Don’t mention the P-word: Part 2 of a 2-part series

You can read part 1 of this series on IDEA Pharma’s approach to positioning here.

With the stage now set from part one of this series, let’s delve more into the subtleties of IDEA’s approach to early-stage asset positioning compared with traditional marketing positioning—our differentiation, if you will—and how it can be leveraged across clinical, medical, regulatory, and commercial teams within a biopharma company.

While traditional marketing positioning is very much about what you can say about a product or medicine with the information already available, early-phase positioning aims to create strong mental constructs consolidating a future unique value for a product. It aims to provide guidance on a molecule’s developmental pathway to enable strategic decisions for a company in terms of market choice and shaping.

Decision and choice are key concepts here—as the same molecule could be brought forward in very different ways, depending on the company that will take it to market. Organisation, capabilities, portfolio mix, appetite for risk or investment will all determine which pathway a molecule’s development could take.

The beauty of this approach is that a series of well-researched and validated concepts could be provided for the same molecule, and the pathway taken by the marketing company could be completely different depending on its unique context and circumstance. This approach surely empowers a company to take control of its own asset—rather than march to the beat of a marketing template and set of generic words to frame expected performance against a set of bland criteria.

The original positioning concept focussed on differentiating against a current competitive set and how to break through in a crowded marketplace using some form of advertising and promotion. In pharmaceuticals, the features and benefits of a product or medicine tend to be treated generically. A medicine can claim to be highly effective or convenient, but this means next to nothing. The benefits of a product need to be clearly described and broken down into something that compels prescribers and patients alike with clarity.

“Efficacy” per se does not exist as a decision point for prescription or even as a reason for a patient to take a medicine. We need to know how and why a medicine ostensibly works, and what a medicine actually does. That may entail, say, getting people back to work, or helping them remember their child’s name, or giving them more days at home and not in the hospice because of their disease. The benefits of a product need to be articulated in terms of tangible meaningful outcomes that will truly make a difference in a future medical landscape.

When thinking about what makes a medicine unique—we can distinguish between intrinsic differentiation (something that makes the way the molecule works differently from the other products on the market) and extrinsic differentiation (what does the medicine do that is different). While a team may be stuck with the intrinsic features of a medicine (you can’t really change its molecular structure or the way that it works), it is possible to be ingenious when considering how to develop criteria for extrinsic differentiation.

This could be about choosing which disease area to operate in, the type of patients to study, or thoughtful endpoints in clinical trials that clearly demonstrate a difference from incumbent or future treatments. While marketers tend to pride themselves on being the creative force when it comes to bringing a new medicine to market when all things are considered—the R&D and clinical teams can also step up to the plate and embrace their power to be unorthodox and make a difference.

With that said, moving on from our marketing folks and their clumsy force-fit positionings, let’s consider the potential for our medical and regulatory teams. To them, the word “positioning” means something different again. Even more than before, positioning from a medical guidance perspective is based on only those things that can be said at the time, backed up by current evidence, and ideally supported by experts and peers. Medical positioning (as it means to a medic!) is where and when treatment should be used in the ladder of treatment choices to be considered for a patient at a point in their disease progression. There is a regimented order to choice and decision, with no room to manoeuvre. Treatment X can only be used after treatment Y has failed, and only in patients who display characteristics A, B, and C. The positioning is literally a box in a flow chart—moving through sequential choices, based on clinical outcomes and objective measurements.

Here there is no scope for deviation, no appetite for creativity (that’s not in scope). How can we change this mindset for a team when we are considering the potential for an asset before data has even been generated? When markets or medical landscapes will be vastly different in the years ahead when this fledgling product may gain therapeutic approval? It’s hard (but not impossible) to future think and anticipate differences and changes based on knowledge of current trends and incoming changes to treatment armamentariums. Medical and regulatory teams need to be fully aware of what might be in the years ahead—the use of different endpoints or comparison to current or future standards of care may be pivotal to helping a medicine, not only differentiate, but also gain access for patients in the new world ahead.

IDEA’s early phase positioning provides medical, clinical, regulatory, and commercial teams forward-looking insights and knowledge allowing them to make informed and powerful decisions on developmental pathways for their product. Before it becomes a medicine, a molecule is subject to thousands of choices—formulation, indication, patient population, endpoints, comparators, etc. Teams can be given the power to move beyond the expected, to understand and anticipate a future context and landscape, and enable a product to achieve a new and better potential, or value proposition, for physicians and patients. Teams have the opportunity to make “known unknowns” (e.g. does my product work in indication/patient X, Y or Z, can it make a difference there?) known…. And by embracing this uncertainty, with the aim to find answers to questions that could make a difference, teams can forge a future for a medicine far beyond that ever anticipated from treading an expected well-worn path to approval.

So, what about Maslow’s hammer and nail, as we referenced in the first part of this series? How do you align the spectrum of the hammer-wielders when it comes to positioning? Clearly, a marketer and a medic will have very different concepts of “positioning” and what role it plays for them. Based on the familiar and likely, their assumptions can often confuse or derail an early phase positioning process, as IDEA seeks to move teams away from the expected and into ambiguous territories. Hammering on about “you can’t say that”, “we haven’t got the data” or “we don’t know that yet” is no excuse and can cloud possibilities or restrict opportunities to explore options to maximise value for a new product.

Maybe it’s the word “positioning” itself that is at fault. Indeed, depending on the role a person may play, their notion of “positioning” has its own “positioning” (talk about a circuitous conundrum!) which can be hard to counteract or break. Given that IDEA is providing something so radically different, so creative and forward-thinking from the traditional marketing or medical definitions of positioning—should we “reposition” positioning to better reflect what we mean and what we do? What alternative term could we come up with to lie parallel to and out of conflict with the different nails that our marketing and medical Maslow hammers are searching for?

In both retrospect and prospect, the answers are “no” and “none”. IDEA Pharma has been conducting early-phase positioning for years and has perfected its methodology and mindset. IDEA fearlessly owns this space—this position for positioning—and has no intention of giving up precious ground to featureless concepts. Rather than a carpenter working with the wood on their bench and using the hammer and nails they are accustomed to, IDEA seeks to design a molecule for its future in a new healthcare landscape.

We see ourselves as architects providing blueprint designs, all of which could be developed, but only one of which will be the perfect build for the client in question. As long as our workers’ hammers and nails don’t detract from the vision, let's embrace the P-word and take positioning back to where it should be—early enough to let companies determine and drive their molecule’s path to future success for patients, the healthcare system, and the business itself.