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‘I wouldn’t start from here!’ – Efficiently Creating an Enhanced Evidence Portfolio.

Muzeable Thinking No.24 posted by Tim Brooks 4th October 2017

 

This is a guest piece from Dr Tom Kenny of Dune Consulting. Muzeable has had the pleasure of working with Tom and find the mix of his expert, clinical perspective and our marketing/brand views has the potential to deliver genuinely fresh thinking. Thanks Tom.

Using finite resources and the available data to build a compelling story that creates and defends a value proposition or tries to deliver distinctive claims for a medicine (POM or OTC) is one of the most important – and difficult – tasks for anyone managing a healthcare business.

Yet, we are repeatedly shocked by the poor use of evidence companies make when it comes to constructing a value story for their healthcare brands.

Too frequently the company who are aiming to promote a medicine do not put enough energy into seeing the world from the perspective of a payer (and that includes people shopping for medicines) at the beginning of their clinical trial programme – the focus is single-mindedly on the regulator and the ‘hurdles’ they need to jump.

We understand the pressures that drive this, but as they say, “if wishes were horses, beggars would ride” and at the late stages of your positioning around pricing and reimbursement, or creation of a value proposition, or a setting of marketing or promotional messages it is a little churlish to be wishing that some deeper, or different, thinking had been done earlier. At this point the more appropriate saying often appears to be “beggars can’t be choosers”. It is was it is, we need to work with the evidence portfolio that we already have…

…or do we?

Our experience is that, unlike the old saying, you actually can ‘start from here’ i.e. with the data you have. An evidence portfolio/framework can actually be enhanced relatively simply, quickly and cost effectively. These thoughts come from a long experience of working with, often imperfect, data sets in order to design care pathways, choose between different medicines or make a reimbursement decision. All of this is equally applicable in the self-medication environment, even if the scale of the data and clinical investment might be smaller. In fact, it is particularly relevant to the competitive world of differentiating OTCs with evidence beyond marketing spin and in the absence of large clinical investment. But, firstly a couple of, perhaps, obvious things to remember about clinical studies and real-world research:

  1. It is rare that any single study provides ‘the answer’. Even when beautifully designed, bias, chance and simple errors can, and do, occur.
  2. There is no such thing as a perfect study design. A well-designed study will set out to answer a question and be specifically designed to do just that, this will mean it will have strengths and weaknesses. Pose a different question and these strengths and weaknesses will be different. The weaknesses, especially, become obvious and magnified when it starts to consider answering multiple questions.
  3. A study lives or dies on its methodology. We may or may not like the results, but whether we trust them or can use them depends entirely on the methodology used to get them. Research is often designed in such a way that it undermines its own results. For example; multiple outcome measures and designs that allow for a multitude of explanations of the data.

So, here are 5 things that you should consider when you are faced with a weak portfolio, generic data or when you want to build a data-set to differentiate or support your brand and you lack the money – or time – to run a large study program:

  1. Trawl & Steal. Systematically draw together the other work that has been done in the same field; the work that has asked similar or related questions. This is by far the most cost-effective way to get a large number of robust enhance insights and a clear data baseline.
  2. Polish. Prospectively re-analyse a study’s results; this can yield valuable insights without the cost of setting up and running a whole new trial. Get relevant associated/secondary data in the public domain [gray papers etc.] and use it!
  3. Strengthen. Run simple studies in parallel to provide a basis for comparison and defend against alternative explanations; this maximises the insights from the investments and supports the production of great claims. It’s like a puzzle and the creativity comes from how you fit the pieces [data] together.
  4. People first. Use simple studies of Patient Reported Outcomes Measures (PROMs) to uncover outcomes that are meaningful for patients and compelling for payers; data that enhances the proposition/claims. To date PROMs have been poorly understood and little used for OTC medicines.
  5. Build a context. Capture the natural history or epidemiology of the condition to provide comparisons data that are often otherwise lacking.

This is not a tick box exercise. This approach needs to be wedded to practical, expert input to pull together a roadmap to evolve and build stronger evidence in a finite resources environment. A hybrid commercial/clinical input model is at its heart. And start small. A few weeks of analysis could quickly confirm the potential and define the benefits/outcomes.

If you would like to talk to Tom and Tim about building an evidence portfolio to drive claims and growth please contact us.

Dr Tom Kenny started life as a GP, he then moved into NHS/Public Health Medicine. He is expert in clinical drug/data evaluation and building real-world data/studies to enhance patient/consumer experience & outcomes. As well as running his own consultancy, Dune, he leads the core team delivering clinical research programmes at Spoonful of Sugar the behavioural data consultancy at Imperial College, University of London.

 


‘Because an appeal makes logical sense is no guarantee that it will work.’ Bill Bernbach

Muzeable Thinking No.23 posted by Tim Brooks 18th July 2017

It’s a near miss.

No, not Bill’s quote[1]. That’s fab. Spot on. The near miss follows…

A week or so back an interesting and important new piece of research was published by The Academy of Medical Sciences entitled ‘Enhancing the use of scientific evidence to judge the potential benefits and harms of medicines.[2]’ It raises a host of critical issues, but in the end, relating to communication with the ‘general public’, it almost misses the point.

The research’s key soundbite – which BBC Radio Four’s Today programme focused on – is that ‘one-third (37%) of the public said they trusted evidence derived from medical research, but around two-thirds (65%) trusted the experiences of friends and family’. The report runs to 116 pages and goes well beyond a soundbite and makes valuable and relevant recommendations, 12 in all.

Think about it. It has to be scary that only a third of us trust medical data – even the good stuff – yet two-thirds of us trust in anecdote. Though, as a brilliant medical director I worked with often said… ‘Tim, the plural of anecdote is… data!’ Seriously, whilst reported outcomes produced in a clinical context are relevant and undervalued[3], friends’ data has usually gone through a complex filter of Chinese whispers, myth and misinterpretation before it lands i.e. it can be critical/valuable, but it is a curate’s egg/lottery.

Moreover, for data produced by the pharmaceutical industry it reports a staggering 82% of GPs and 67% of British adults ‘agreed with the statement that clinical trials funded by the industry were often biased to produce a positive outcome.’ Worrying, since industry funds much of the new research.

‘Houston, we have a problem’. So, why does this positive piece of work almost miss the point?

Well… although it starts by acknowledging the behavioural/real world component of the ‘issue’ and that healthcare systems often ignore people’s actual needs, it then repeatedly reverts to a solutions framework that focuses on education and rationally-based solutions to change the outcome. The argument is that better information and clearer presentation will change people’s acceptance of science per se and, ultimately, make us all more rational. Doh. It simply will not work. It is an example of expecting a better version of the wrong solution to deliver dramatically different results.

To change this, we need to start and end with a 100% focus on responding to real world needs/behaviour. People doubt experts [witness recent political upheavals] for many reasons, but most of them are fast, emotional responses, built on doubt, fear, mistrust and denial, NOT usually an intellectual inability to understand a rational message.

Of course, we need better/more consistent data that is better presented, but we also need a step change throughout our whole clinical, medical and regulatory framework. Don’t just ‘acknowledge’ real world behaviour – construct the entire universe around it. The ‘data’ has no role other than to enhance/facilitate this[4]. This is scary. But don’t hold your breath, because the health eco-system is still founded on a deeply paternalistic [with a capital ‘P’] world view and here lies the problem.

So, implement ALL the great recommendations around improving the data/presentation, but reconsider the desired end game. Stop seeing the output as a more rational – homo pharmaceuticus[5] – general public, making informed decisions. THIS IS ALMOST CERTAINLY A NAÏVE THEORETICAL CONCEPT. It will never happen. Reason? End users are not interested in the data per se, but in the benefits/ experiences/outcomes they receive and how this meets their needsas they see them. Until we approach public/health data through this lens we will never change anything.

Take packaging and labelling – a personal passion. It’s bad enough in prescription medicines, but in OTC/self-medication, where we are asking people to make their own choices, often at a supermarket shelf, it would appear that the MHRA [Medicines and Healthcare products Regulatory Agency] has never actually met a real person, let alone tried to understand how they behave and feel about their needs. We need even more fundamental changes than this paper’s sensible ‘Recommendation 8’. We must start with needs – not active ingredients, doses, pharmaceutical forms and modes of action etc[6]. [arghhhhhhhhhhhhhhhh!] – as the user would express it and stating benefits in their language. And yes, sometimes this might start to sound a bit ‘unscientific’ or ‘promotional’, but so be it if it helps people and gives no-one an unfair commercial advantage. This is fundamental, not a tweak from the excellent Plain English Campaign[7] or PIF[8]. [NB totally agree on a UK equivalent to US Drugs Facts Box… people would appreciate it, we’ve even done the research and have developed a working style guide available to those who are interested!]

All of this requires one particular group to change more than any other – medics, regulators and academics. It is a gross, unfair generalisation, but they need to stop telling us to be more rational and do the right things – e.g. losing weight, giving up smoking etc. and dramatically change THEIR approach to making it happen. Work harder to make their input more – sometimes, even at all – relevant to its recipients. I think it was Dale Carnegie who said ‘that people buy what they are buying, not what you’re selling’ – it was never truer here. Let’s start with what people are buying.

Rant over. Well done AMS this is good work and we hope it sparks change/debate, but until we truly, madly, deeply put PEOPLE @ THE HEART of our healthcare debate – especially in self-medication situations – we will only move at a snail’s pace. If that. If at all.

And finally, a plea. The people who can really make this change happen are rarely asked to contribute. The medical community/MHRA/academics generally see them as personas non-gratis; they look down their noses at them; they don’t trust them; they are not represented on the oversight committees; they are ignored. But, it’s the tawdry old commercial marketing community who is the most qualified to change people’s behaviour. Aggressively protect people from lies and sharp practice, but beyond that we need to let business talk to people about healthcare solutions without one hand tied behind their back. It’s another near miss.

 

 

 

[1] Bill Bernbach one of the true greats of advertising and communication. The agency that bears his name is still going strong. http://www.ddb.com/BillBernbachSaid/more-about-bill/biography.html

[2] https://acmedsci.ac.uk/more/news/action-needed-to-prevent-confusion-over-medicines

[3] Our current crusade on new ways to produce breakthrough claims reflects this. http://www.muzeable.com/muzeable-thinking/join-the-revolution-new-ways-to-deliver-breakthrough-otchealthcare-claims

[4] Obviously, much data exists, beyond this context, in a purely scientific/academic environment and contributes beyond patient information.

[5] Muzeable blog on self-medication and homo-pharmaceuticus. http://www.muzeable.com/muzeable-thinking/page/3

[6] NB this/safety data is VERY important, but only needed/helpful on the back of pack; leaflet… not front of pack.

[7] http://www.plainenglish.co.uk/

[8] Patient Information Forum https://www.pifonline.org.uk/

 


Join the revolution: new ways to deliver breakthrough OTC/healthcare claims

Muzeable Thinking No.22 posted by Tim Brooks 21st June 2017

An uncomfortable truth. Claims are a key component of successful OTC/healthcare marketing, but most claims work ends up as an exercise in polishing pebbles in search of marginal differences rather than delivering market share or game changing messages.

Reality? A world of data parity and regulatory constraints, where serious clinical work based on old, generic ingredients is high cost, high risk, low PTS [probability of technical success]. Consequently, finding highly relevant, distinctive, ownable and differentiated claims is unicorn-rare – as a result, let’s be honest, we usually just play at it.

Imagine… if the approach and our points of reference could radically change? If a hay fever brand [for example] could start to use clinically validated claims based on published outcomes data [not a bit of lightweight cosmetics-style survey data] like:

  • 75% of allergy sufferers reported more symptom free days & better quality of life when using brand x.
  • x% said ‘I was allergy free on the days I really needed to be/when I had things I had to do.’
  • using the app plus product improved compliance and delivered better quality of life for x% more people than those who just used the product.
  • 80% of allergy sufferers said that ‘x’ mattered most to them and that brand x gave them effective support vs this’. Etc.

Data like these – and better – are now completely in reach and supportable by robust, credible, published data. A claims revolution is in play.

Why the step change? A host of factors are converging that together make us VERY EXCITED about the future of claims generation:

  • the quality/growing credibility of patient reported outcomes data [PROM] used by big-Pharma;
  • the wealth of insight consumer healthcare companies produce – but don’t fully leverage;
  • mobile tech/real time data capture and two-way dialogue;
  • deep dive social media analytics are moving to another level;
  • new interactions – services/apps etc. – that impact outcomes, but are not measured effectively;
  • Etc. Etc.

All this creates a data landscape pumped full of opportunities! The new data we can produce is robust, quantitative, measurable and people centric. It can be produced at highly efficient investment levels [i.e. cheaper!] versus trad clinical work, with a far higher PTS, but the outcome is still published data that regulators must take seriously. It will also be highly ownable as it is based on branded user-experience/outcomes versus the ‘chemical’ performance of generic formulations.

WARNING! There is a critical success factor that it is easy to ignore – it is not just about embracing PROM research. The ‘trick’ is to use a hybrid-approach. A blend of expert, clinically experienced, academic data/study/publishing savvy ALONGSIDE a highly commercial, marketing, insight-led, advertising/comms expertise. Most people in this space are either clinical study-led or creative/ideation ‘workshop’ focused. Our experience is that both approaches are, on their own, inherently flawed. We focus on the yin and the yang… so, our core team is a published professor, expert in behavioural medicine, and an experienced senior healthcare marketer. This drives the approach and creates an environment of challenge and appropriate disruption!

And… we can do all this – NOW! Ambitious brands taking a medium term, imaginative view of claims/data can start to own new, persuasive spaces in the minds of consumers that challenge the historic low engagement with our brands and categories – not least because these data are built from the users’ experience of the need, not a clinician’s – often hypothetical – perspective.

Our search is on for a few enlightened clients who get it. Clients who are prepared to commit/collaborate in producing specific outcomes data and then to persuading regulators – because they won’t like it – to leave their ivory towers and consider data on its quality/merits not just its style/method of origin. The level of PROM data being built into Phase III/IV work in ‘big Pharma’ proves it can pass hurdles higher than those in consumer healthcare.

It’s a new age. A revolution is coming. Are you going to play, or just watch?

If you would like to receive our longer [much duller], more detailed paper – Consumer Healthcare Claims: Join the Revolution – or perhaps more interestingly discuss our breakthrough approaches in the specific context of your business – just call Tim Brooks on +44 [0]7802 531578 or email on tim@muzeable.com. Apologies in advance, we will only share our content with genuine healthcare/client organisations


“For every complex problem, there is an answer that is clear, simple and wrong,” HL Mencken.

Muzeable Thinking No. 21 posted by Tim Brooks 9th March 2017

 

A Muzeable rant in the naïve hope of some behavioural change.

I’m bored. Not with Mr Mencken, his work is still mildly engaging.

But, with the smorgasbord of opinions that litter my work, life and the future.

I’m not being holier than thou either. My own need for opinions – endless opinions – is irritating too.

Days are filled with too much of:

  • Clients – usually senior ones – who take ‘gut feel’ to unsustainable levels because they don’t keep up with the data or don’t understand it [e.g. digital/social!]. Their fear of appearing indecisive; seeing reflection as a sign of weakness; their need for short-term solutions – that are ‘clear, simple and wrong’.
  • Me, filling the silence, or people will think I’m stupid/not earning my fee.
  • You, managing upwards and over simplifying to force the problem into a box [usually because your bosses are impatient with short attention spans and need a PPT soundbite].
  • Brand Communication/content… that exists for no other reason than it can be done and we feel compelled to do it… whatever. Digital really drives quantity over quality.
  • Qualitative research that is just the personal worldview of the person who did the groups – regardless of the aims and input from the attendees.
  • Linked In groups. With comments that add no value and just opine. I don’t play anymore.
  • Twitter, Facebook et al… more vast spaces that we are compelled to fill with opinion and limited reflective thought. A POTUS should not be allowed to dilute complex issues into 140 characters. Period.
  • The age of the instant reply. OMG. IMO. The anger. The dumbing down. The drab made briefly shiny. Then forgotten.

Most of these opinions are… simple. Simplistic. Unnecessary. Self-serving. Problem creating. Etc.

Solutions:

Let’s have a bit more:

  • I don’t know. So, I haven’t got an opinion yet. Let’s have a conversation about it and see where it takes us… it’s complicated so don’t expect a great answer immediately.
  • Reflection. Technology breeds hares when we need tortoises. Let’s have more managers with a ‘Don’t just do/say something, but sit there… very quietly’ attitude.
  • Humility. The strong opinion is often a sign of a lack of any – especially in the hands of the most senior person in the room. Shut up, listen more, think a bit and say less.
  • Confidence. Not having an immediate opinion and being comfortable with it… is really cool.
  • Less persuasion. We work for the same organisation, yet the adopted position of most senior managers is that subordinates have 30 mins to sell them the idea. It leads to poor behaviour on both sides; exaggeration and excuses [even a legitimate excuse is still an excuse]. How about more open dialogue, collaborative dialogue and brutal truth?

I will work hard to reduce my own opinion count – starting now. And no shit, I realise this missive is… an opinion. Occasionally people will be disappointed in me, or consider me a bit slow on the uptake/unable to keep up or even stupid. Sod ‘em. The enlightened will be my new best friends.

RANT OVER.


The Elephant in the segmentation room

By Tim Brooks and Kath Ludlow [Founding Partner at Legend Engage]

Legend Engage: http://legendengage.com/

Do digital analytics mark the beginning of the end for traditional market research? In the first of a series of articles exploring the impact and opportunities afforded by digital and social data, we debate to what extent these new research functions can replace or supplement traditional consumer marketing research. In this paper, we discuss segmentation opportunities in 2017.

Can digital make segmentation studies truly actionable?

There has been a long debate on the value/ROI of the major investment consumer-facing brands make in global [and local] segmentation studies. As a benchmark, a robust global segmentation can set you back a cool £1-2m.

At one end of the debate are the Sharpites[1] and their disciples [e.g. Mars] who don’t really believe in targeting at all. Their marketing target is seen as… just about everyone. At the other end however, we have most other FMCG brands who invest millions in segmentation to better define their category behaviours and ideal target audience, the aim being to improve the effectiveness of future marketing.

For the record, I’m happy to declare myself a fan-boy of Byron Sharp. ‘How Brands Grow’ is the only book I would insist that every person connected to a consumer business should read. That said, I am uncomfortable with following this sort of fundamentalism and dogma. Segmentation is clearly not the answer to the question, but it is a robust insight/understanding framework that should enable brands to refine and discriminate their marketing.

Segmentation creates a single, global version of [some of] the necessary consumer truths – which is always valuable to drive alignment on a global brand/category approach. A needs-based segmentation will also create valuable inputs for innovation, campaign creative etc.

But, there is an elephant in the segmentation room.

I have been involved in multiple global segmentation studies and have seen some fabulous work, but there is nearly always an issue. Segmentation outputs are just not very actionable versus the tasks most brand marketers have to do today. The theory can be lost in translation. Here are just three examples of why most segmentation studies sit gathering dust on a shelf rather than being used to drive business growth and brand loyalty.

  • Talk to your media agency… and ask them to buy media against your key segments. They can’t. They use proxies [TGI etc.] that don’t really match the deep insight of the segmentation.
  • Talk to your comms/digital agency and ask them what difference this makes to their work/output… and how closely they use it to plan and deliver your campaigns. Or do they ignore it and just ‘do’ stuff?
  • Review your business strategy – has it integrated your segment outputs into its priorities and tasks? Doubt it, as most current segmentations are just expensive, albeit useful, background data.

So, we have many FMCG brands still investing in a potentially great piece of input that is only partly executable – and see limited evidence of them becoming hard-wired into company ways of working. They are diluted through the machinations of pragmatism and real politic. And 18 months later… they are useful background info filed on the corporate server.

So how might we make segmentation more actionable and therefore valuable? The solution is relatively simple and I’ve seen it done – so we are talking about an immediate action that can be taken now, not a hypothetical one

  1. Choose evolved learning cycles – when you have your final segmentation and targets in place don’t think you’re done. Add a continual learning step to your process. NB your segmentation agency currently can’t do this.
  2. Choose a specialist marketing and social insight consultancy who has a proven expertise in building and actioning segments in the digital space. NB there aren’t many who do it properly i.e. don’t be fooled that this can be created from a bit of social listening or a programmatic ad buying algorithm – it needs deep analysis/insight and human expertise.
  3. Give this specialist consultancy your £2m segmentation study and brief them to turn the segments into actionable ‘audiences’. Maybe, it will add 10% to your segmentation study investment. But it will exponentially change the ROI.
  4. Use this data to brief your business [Marketing and Shopper/Category should have it hard wired into their plans]; brief your agencies [your media agency will have no excuses, your creative agencies will suddenly be accountable for who their work engages with etc.]
  5. Use this process to turn it from an interesting piece of market research into a measurable piece of planning at the heart of your future growth.

How do I know it’s doable? Cards on the table, I’m not neutral. I came across just such a consultancy last year and now work with them as an advisor – Legend Engage. Their Mapper360 approach can do exactly this. It has actually done this with segmentation studies. And they could do it for you… even rejuvenating your recent moribund segmentations. It can work globally or locally and for a hoary old marketer like me… I find it amazing. It’s what I’ve always wanted. Every CMO or Insight Director should be talking to people like Legend Engage… before, during and after their shiny new segmentation is in play. And the research company should not feel threatened either. It’s building on the original work.

So before segmentation moves from being the elephant in the room to the dinosaur on your budget sheet, don’t replace it… revolutionise it.

 

 

[1] Byron Sharp: How Brands Grow.


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