How to win in specialty markets when differentiation is hard to find

Competition in today’s specialty pharmaceutical markets has never been higher. In oncology, for instance, individual biological targets (like HER2) have upward of 90 drugs currently in clinical development, while the long list of biological targets continues to increase. Immunology has seen more than 10 approved molecules across four indications (psoriatic arthritis, rheumatoid arthritis, psoriasis and ulcerative colitis) and a number of other molecules set to hit that mark in the coming years. Our recent analysis has shown that rare disease has ballooned from single-digit approvals per year pre-2020 to more than 20 in 2023 and 2024.

This competitive environment creates a challenge for companies looking to develop and commercialize new treatments in these areas—but recent history has shown us that success is still possible when an effective competitive strategy is employed:

• Brukinsa overcame a third-to-market position in chronic lymphocytic leukemia (CLL) by focusing on safety and dosing flexibility, two attributes not commonly focused on in oncology. It helped Brukinsa to overtake Imbruvica and challenge Calquence for leadership in the BTKi class.
• Cimzia overcame a fifth-to-market position in rheumatoid arthritis by creating differentiation based on its safety in pregnant women and women of child-bearing age. It helped Cimzia to achieve a high-single-digit share (remarkably high for a fifth-to-market entrant) and global sales of ~$2B at peak.
• Evrysdi overcame a third-to-market position in spinal muscular atrophy to become the market leader by focusing on its oral route of administration and ability to be taken at home.

Although many brands try to differentiate on safety, efficacy in targeted populations and convenience, there are three key ingredients that really seem to move the needle in competitive specialty markets.

Effectively developing and deploying a strong competitive strategy requires organizations to think and work a bit differently than for a typical product launch. The key ingredients are:

1. Anticipating with data. These companies leveraged advanced analytics and AI-enhanced competitive intelligence collection to predict where the critical customers and battlegrounds will be. The U.S. subsidiary of a large oncology manufacturer, for instance, focused on a rare oncology indication, leveraged predictive patient progression models using claims data to anticipate which patients would be likely to progress on their previous treatment, allowing the company to focus their commercial efforts on specific accounts and customers and ensure a higher share of voice than their competitors.
   
   In a previous article on data strategies for AI, we highlighted an example where a U.S. subsidiary of a global biopharmaceutical company was using data to identify patients coping with rare diseases who were experiencing activation delays. By combining patient data from hubs, pharmacies and claims, the company’s commercial team was able to engage providers proactively to address delays ahead of competitors.
   
   
2. Thinking strategically and anticipating competitor responses. These success stories make clear how essential it is to make strategic choices about where to create differentiation and think two steps ahead about how competitors are likely to respond. If you can’t rely on raising the efficacy bar, you have to think about solving a different problem or building a new yardstick.
   
   For instance, a top-10 oncology manufacturer launching into a crowded biomarker-driven market, identified that their competitor was likely going to focus their messaging on niching their product to later lines of therapy, arguing that was the best place for it in the treatment sequence. This triggered the company to initiate an additional clinical trial and a series of medical evidence initiatives to show the value of using their drug first in the sequence.
   
   
3. Differentiate the customer experience. Identifying the critical places to orchestrate across internal functions, channels and tactics allow companies to win customer hearts and minds. In undifferentiated markets, experience has been shown time and time again to be the tiebreaker that healthcare providers use in treatment decision-making. We suggest focusing on removing your customers’ unique barriers (versus broad drivers of treatment); once HCPs have a single bad experience it can drive them toward your competitor.
   
   AbbVie did this with Humira through their Humira Complete program, which improved patient adherence and lowered discontinuation rates and drove brand loyalty that slowed biosimilars erosion.

Here’s what you can do today to ensure these key ingredients are integrated into your next launch.

It starts with data

Companies who have not already built the capability to integrate primary, secondary and third-party data sources fully should start there. Once that capability is in place, you can leverage AI to enrich the data and build the CONTEXT stream. Knowing your customers better than the competition and their complete context—including their preferences, their patient mix, the ecosystem they operate in, the influences on their decision-making, etc.—is a huge competitive advantage.

Watch your competition closely—and often

Building a strong competitive strategy starts with putting yourselves in your competitor’s shoes, a feat sometimes difficult for teams so focused on their own product. These initiatives, often referred to as competitor simulations or competitive strategy workshops (CSWs, or more informally “war-gaming”) should be triggered ahead of major competitor events (e.g., data readouts) but also should be used as a maintenance activity (e.g., once every one-to-two planning cycles) to ensure that the brand’s strategy is still headed in the best direction. The key ingredients for success for CSWs are five-fold:

1. Being clear on the objectives: Define the specific decisions that the simulation will inform
2. Getting the right people in the room: Include a broad cross-functional team
3. Collecting the right briefing intel: Build dossiers on both the competitive asset and company highlighting some of their past actions
4. Creating an immersive environment: Take people out of their day-to-day environment and use visual cues to improve immersion
5. Properly positioning the outputs: Identify no-regret moves and triggered actions to help manage uncertain environments

Your customer’s experience matters

Define the characteristics of the experience that you aim to create for your customers and coordinate across functions with a CX lead at launch. Your customers have an experience with you whether you design it or not. And if you aren’t proactive in shaping that experience it will at worst detract from your brand value, and at best be undifferentiated. 

Establishing a clear customer strategy is the missing link that many organizations lack today—it’s the captain that steers the experience and the glue that holds it together. Evolving the structure of the marketing organization to support both a product strategy and customer engagement strategy is an important step, but transforming omnichannel engagement through digital transformation is essential as well.

With the world of specialty pharmaceutical markets starting to closely mimic the highly competitive dynamics of other markets, success in specialty pharma is starting to require deliberate focus on differentiation beyond the data. The companies that can leverage the emerging set of tools, data and commercial models of the future will be the ones that enjoy success in these markets and have the opportunity for their products to impact the largest number of patients.