With much talk of a changed pharma and biotech market landscape, we ask Jon Bircher, Chief Commercial Officer of Cello Health, and Carl Engleman, Vice President at Cello Health Consulting, for their thoughts on tackling the challenges of asset and brand planning against the backdrop of such an uncertain future.
1. What challenges are pharma brand and launch teams having to consider in the context of a new, COVID-shifted world?
Jon: We are in a period of huge change and uncertainty - we can’t know all the implications for pharma yet, but it’s clear that the landscape has already shifted and this poses some complex, far-reaching questions that challenge the most fundamental assumptions for companies and brand teams. For example, and beyond the obvious budgetary implications of the pandemic, public health perceptions are changing rapidly - how will society and payers define value in the future? How might extensions to life in oncology patients or investment in rare disease be viewed in comparison to a likely increased focus in diagnostic, vaccines and infectious disease programmes? Such questions will have implications on where drug companies and the industry as a whole seek to prioritise and invest.
Carl: If you are preparing to launch, there’s likely to be a need to make some immediate choices as well as to take stock and consider how the future may evolve. Identifying the decisions to be made, and understanding the timing and inputs to these is the first step in managing through uncertainty. A clear example would be clinical development plans, with short-term implications for protocols and recruitment as well as longer-term questions around how trials may need to be run in the future. Another obvious example is the promotional model itself - how do companies now need to approach everything from data dissemination and advocacy through to commercial promotion? These questions cascade through to the fundamentals of the commercial model. Defining and thinking through these challenges is critical for planning teams right now.
2. What specific challenges are first launch biotech companies facing?
Carl: For biotech companies planning their first commercial launch, the launch plan is intrinsically linked to the wider organisational strategy. There is the immediate challenge of how to maintain operational effectiveness and focus while COVID-19 restrictions are in place, but the longer term question is ‘do I need to change my buildout plan’? The capabilities required for success may have shifted, along with the resourcing allocations and timelines for recruitment and on-boarding. Another major consideration is around financing - the appetite and priorities for investment risk are changing as well as the perception of value. It’s not just the first launch asset that is impacted either – there are implications for follow on assets when you’re looking at mid-term financing and organisational build out. For example, the current business plan will likely be predicated on the launch of follow-on assets. Where these launch timings are impacted, there’s potentially a need to deliver more from the lead asset.
Jon: There’s also the decisions you’ll make about the go-to-market strategy - COVID challenges the assumptions that inform your level of risk. Assumptions that you’ll achieve a certain market price and reach a certain number of physicians all have to be re-assessed. Manufacturing and supply decisions too need consideration. For many small biotechs, the ability to self-commercialise in niche areas has been highly viable because you’re dealing with smaller populations - COVID may put a different perspective on this model, particularly if the industry shifts focus to wider population health.
3. With such a high degree of change and uncertainty, how can teams accurately plan for the future?
Jon: You can’t accurately predict the future – what you can do however is create plausible views of the future, exploring scenarios that allow you to make confident, ‘no-regrets’ strategic decisions. The point in time we’re at now means a scenario planning approach has never been more important. In various ways we are being forced to think and act quickly - whilst critical, we must in parallel take time to think through what we are seeing unfold, and to best prepare for the longer-term future.
Carl: I agree, the value of scenario learning is not that we deliver a precise view of the future – it’s about thinking through trends and themes and building some tangible versions of the future world that we can interact with and prepare for. The objective is to ensure that our plans are robust and flexible, delivering commercial success irrespective of how the future plays out.
4. So the aim of scenario learning is to stretch thinking and plan confidently, irrespective of the future that unfolds?
Jon: Yes, we need to ensure we have understood different views of the future and produce a plan that will help us navigate the various consequences. Scenario planning works by considering different extremes and thinking deeply about the issues and opportunities presented by each scenario, but more importantly those that are common across them. These extremes help stretch our thinking and provide a framework to consider and respond to. Scenarios are not necessarily about ‘most likely’, but they should be feasible. Ultimately you should address the questions – what do we need to deal with and what do we need to be good at, irrespective of future? Even with lower likelihood scenarios, there are elements that could be so impactful that they still need to be considered.
Carl: COVID-19 is a prime example. A few months ago this would have been considered a low likelihood but high impact scenario. By considering the potential impacts of a serious global pandemic you’d see that this would have important consequences including access to stakeholders and market value perception. It allows you therefore to consider in some detail how for example, to shift stakeholder beliefs in a more restrictive environment. Even if a certain scenario doesn’t play out, there’s enormous value in what’s been considered and how it can be applied to alternative scenarios.
5. At a practical level, how should planning teams approach scenario planning right now?
Carl: The starting point is to revisit your core planning assumptions and to check how confident you are in those assumptions. It’s important to utilise the full cross-functional team in this exercise - there is real value in combining a wide range of perspectives and in understanding how these perspectives interact and combine. From there, our approach is to define the key questions and to revisit the market landscape analysis. Again, it’s important to bring in the right subject-matter experts to give sufficient depth to the different perspectives – these may not be your typical Key Opinion Leaders. The next step is building and characterising scenarios, making them tangible enough to interact with in a meaningful way in order to understand the potential implications.
Jon: We run a large number of scenario-led simulations that help teams interpret, learn from and address the future – as we’ve both already said, it’s really important to accept you’re not looking to accurately predict the future. What you are looking to do however is make good strategic choices, based on the information you have at a given point in time. It’s worth remembering anyway that strategy should never be static, and it’s essential to keep re-examining and evolving our thinking as we learn. There has to be some level of discomfort with planning as you are making strategic choices that impact your future. Ultimately it’s about making confident decisions because you’ve considered all relevant perspectives – as well as being prepared to adapt as things evolve.
Carl: These principles hold true across our projects, but the execution of the work is never a rigid process. We work in close partnership with our clients to understand their world and then determine how best to tailor different methodologies and tools to their specific situation. We then work with them to apply and interpret these tools either as a stand-alone engagement or as a key element within their broader strategic planning process. For example, if you’re a small biotech, commercialising your first asset, we’ll develop a scenario methodology that goes deep on building out the scenarios whereas for a brand team working on their annual planning cycle, the approach may be more light touch, integrated into their situational analysis process.
Of course, the obvious practical step I’d advise to anyone considering planning for an uncertain future is to give us a call!