Reshaping pharmaceutical marketing: moment of truth

In this article I will try to highlight the disruptive acceleration in the field of pharmaceutical marketing in Italy induced by Covid-19 on one specific aspect: that of the value chain.

Since Normann, the evolution of the industrial paradigm 'from product to service' has become common culture. We are talking about the early 1990s, and I must quietly note that in pharmaceuticals and related marketing, I do not see any major breakthrough. Nor do I see it yet in the long-term strategic plans of the multinational drug companies presented in recent months that I have found in some interviews on youtube.

Let's start from the base: the value chain

Even today, everyone adopts the term 'market' to refer to 'the indistinct plethora of customers, or in the case, prescribers'. Even today, most marketers consider the term customer to be evolved to describe the doctor or patient from time to time. Customer is the consumer, the last link in the value chain, the one for whom everything is made, where everything ends, the user of our product and who our product uses until it is consumed. Using the term customer is not a step forward in the evolution of pharmaceutical marketing thinking. The customer is the ultimate terminal of everything that, starting from resources and assets, raw materials, research and industrial activities in general, progressively acquiring added value in production thanks to economic steps, barriers, competitors, is produced and then consumed. It is the last link in the chain, the one where value is finally released and who pays the price for it all, thanking it for the benefit it derives from consuming what it has produced.

In this interpretation, it is the pharmaceutical industry that knows what consumers need, that has invested in buying labour and raw materials, that has done research, that launches products on the market and, in a modern-day secular mission, manages to save lives in exchange for a coin. If this is not Fordism, I don't know what to call it.
The pharmaceutical sector is characterised by: industrialisation pushed to the highest technological level, research at the limits of science always on the frontier, intrinsic quality superior to any other sector, production control processes and a distribution chain more careful and controlled than any other sector, efficacy and tolerability asseveration carried out in advance and on a permanent basis, tracking and control systems that not even civil aeronautics can afford. But the real reason for the very existence of the pharmaceutical industry today must value results in terms of health more than true successes in technological and scientific terms. Customers, therefore, are not those for whom the dose is intended, but those whose lives we improve. I.e. they are not customers but benefactors.

I find the drug industry to be the most valuable human resource of the last century (think for a moment of anaesthetics), which has enabled us to extend life and make it better, to bring down painful diseases for people, and which is - at the same time - the one that has the worst relationship with its customers along with that of alcohol, petrol and smoking. Why, where did we go wrong? All the fault of pharmaceutical marketing, not of the industry itself, probably.
The demanding customer is not an invention of today, the aware and informed patient was not born yesterday, yet we have treated our customers as we would never want to be treated and this has been the effect of a huge misunderstanding: we treat, ergo, we know what is good for our customer.


Let's rewind the tape to the 1970s

In that context, products like pasta went from being commodities to 'values' thanks to genius thinkers like Gianpaolo Fabris. While the contestation of mass consumption brought the side effect of greater investment in marketing, distribution, branding, research and needs analysis, companies realised that they had to reflect on the importance of the customer relationship. What was the pharmaceutical industry doing at that time? It was consolidating a model of promotion and information that has remained granitic for decades. Incontestable, incontrovertible.
Which pharmaceutical company has been putting the Moment Of Truth (MOT) at the centre of the consumer, really, in recent years? I have a drug, it is the best to treat this condition, I have the clinical evidence based on international studies, top university professors confirm its prescription, what more do you want? The moment of truth is a very valid metaphor for looking again at the interface with the consumer, both doctor and patient, its overall touchpoints, but it has not been used in pharmaceuticals as a pole star unlike all other consumer sectors.
The theme of the moment of truth comes, I believe, from the transposition of bullfighting and is the moment when the matador standing in front of the beast must, with a feral blow, strike the weary bull and kill it by exposing himself to the charge of its horns. It does not represent, if only in part, the life of marketing, as in this case it refers to the moment of contact between the consumer and our product and helps to investigate the reasons for the choice. Therefore, the more doctors and patients become aware of their purchase decision, the more this moment has to be investigated; the more power they have and know they have over all the health actors with whom our product - or rather, therapy - impacts, the more our job as marketers has to be to get into the mind of the consumer and to analyse the current positioning and enhance it.

On this, the extensive and thorough literature on MOT overwhelms us since the first P&G studies. First defined at three stages:


1. when the customer physically or virtually confronts the product and chooses it among competitors;


2. when he buys it and uses it: from the first moment to the following times and has the experience of using it;

3. when he becomes aware of it and becomes its supporter or denigrator and recommends or discourages it personally or indirectly and decides to repurchase it.



Then, as I think everyone knows, Google appropriated it by defining a new moment, ZMOT, with a new phase:
0. when during the search and before making the decision, it analyses how other consumers reacted to moment 3 and then judges, based on the evaluation, its other peers (Amazon reviews, how does that sound to you?).

No one, it seems to me, has ventured to relate this back to pharmaceuticals. We seem to be talking about markets where the product is perfect and it is our customer's obligation to understand it, and we, with our information pressure, do him the favour of making it known to him, explaining the data sheet in plain language.
I am well aware that I am being a tad controversial, but I believe that we need to shake up the established way in which pharmaceutical marketing operates and today, more than ever, it is essential to keep up with the changing and growing elements of consumer awareness.

I would like to bring here an experience of my own, which, although anecdotal, seems fitting.
I was analysing with colleagues a client's briefing on an innovative and effective CNS product with decisive elements of differentiation from previous ones in the same therapeutic area, and we were asked how to reach new market segments and new prescribers. The topic was intriguing, everyone was on the ball evaluating the best hypotheses to enhance the very valid arguments prepared by the marketing department of our client pharmaceutical company. Then, coincidentally, a fact emerged: a significant proportion of patients drop out of therapy. As soon as they are better? I ask. No, it seems by simple abandonment. But before the end of treatment? Yes, from what appears before the results are evident, i.e. before two or three months. I try to investigate: do we have a Customer Journey? Yes, I am presented with - I must say very well done - one towards the doctor. Then I ask a final question. Since abandonment is an important data point (and could lead to much higher consumption and significantly increase sales), why do we not evaluate the patient's behaviour before taking action on doctors?
We were not asked and the client asked us to act on several target markets of prescribers. It will come out a very good project, I am sure, we are very good at it. But it could have been better.

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