The New Landscape in Oncology Commercialization

Maria Whitman, Principal

If you want to be a leader in oncology today, then you have to really step back and proactively challenge your commercialization and go-to-market models.

I think when we look at the science at ASCO this year, it was a great reminder of not only how far we’ve come, but how far we still have to go.

The promise of immunotherapy, the reality of investment in targeted therapies, and now the clinical benefit we're seeing in targeting multiple pathways at the same time, it’s very exciting and it’s led to advancements that have changed former death sentences into chronic illnesses, like CML.

They're now looking for more overall survival benefit, more quality of life, and this means that we have to raise the bar in terms of our clinical trials and what we’re trying to prove. It also means very carefully selecting what patient types we’re going after and how we’re going to think about our molecule and our portfolio strategy.

The competition has also tremendously intensified in oncology in recent years. Since 2008, there’s more than double the amount of oncology players in the space.

We used to be in a situation where a strong oncology product meant success. But now the white space is limited. And we’re fighting for individual patient types, meaning billions [of] dollars worth of investments are getting fractionalized.

The pressures on oncologists today are more than ever. They’ve seen decreased revenue, [an] increased amount of information that they have to hold, more pressure from the environment on the total cost of care, more companies vying for their attention, and frankly, savvier patients that they have to spend more time with. And with patients living longer, that means the amount of patients is increasing on their practice as well.

It’s limiting the opportunities for us to effectively engage with them. They’re dealing with the pressures of budgeting overall in every country. But in the U.S., for example, we estimate the impact of federal budget sequestering on the average community oncology practice to be about $250,000 per year.

So this is a lot of change, and we see some companies looking to win by making radical changes to their commercial model, whether it’s thinking about our identity and what we’re really saying and positioning ourselves to be as a leader in oncology or whether it’s tearing down the commercial sales and marketing organization to reengage and realign around the customer.

I'd say that those considerations are highly important, but here’s three tangible things you can think about today.

[First], seek to own a patient type for the long term. I think this strategy really has to change from what we've historically seen in pharma, which was large patient type opportunity, into embracing the fact that we're headed to targeted therapies and niche populations. Embrace it, recognize what patient type you’re really after, and look to own them in the long term, not only through the development of the molecule you have today, but over time through the development and replacing yourself with molecules you can offer tomorrow. We've seen this happen tremendously successfully in metastatic breast [cancer], for example.

[Second], get the launch right. I know this is true for every therapy area there is out there. But in oncology recently, we’ve seen some failed launches. We’ve also seen slower adoption than anticipated—for example, with oral oncolytics.

The reality is all the complexity we've been talking about has changed the skill set needed to effectively launch a global product in oncology.

Are the skill sets of the people I have really ready? Am I integrated in terms of my functions? Do my regions on local markets really understand the trade-offs they’re going to have to make as we have more complex portfolios?

[Finally], build for agility and customer engagement. Whether you’re starting with your first oncology product or whether you have an entire portfolio, we’re going to see more companies facing the challenge of large tumors and rare diseases; more product launches over the next few years. And the reality is your organization has to be able to adapt and move to that flow.

And we can't forget the customer in that mix either. As we’ve talked about, their world has changed tremendously, so the roles that we put in front of them, the offerings that we bring them are so much more than the education on the science. So you really have to think about, is my organization ready for the changes ahead? And am I meeting the customer needs in a way that is empathetic and engaging?