Growing with the role: 365 Days of 7-Day Supply – MM+M Online


Highlights from Marc Iskowitz’s weekly MM+M franchise, and a year-end salute to the professionals who work on the commercial end of the healthcare business.
From its inception, the 7-Day Supply column was geared to be the universal ball joint of MM+M’s editorial coverage. That is, to function either as a column or news analysis while tackling a mixed multitude of intriguing topics of concern to medical marketers, from pre- to post-marketing and everything in between. 
That approach seemed appropriate. Yet as our audience members’ roles expand with every new therapeutic modality and competitor, it’s only fair that the scope of their industry trade publication should grow in kind.
This past year, a handful of subjects vied for our attention, like Biogen’s quixotic Alzheimer’s quest, progress in the oncology field, and the pandemic’s impact on commercialization, to name a few. Then there were some – let’s call them non-endemic stories – like the Elizabeth Holmes saga, period-tracking apps and post-Roe fears about the weaponization of health data – that begged for inclusion.
As seemingly removed from classical pharma marketing as some of them are, these stories can no longer be dismissed by healthcare product managers and marketing chiefs as being “above my pay grade,” if they ever were. 
Readers know my penchant for top-6 lists; consider this one a salute to the professionals who work on the commercial end of the healthcare business, and their ever-expanding job description.
6. Built to fail: Pharma’s digital product launches plagued by single-digit success rates (May 2, 2022)
Of course, sorting out the impact of the COVID-19 pandemic on pharma marketing continued to weigh heavily on our reporting this past year. When the brick-and-mortar medical infrastructure cratered in spring 2020, medical marketers had no choice but to make the jump to virtual selling.
The problem, as clarified by this piece, was that when the dust settled, it became clear that pharma had simply rushed to digitize its old-school marketing tactics – like visual aids and glossy brochures – versus tying all the websites and apps together to achieve real digital transformation. “Single-digit success rates,” screamed the headline.
We hesitated to proclaim “double-digit failure rates” for fear of seeming sensational. But, judging by the readership of this piece, the conclusion that over 90% of the industry’s digital launches were failing seemed to strike a chord. Exploring the reasons behind it made for an intriguing podcast, as well.
In 2022, we’re seeing the digital tactics that were leveraged during those early pandemic days, from telehealth to digital therapeutics, pulled through in many aspects of healthcare. But for pharma marketing, it’s still a long road.
5. Déjà vu all over again: Pfizer reduces its U.S. sales force (Jan. 14, 2022)
One factor responsible for protracting pharma’s path to digital transformation is that it’s a traditionally sales-driven industry. For years, we had anticipated that budgets for the sales force would significantly decline, but the decline came in dribs and drabs.
Leading up to the pandemic, traditional advertising had been slowly giving way to digital tactics. From 2017 to 2019, budgets for sales reps, meetings/conferences and sales materials rose, but to a lesser extent than digital. Unsurprisingly, 2020 proved to be the tipping point, with companies shaving outlays on sales materials and funneling some of it into digital selling. 
That backdrop made Pfizer’s January announcement, which harkened back to its historic field force resizing of 2007, all the more meaningful. The big drugmaker said that it would shrink its U.S. sales staff on the expectation that a sizable portion of meetings with healthcare providers will stay virtual even after the pandemic.
Even if the rest of the industry doesn’t flock to do the same (pharma is notoriously slow to change), Pfizer’s announcement wasn’t merely symbolic. 
Other companies have been experimenting with population health selling strategies for drug launches, as well as integrating telemedicine into promotion to allow patients to skirt the doctor’s office altogether, as the typical rep-driven model looks primed for further shake-up. 
4. What the Elizabeth Holmes verdict could mean for marketing (Jan. 10, 2022)
As mentioned, the criteria for 7-Day Supply were set – in true Swiss Army knife fashion – as broadly as possible. That includes anything that could impact the way a pharmaceutical product or medical device is sold, promoted, prescribed, dispensed, reimbursed, or even discovered, developed or manufactured.
In the case of Theranos, and its convicted ex-CEO Elizabeth Holmes, the connection to marketing was anything but tenuous. 
The trial itself became a sort of referendum on Silicon Valley’s fake-it-until-you-make-it culture. Likewise, the verdict and strong prison sentences for both Holmes and former second-in-command Sunny Balwani sent a strong signal to startups and their advertising teams that when it comes to healthcare, there’s a fine line between hyperbole and public deception.
That Silicon Valley’s most infamous meltdown happened to be a healthcare startup was not lost on those in pharma. As we’ve pointed out, the Theranos scandal casts a long shadow on medical marketing. 
Stan Fiorito, who was a group account director at TBWAChiatDay when Theranos hired the ad agency, told MM+M that Theranos was his first and last healthcare client. In the interview, he urged agencies to be curious and ask questions about the brands and products they are attached to through their work.
3. 3 practice-changing data readouts from ASCO (June 10, 2022)
It was a busy year in oncology but, as this piece points out, a very promising one. With the vast majority of cancer treatments usually able to increase lifespan by only a few months, and often at a reduction in quality of life, oncologists are conditioned to be a skeptical bunch. 
A trio of data readouts had even this show-me specialty standing up to cheer, in one case literally so. All were unveiled during this year’s American Society of Clinical Oncology (ASCO) meeting. And in all cases, the data could have practice-changing implications. 
The Food and Drug Administration recently granted accelerated approval to one of the drugs involved, Mirati TherapeuticsKrazati (adagrasib), for use in adults with previously-treated non-small cell lung cancer who have KRAS-G12C mutations. The ASCO data may eventually give Mirati the wherewithal to discuss use of Krazati, combined with Merck’s PD-1 inhibitor Keytruda, in newly diagnosed NSCLC patients, too, as it goes up against rival KRAS-inhibitor Lumakras, sold by Amgen
Another competitive situation potentially impacted by the ASCO data involved GSK’s PD-1 drug Jemperli, which is trying to measure up with Keytruda, the standard-bearer in the immuno-oncology space. In a small but preliminary study, Jemperli produced a 100% remission rate in rectal cancer, a stunning result. But confirming the Jemperli results may prove difficult.
2. Period-tracking apps are the tip of the post-Roe privacy iceberg (July 29, 2022)
We decided that an in-depth look at women’s health apps was in order because, well, they are the tip of the iceberg when it comes to security of health data. The tendency for period-trackers to share data with third-party marketing and analytics firms like Facebook – often in violation of their own written policies – has been well-documented.
Of even greater concern now, with at least a dozen states moving to outlaw abortion in the wake of last summer’s overturning of Roe v. Wade by the Supreme Court (and a “crazy quilt” of abortion laws still in place after the midterms), is that health and pregnancy information stored in an app and then passed on to others could prompt someone to look for a person, or prosecute them or their doctor.
These apps may have grabbed the spotlight, but the entire data-brokering industry has come under fresh scrutiny ever since SCOTUS’s June decision upending the constitutional right to an abortion. This piece was part of an ongoing series examining the implications of the overturning of Roe on the pharma industry, which led to medication access issues, stoked fear among providers and had a chilling effect on the digital ad industry.
Yet one of the most overlooked consequences could be new rules that exempt any manner of health data from what’s allowed to be collected and sold by data aggregators, or used by pharma marketers in medical condition advertising. The Federal Trade Commission recently sued ad-tech firm Kochava, and in November announced a proposal to regulate what FTC calls data-driven “surveillance marketing,” which may result in some harder lines around these practices.
1. Long-term safety remains a question for Biogen-Eisai’s lecanemab (Sept. 30, 2022)
It may be hard to believe, but about a year after its Aduhelm commercial debut floundered, Biogen may soon get another shot at an Alzheimer’s drug launch. Next week, the Food and Drug Administration is set to decide whether to grant accelerated approval for anti-amyloid antibody lecanemab.
Recall that lecanemab met the primary endpoint in a Phase 3 trial, with a treatment difference of 0.45 on a major outcome measure called CDR-SB. That translated into a statistically significant 27% change versus placebo, and a full readout this fall showed that lecanemab duplicated that treatment effect in CDR-SB across multiple subgroups. 
Its effect in slowing cognitive decline is about on par with Aduhelm’s (even though Aduhelm didn’t show statistical significance and lecanemab did). Despite analysts’ high expectations, this piece warned that Biogen and co-developer Eisai may nevertheless have a hard time convincing holdouts who are skeptical that the treatment will provide meaningful benefit to patients.
In addition to concerns around brain swelling and bleeding (and now a third patient death), the drugmakers must also contend with lack of Medicare reimbursement for the med or related diagnostic testing. Unless, that is, lecanemab locks up full FDA approval, and the Centers for Medicare and Medicaid Services deigns to reconsider expanding payment for the anti-amyloid antibody class beyond just clinical trial enrollees.
That possibility isn’t expected until the back half of 2023, at the earliest. But if you’re Biogen, what’s another six months? It’s already been a long, strange trip.

Join us at MM+M Transform: The New Era of Connectivity for an in-depth look at trends likely to inform the industry’s evolution over the next 18 months.
How a different kind of ad agency prioritizes relationships.
From patient engagement to patient empowerment, Outcomes is moving upstream to give patients control of their prescriptions.
Campaigns focused on diversity in clinical trials and addressing implicit bias.
How can technology facilitate inclusion and diversity in clinical trials?
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