Just What the Doctor Ordered

Elena Ripamonti, Massimo Massagrande and Marina Panizza

Same professionalism … but not necessarily the same approach.

Experience teaches us that pharma marketing research is always one step behind mass marketing research. New methodologies, creative approaches, innovative proposals are a must-have in mass consumer research yet remain an objective to aspire to in the pharma sector. For example, laddering – a mainstay in the mass market for the last ten years – has only recently made its appearance in pharma research and in most cases innovative methods are still ‘standing on the doorstep’, or is being used in the wrong way! Projective techniques are starting to be used in the pharmaceutical industry but these are still uncommon. There is a tendency to be cautious almost as if they are not considered entirely appropriate for a special market such as the pharmaceutical sector.

Is it perhaps because we think that the client isn’t ready for this? Is it because we think that pharma ethics are very strict? Or is it because we still believe that in the pharma sector some approaches are not allowed or are not compliant?

Not only is the pharma industry ready to open itself to new things, but given the difficult economic situation and the growing and tougher competition, there is a real need for innovation and marketing researchers should be able to guide the sector into what could be defined as being a new ‘era’ in pharmaceutical research.

We would therefore like to present a case history that explains what we mean by an innovative/creative approach, an authentically ad-hoc approach, based on the single, special and unique need of a company.

What was our client’s problem?
The company, based in the psychiatric field, needed to reposition a well-established drug (an atypical anti-psychotic) with a new and additional indication in a ‘hostile’ therapeutic context: bipolar disorders. An area fraught with cases of misdiagnosis and under-diagnosis and with a tendency to treat depressive phases with other drug classes.

In brief, for the client this meant promoting the drug even during the depressive phase of the disorder by taking a two-track approach: on the one hand, arousing a sense of awareness about the disorder and its diagnosis in order to strengthen the need for a therapy; point out that the problem exists, identify the disease and avoid treatment with antidepressants only, which can lead to the risk of patient switching. Thus building a new sense of awareness about treatment among physicians; motivating the choice of atypical anti-psychotics as well as their own drug even during this phase of the disorder.

What were the client’s requests? How did we decide to satisfy these?
In order to develop an effective strategy, our client needed to have new insights from physicians. Insights that would reflect the emotional and psychological experience more so than the rational motivations of specialists in this delicate area. The client’s need to identify these insights (an aspect that was already challenging in itself and even more so because it was for a well-established drug) meant we had to go beyond the limits of a more traditional approach . We were faced with the fact, that in order to make the non-rational aspect emerge and to give voice to the unspoken, it was necessary to follow a different and very creative path. Moreover, the fact that the client himself was not only ready to accept original proposals but also keen to be able to explore new research methodologies, clearly showed that the market is already open to embrace innovations whereas research institutes are reluctant to adopt novel instruments.

We therefore needed to prepare a research methodology that was based on two values: integration and innovation.

First, the integration of research methodologies. We created a method that would combine the strong points of one-on-one interviews with those of focus groups, but that would also succeed in creating a setting conducive to an exchange of ideas, in order to make new thoughts and opinions emerge. This led us to form interactive duos. In practice, two physicians with opposite ideas and schools of thought about the topic were found. This was then followed by a two-step procedure, first a one-on-one interview and then interactive duos, that is, conversation and interaction between the two respondents. This allowed us to maintain the in-depth investigation of one-on-one interviews while also maintaining the creative potential that was guaranteed by the interaction between the respondents and maximise this by comparing opposite points of view. The interactive duos – designed and conducted on the basis of the specific needs of this case history – are also useful in other research areas, especially those dominated by conflicting schools of thought or inconsistent behavioral approaches. For example, market research in the social area/ public affairs or for consumer products, in order to elicit different perceptions of a brand or lifestyle by users vs. non-users.

Innovation however, was required not only for the “packaging” but also for the “contents”. We therefore decided to follow the mass consumption approach, by opting for projection exercises, which, while inspired by mass consumption, could be as functional as possible for our objectives. We used the ‘Lego exercise’ to visually reconstruct the therapeutic algorithm applied by the specialist during the various phases of the disorder, in other words the way the physician chose the treatment pathway and the different therapy lines as a function of the severity/history of the disease and of the manic vs. depressive phase. The exercise consisted of fitting together Lego pieces of different shapes and colors. We then followed with the ‘scales of justice’ exercise, the two respondents had to tip the scales in their favor and in so doing create a discussion, the video of this exercise was used during the creative production and discussion phase.

The challenge lay in identifying the stimuli that could really generate new insights, that is, stimuli that could really get the physician interested and even provoke him. We decided that the best strategy to interest our target should be based on authenticity. Unnatural stimuli would not have generated any empathy or sense of belonging. Here, the only thing to do was to involve real patients who would represent the population that physicians deal with on a daily basis. We therefore held one-on-one interviews with patients of different ages, backgrounds and histories of bipolar disorder, these interviews were then recorded on video, we took the important segments of videos and made a film that was journalistic but contained personal accounts to show the physicians during their interactive duos.

This decision was the right one in many ways: on the one hand we as researchers identified ourselves personally with physicians and this enabled us to better understand their needs and points of view, on the other hand we really stimulated the physicians and ‘dispelled’ any resistance by leading to new insights, and last but not least, we offered our client a representative sample of his target and his end user by providing him with video material that would be valuable in many ways, such as during the company’s training courses.

This challenging experience allowed us to fine-tune research techniques that can be used in a variety of different therapeutic areas (but also in a number of research sectors as previously mentioned) and further confirmed our belief that even in the pharmaceutical sector we should not stop testing, nor should we turn down new ideas by hiding behind the alibi that the market is not ready.

Elena Ripamonti and Massimo Massagrande are managing directors and Marina Panizza is research director at Elma Research