Story:
Transforming new product commercialization in pharmaceuticals: how patient journey became the foundation of marketing planning at Novartis
The healthcare environment is going through a period of unprecedented change and complexity due to new regulations and pricing pressures that has created significant limitations on how the pharmaceutical industry can operate in the evolving marketplace. This also means that established processes for commercializing new pharmaceutical products are now increasingly becoming obsolete thereby compelling sales and marketing teams to re-engineer their processes in a changing world -where rules of the business are getting redefined by the day. At Novartis, we were able to address this issue head-on by building deep organizational capabilities for customer journey mapping through an organization wide innovation program whereby the strategic role of patient journey mapping became an enabling framework to transform our product plans and established a completely new approach to understanding the evolving stakeholders in the healthcare journey. Further our team was able to take this innovative approach to the next level by helping internal marketing teams leverage this approach in designing the right organization blueprints for our new launches with recommendations for appropriate team structures, skills, capabilities and roles within the pharmaceutical selling organization to create winning business models for our new product launches.
"To meet today’s demands and lower costs, we must shift away from the traditional “transactional” healthcare approach. I see a future of healthcare systems that is focused on delivering positive patient outcomes. Instead of rewarding stakeholders for simply providing care, value would be placed on products, services or business models that incrementally benefit patients or reduce costs."- Joseph Jimenez, CEO Novartis
Novartis is a world leader in the research, development, manufacturing and marketing of products to protect and improve health and well-being. Our goal is to discover, develop and successfully market innovative products to prevent and cure diseases, to ease suffering and to enhance the quality of life. We also want to provide a shareholder return that reflects outstanding performance and to adequately reward those who invest ideas and work in our company.
In 2010, a key internal challenge that was identified within the General Medicines department of the Pharmaceuticals division was a lack of a consistent approach within product teams in mapping the healthcare journey of the patient in moving from the early stages of the disease through all stages of treatment until final outcome or cure. This was particularly important for the organization because in order to map the rapidly evolving healthcare marketplace and to stay ahead of the competition, product teams needed to obtain a much better grasp of the key interlinkages between different stakeholders as well as the different challenges and bottlenecks that patients faced across priority disease areas so that we could better address real patient needs.
Thus, a lack of systematic approach and methodology led to significant gaps in developing a meaningful and comprehensive commercialization strategy for new products as teams were often missing out on key insights and opportunities which led to sub-optimal marketing strategies in their product plans. Developing comprehensive customer journey maps was a complex endeavor because it involved assimilating customer information from multiple functions where information often existed in silos and need for deeper cross-functional team engagement to gather meaningful insights in the marketplace was often at cross-purposes with low priority given to this exercise within annual product planning cycle. Further, patient journey was seen to be a marketing functional deliverable only with limited participation by other critical organizational functions such as medical or market access functions within the overall planning process.
This issue was further exacerbated by the fact that there was also not a organization-wide common approach to understanding the patient journey across product teams in global, regions and country functions leading to a fragmented customer insights landscape worldwide that prevented effective customer strategy development at all levels.
Our team addressed this topic by developing a roadmap and toolkit for mapping the patient journey- we called it the Unified Patient Journey framework and developed detailed guiding materials and supporting tools to help product teams develop a comprehensive understanding of patients needs along the entire treatment journey.
Together with senior management, development of high quality patient journeys within the product planning cycle was identified as a core strategic capability for which a cross-functional core innovation team was appointed. As the innovation team started engaging the organization through a series of workshops and round-tables on this critical topic, core definitions and business rules around this project emerged and was incorporated within planning guidelines creating a spirit of co-creation and co-ownership across the organization that led to a flood of new innovative ideas on this topic.
For example one of the workshop teams came to the conclusion that given the confusion around the terminology of the patient journey and lack of clarity within teams on how to best leverage the putputs, a clear definition was needed for the organization on what it was. The team agreed that - the patient journey is a systems based approach to understand how an individual becomes a patient and how they move through the healthcare system with mapped interaction points with each stakeholder in the journey.
Further the above workshop team also identiied the outcome of the project in terms of clear benefits for the business and the team agreed that completing this exercise as planned would enable us to uncover the most critical unmet patient needs where we could offer superior value propositions vs competitor products available in the market.
In hindsight, articulating a clear definition of what we were trying to do and defining clearly what the business benefits were helped immensely in aligning the business and moving faster with implementation than we had previously anticipated.
Also for the first time , the coordination team fostered a truly cross-functional approach to mapping the patient journey and each of the functional leaders were fully engaged from the very beginning. For example, to improve the engagement of critical non-marketing functions such as medical affairs and market access, each functional leader was asked to imagine how their function could benefit from the patient journey exercise and were asked to submit functional checklists and questions that got incorporated within the guidance manual for product teams.
Further, learning manuals and quick summary guides together with live workshops were used to embed this new approach within annual marketing plans. This led to a consistent worldwide approach to mapping the patient journey thereby helping the organization develop a common language and vocabulary while maximizing the value of dialogue and teamwork between global functions, regions and countries.
A key outcome of this approach was that teams started envisioning their current and future patient journeys leading to clear benefits that helped product teams create innovative business models around new launches.
Current patient journey- was developed by populating the framework with available market insights with contribution from market research, sales and other functions with direct customer interactions
Future patient journey - was developed through live cross-functional workshops where each team were asked to imagine what the ideal patient journey would look like taking into account the biggest gaps and unmet needs within the current patient journey. Each contribution and idea was colour coded by category and grouped together on a flip chart (see photo) and thereafter screened through a prioritization exercise.
The gap between the current and future patient journey would then lead to identifying critical hypotheses that teams would brainstorm together to develop future business models. Some questions that emerged were -
-What healthcare problems are our customers trying to solve within the patient journey today and what are their biggest frustrations with the pharmaceutical industry?
-Are solutions to our customers needs available in-house or do we need to find the right partners to create the right beyond the pill solutions for our customers ?
-What skills, capabilities and roles do we need in order to be successful with the right sales team and ideal business model for realizing the vision of the future patient journey ?
-What services and programs do we need to complement our selling organization and complete the business model to commercialize successfully ?
One early challenge the team came up with was that certain groups within the organization wanted to champion their own patient journey approach and in particular 2 of these groups wanted to drive their own preferred framework. To address this conflict, the coordinating team invited members of both these groups to cross-functional workshops and also addressed their pet issues by reframing the key needs to a step earlier than the framework in terms of golden rules that all great patient journeys should follow. Having agreed to the common definition, the teams came up with 8 golden rules that should be part of all completed patient journeys. For example one of the rules was that the patient journey framework must truly be a end-to end mapping exercise and must illustrate the patient pathway from pre-diagnosis to diagnosis through treatment and final outcome. Another rule that was agreed by the team was that the framework must be able to capture all stakeholders in the healthcare journey and not just physicians alone. By spending time upfront in workshops and coming up with these golden rules helped the project team ultimately move faster as those existing fameworks that did not embed all the golden rules were quickly rejected and the team was able to come up with a final patient journey framework that incorporated all the golden rules.
Another observation post implementation of this project was that although teams worked cross-functionally in completing their patient journeys, there was limited knowledge sharing of patient journeys across different product teams leading to incomplete understanding of common issues and knowledge gaps. To address this issue, the coordinating team organized a full day workshop where all completed patient journeys were displayed side by side in the conference venue and each team was asked to comment on key insights from their own journey. A major benefit from this exercise was that teams went away with a much better understanding of common issues and challenges as well as formed joint working groups to address common issues together. For example one such group was formed when the hypertension and diabetes product teams agreed that due to high overlap of these diseases within the population as a co-morbid sub group, it made sense to look at the journey of those patients who were afflicted with both conditions, thus creating a common sense of purpose within these teams to address some of the common levers that emerged from the patient journey exercise.
Having established the new approach, 2 years on, a number of key benefits heve emerged-
-Product cross-functional teams across global, regions and countries can now engage in common dialogue and discussion around key insights around the patient journey as well as benefit from a much more constructive engagement throughout the planning process
-Where there are significant differences in country market healthcare landscape, teams often come up with different sets of opportunities within their local patient journeys - for example in certain countries healthcare restrictions prevent them from engaging with patients directly through patient programs whereas in other countries teams can develop such programs with minimal regulatory challenges.In these instances, a common framework fosters a strategic dialogue on differential opportunities in markets based on local business rules and unmet needs
-As strategy is about fundamentally articulating where we will focus and also where we will not focus, the completed patient journey has become a useful strategic communication tool for product teams to be able to explain their strategy of focussing on patient segments with the highest unmet needs while de-prioritizing lower priority segments across the journey.
-Rather than product teams stopping at completing their current patient journeys within their planning process, for the first time, teams were able to develop a vision for an aspirational patient journey-in other words, what would the ideal future look like in a world where our products and services come together with the right team with a clear vision for commercial success.
-Creation of the future world through the above step became the template for launch planning by unleashing new innovation within product teams helping them create new organization blueprints for launches with people and services that would address patient and customer needs better than the competition.
-Once the patient journey framework was in place within the planning cycle and it became routine for teams to plan in this manner, this unleashed a further wave of innovation that emerged within countries with minimal global guidance. For example a couple of country teams developed a innovative patient journey app on an ipad that became a customer engagement tool to map hospital patient journeys and supported identifying critical unmet needs within the hospital so teams could come up with the right solutions to address needs of their customers within those hospitals.
-Customer journey mapping should be an organization wide exercise rather than limited to marketing responsibility only in order to unleash innovation at all levels within the organization. Sales function -in particular for already launched products- are critical stakeholders who need to be at the table during this exercise and can bring tremendous value in representing customer insights gained through their day to day interactions.
-Understanding and mapping the current customer journey itself has limited value. Organizational teams should invest time, resources and energy to develop future customer journeys imagining new future worlds and touchpoints between their products, teams, services and consumers that they seek to create and nurture. In times of significant uncertainty within the external environment which can sometimes cause paralysis of decision making particularly within product teams, such an exercise can become a powerful catalyst in mobilizing the organization at all levels -particularly the middle and lower ranks who may feel dis-enfranchised due to their limited input and impact on customer strategy development.
- Aligning global, regional and country organizations through a common customer mapping framework and processes can unleash innovation by fostering greater dialogue and partnership in co-creation of new business models while creating a sense of one team and significantly minimizing territorial boundaries. Further teams can benefit immensely by incorporating customer journey mapping within the annual planning exercise as it allows them to continuously hit the refresh button and revisit their assumptions and business models in light of an ever changing environment and evolving competitive landscape.
-Beyond its role in helping create new business models within a changing environment, the next wave of innovation will emerge from co-created customer journeys where customers will play an active role in creating and utilizing these customer journey maps sometimes even championing the creation of such maps within their own offices and hospitals. This new wave of innovation will also force traditionally product centric industries such as pharmaceuticals to become more value and solution centered enabling them to think of new solutions and business models to partner with external providers to create appropriate product+solution value propositions that best address the most pressing challenges within healthcare in the 21st century and deliver better patient outcomes further enhancing overall benefits to society.
-Global Commercialization and GPS&C team members
Debraj so pleased that Novartis has enbraced the need for personalised approaches/solutions to addressing clinical and non-clinical pressing needs of stakeholders/customers. For far too long Pharma have attempted to push their own short term customer focused strategies that are adding no 'value' for anyone in the healthcare value chain. Your approach to supply agreed needs based solutions wraped around your disease and therapy areas is welcome news. This level of transparency and willingness to provide services and offerings will resonate well with clinical and budgetary stakeholders in many health economies. Economies are facing enormous challenge over the next few years with crippling non-communicable disease rates, unsustainable healthcare infastructures, low resources and lets face it no more money. Have you thought about how mobile health will support the development and delivery of some of your solutions/offerings? Certainly this technology when deployed, for example with remote patient monitoring, disease management and wellness and education, offers the potential for improved clinical management, behaviour modification, education and wellness, and all done in a more affordable way.
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Thanks for your comments Michael. Fully agree that mobile health will radically transform healthcare delivery so we should definitely integrate it where possible within our programs. A good place to start would be to go and visit customers as we are developing our patient journey and see what they are doing in this space. Some of the larger hospitals and healthcare systems are more advanced than pharma in embracing these technologies in multiple areas that you have mentioned so there is a great opportunity for us to learn from them.
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You are very welcome Debraj, maybe Novartis and my organisation, The GSMA, might like to work together to engage with your customers to undertake a review of the opportunity within your programs and develop some hypothesis/concepts for mHealth services?
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This is a nice initiative. Specially when it comes to healthcare, the terms has to be specific. We cannot compromise with a patient's life . So the more will be the facilities, more will be its advantages.
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