Prescription and drug switching dynamics in oncology

Background and objectives

Lifescience Dynamics was commissioned to carry out a patient diary study in multiple myeloma. Our client had a chemotherapy product and its sales were not matching their expectations. They wanted to understand the market at a granular level to diagnose the low sales issue. The objectives included measuring the frequency of behaviours and results within the key steps (brand choice and re-initiation) in the treatment decision process:
In addition they wanted to know:

• Why patients "leak" or drop-out?
• What are the clinical patient characteristics that influence treatment choice?
• Where are the high value opportunities in terms of potential our product?

Approach

We designed a qualitative phase with focus groups and IDIs to understand and catalogue all parameters for decision making in different stages of cancer in both treatment native and pre-treated patient groups.

This helped us to design pre-coded field materials for an on-line survey in the USA and EU5 markets in the form of a 30 minute patient medical note collection.

Results delivered

Our report covered all the objectives of such patient referral patterns for un-diagnosed and diagnosed patients. It included data analysis (according to analysis plan) such as switching and churn rates, conclusions and recommendations.

• Market dynamics simulation model from conjoint
  • The resulting perceptual model is held in an Excel-based modelling structure developed by Lifescience Dynamics which, given its user-friendly Windows interface, was supplied to the client for their own internal use in future model simulations with minimal training.
  • The Excel-based interface is vastly more user-friendly than the CBC simulation programme, yet more powerful because perceptions are incorporated into the model. There is, in fact, a facility for relative adjustment of current perceptions, as well as for the blanket imposition of new product alternatives.
• Patient record form database
• Most of the interpretation of the model structure relied on visual representation of the relationships discovered. To this end a 'results investigation tool' was developed by the LSD team and provided to the client.
• The tool was written in 'Visual Basic' and ran within Excel.
  • There was a front-end tool, which enabled the client's personnel to visualise graphical results from the mined data sets.
  • The tool consisted of user-friendly software, which is menu/buttons driven and easy to use with 'click and drop'.
  • The tool automated the graphing and reporting routines. It was possible to make graphical representation of various possible combinations of fields/attributes within the mined data set.

Single product

Background and objectives

Our client asked us to conduct a market analysis of polycystic kidney disease (PCKD) for a product in their portfolio and wanted a forecast for the top six markets for their product.

Approach

We used a multiphase methodology to cover public domain information which was supplemented by primary market research. The outputs from these two activities, such as epidemiology and key drivers fed into an Excel-based forecast. Our forecast used a Bass Diffusion algorithm to model new product (new technology) penetration. The forecast covered market size, growth, potential market penetration, volume and dollar sales for its product.

Results delivered

The deliverables included a PowerPoint slide report and an Excel-based forecast model. The report detailed all our key findings, analysis, forecasting approach, assumptions, findings and recommendations. The key findings had 'decision tree' for patient flows and referral patterns in each target market.

The model was interactive with an ability to forecast the size of the PCKD market over a period of 10 years, and the sales volume and sales revenue of the product in the top six markets. The forecast model was a custom written programme/tool provided for the client, with the relevant training and support (via telephone). The model allowed quick visualisation of data sets and easy changes of variables in the future.

Total market

Background and objectives

The client was planning to launch a fixed dose combination product for asthma. They wanted to create a scenario planning and forecasting tool to determine the potential share of gain/loss of products against the putative profile at the time of the launch. This was in order to assist in defining a minimum commercially acceptable profile to provide simulations of the relevant therapeutic area markets post launch.

Approach

We undertook a quantitative market survey (n=780) using discrete choice modelling to develop a utility model of the market, and then fused perception data to the utility model to create 'a more complete' picture of the actual marketplace. This was re-calibrated using IMS data. This model produced peak shares at 100% awareness level among GPs, allergist chest physicians and pulmonologists.

Results delivered

The deliverables included a PowerPoint slide report and a custom written programme with an Excel front end and an Access based database in the backend. The front end had two models running in the background:

• Utility and perception model driven by attributes and claims
• A Bass Diffusion-based model with epidemiology and patient scripts from IMS

he model covered the whole market with more than 400 products, and was totally interactive. It had the ability to forecast the market size of the different classes of treatments, such as ICSs, LABAs, SABAs and the leukotriene antagonists market, over a period of 10 years, as well as the sales volume and the sales revenue of the product in the top six markets. This offered the ability to change the order of launch, price points, discounts and to pull out any product from the market.

Market entry strategy

Background and objectives

Our client wished to build an oncology franchise based on their lead product, a novel minor-groove DNA binding agent. The first indication targeted was 'malignant soft tissue sarcoma'. This indication was to be followed up with these indications:

• Renal cell carcinoma
• Metastatic malignant melanoma
• Non-small lung cancer (NSCLC)
• Metastatic breast cancer
• Metastatic ovarian cancer

The primary objective was to evaluate in strategic and financial terms different market entry options, from total licensing-out of the asset to marketing the product themselves, with intermediate options of co-promotion partnerships with companies with established oncology franchises.

For the stand-alone approach a detailed European business plan was prepared which included forecasting and the valuation of different options, the most important of which was whether to employ a contract sales force.

Approach

We designed a three phase project:

• Business analysis
  • Secondary research - external data
  • Internal financial data
  • Internal interviews
  • Forecast modelling
• Financial modelling
  • Building free cash flow model and NPV models
  • Risk analysis
  • External interviews
• Solutions and recommendations
  • Evaluation of financial outputs
  • Recommendations and presentation

Results delivered

A complete going-to-market strategy based on a robust forecast and financial numbers. We evaluated seven strategic options and prioritised them based on ROI and the strategic implications and long term goals of the company.

• Greenfield - 100% organic effort
• Contract sales force
• Co-promo win-win
• Co-promo favourable-profit share
• Co-promo favourable-high milestones
• Licence-out
• Co-promotion with big pharma company