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FIFO Principle – First Patients on a Drug Often Determine Whether It’s First Out of the Armamentarium!

Tags: Adherence

Train WreckAccording to Wikipedia . . .FIFO is an acronym for “First In, First Out.” It’s typically reserved for Accounting, but I’d like to apply this concept to new product adoption by today’s physicians. In the mad rush to meet forecasts, the idea of advocating appropriate use in professional marketing communication is often sidelined. In fact, marketing teams often estimate brand use in patients that were not even studied in clinical trials because physicians might use the product there and they can expand their sales potential by doing so.

This strategy, however, is wrought with complications. You see, the FIFO Principle in pharmaceutical marketing is that the likelihood of a new product being adopted into a physician’s armamentarium is directly linked to the outcomes experienced by the first few patients prescribed the product. In other words, the characteristics of the initial patients (“First In”) and their corresponding results determine whether your product begins to become habit or is jettisoned (“First Out”).

So, what’s the launch product marketer’s answer to the FIFO Principle? Appropriate Use – being crystal clear on patient selection from the outset with physicians. It’s not just about ‘painting a picture’ for the field representative to aid in selling. It’s about pointing out which patients can benefit from the product the most based on the results of rigorous clinical testing. The “First In” (FI) of the FIFO is essential in determining commercial success. A few obvious tips that continue to be ignored:

  • Study Population – Clearly communicate the patient types included in your pivotal studies. The physician shouldn’t expect great results when prescribing your product in a sicker patient population.
  • Line of Therapy – If you’ve been approved ‘first-line’ or in treatment-naïve patients then emphasize this in your promotional materials. Just be sure you’re definition of first-line is aligned with the physician’s definition.
  • Comorbidities – If the clinical trials for your brand excluded specific patient types, don’t be afraid to tell your prescribing physicians about that. There is always a chance that a comorbidity can compromise clinical success.

Think about it . . . as an industry, there is a strong tendency to open up the experiential patient pool at launch as wide as possible just so doctors can get some product use and drive the sales trajectory. But driving initial use in the wrong patient will not sustain brand growth. FIFO is pervasive in pharma and the marketing landscape is littered with its casualties. Just look around.

Where is the Feedback Loop in Your Adherence Plan?

Tags: Adherence

Results from our research indicate that the number of adherence-enhancing interventions that pharmaceutical and biotechnology marketers have put together to ‘help’ overwhelms both physicians and patients alike. The issue is more pronounced when you look at the fact that the average baby boomer is taking more than five chronic medications a day, which translates into the potential of five different adherence programs trying to gain mindshare with one patient at the same time.

As one physician interviewed in market research recently aptly put it – “Every prescription product has an adherence program, but not every prescription product needs one.” So if you have a brand that really needs a program, how do you ensure it gets the appropriate attention? It has to start with the healthcare prescriber, but how do you get them to engage with and recommend your program for their patients?

Adherence Feedback LoopThe main complaint that physicians express with adherence programs is that there isn’t a feedback loop to let them know how their patients are doing. Many physicians understand the issues with HIPAA and would be satiated with an aggregate view of the program’s utility, and incorporating a feedback loop into your adherence plan could differentiate your adherence program for both the prescriber and the patient.

Would you really recommend someone participate in a program without ever finding out what people thought about it? Why should you expect doctors to do the same?

5 Keys to Effectively Addressing Adherence

Tags: Adherence

5 Keys to Addressing AdherenceOver the last year, I’ve noticed a renewed interest in applying our Evidence-Based Marketing principles to effectively address adherence. It’s a stark contrast to the phenomenon I discussed in our January 2011 blog post on adherence.

What I’ve found across the dozen or so Level of Evidence (LOE) Appraisals is that there are 5 keys to effectively addressing adherence.

  1. Become a Student of the Game – Capitalize on available academic and clinical literature that addresses adherence and adherence-enhancing interventions related to your brand / disease state
  2. Think Beyond the Patient – Adherence or non-adherence involves more than just the patient…HCPs (both physicians and nurses) also play a critical role
  3. Uncover the Factors of Influence – Non-adherence in any category is comprised of multiple factors, with varied weighting – before designing a program, it is critical to understand the factors that need to be addressed
  4. Accurately Annotate the Curve – Reasons for non-adherence change over the course of treatment – understanding the nuances of your adherence curve is an essential input to developing impactful interventions
  5. Focus on the First 90 Days – The first three months of therapy are the most critical for a chronic therapy and effectively addressing adherence typically requires a concentrated effort during this initial treatment phase

Still not sure where to start? Why not capitalize on our adherence expertise, our normative data set, and our ‘keys’ to benefit your brand. After all, you shouldn’t have to pay for a learning curve.

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