Promotional Strategy
Communications Sales Force Conferences

Marketing Mix Allocation Comparison

Primary Care Product
10%

Specialty Care Product

10% 5% 30% 30%

15%

15%

5% 0% 10% 15% 20% 10% Journal Ads Reprints Ad Boards KOL Development Detail Aids Samples Market Research Journal Ads Reprints Ad Boards KOL Development 25% Detail Aids Samples Market Research

Whats The Ideal Communication Medium?

Detail Aid Sales Force Messages

Product Slide Set

Speaker Name Title Insitution Date

Clinically oriented communications Guidelines, conference coverage, slide decks Sales and Medical delivered Messages Customer forums

Specialty Marketing: 8 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, IITs. 6. Be Nimble: Medical practice Changes Quickly in these Markets 7. Ensure enough resources are allocated to non-traditional channels Medical Strategy, MSLs, 8. Ensure sufficient conference coverage and presence is implemented.