Cheryl Ladd

By Cheryl Ladd, Ladd Research Group

Ask anyone who has worked in marketing or sales for a pharmaceutical manufacturer what the greatest obstacle is to gaining market share and you’ll hear ‘habit’. In fact, changing physicians’ prescribing habits has not become easier despite the advent of technological strategies (i.e. e-detailing), or the myriad of creative sales force configurations.

Pharmaceutical companies are challenged with getting inside the physician’s head to understand how to change those habits. Most often, they turn to focus groups or in-person interviews to attempt to do this. However, because these research methodologies still take place outside of the environment where the physician actually writes the prescription, they are less than ideal for understanding the complex dynamics that go into a physician’s prescribing.

Seeing the physician in his/her actual setting (office, hospital) enables the researcher to observe how other factors, such as patient preferences or samples, impact the decisions. In an interview setting, a physician may not self-report these “compensating behaviors”, either because s/he is unaware of them, doesn’t want to admit that non-data specific factors impact prescribing, or doesn’t believe that these factors are influential.

Consider the following scenario: Product Y has broad formulary coverage across many plans although it is not the physician’s first choice due to side effects. In a focus group the physician might readily describe why X is always his first choice. In reality, he’s selecting Y because it saves him time and minimizes call backs when it isn’t covered at the pharmacy. Unconsciously, he is prescribing his first choice X far less often than he believes. If asked whether he ever defaults to Y you might hear him confidently state that side effects are the most important consideration even though his behavior doesn’t reflect this. If this feedback were used to develop a new detail aid, marketing might opt to focus specifically on the side effect profile of X which wouldn’t kick his unconscious habit of prescribing Y.

To obtain additional insights, ‘observational marketing research’ (i.e. ethnography), a standard methodology used in the consumer packaged goods industry, is used increasingly in the pharmaceutical industry. While it sounds exciting (and is!) to get out of ‘the back room’ and into the customer’s world, traditional ethnography alone is not a magic bullet nor does it translate easily to pharmaceuticals. Reasons why ‘observing’ a mom shopping for diapers isn’t the same as ‘observing’ a physician interacting with and prescribing a drug for a patient include:

• The researcher’s physical presence can be counterproductive by changing the very behaviors they are trying to observe.

• Not all drugs are routinely prescribed which could make research costly, time consuming and difficult to capture any influencers on the physician’s habits.

• And of course HIPPA regulations and other factors involving patient privacy must be addressed.

So how can you move past what these obstacles to gain the insight needed to ‘kick the habit’?

Answer: By creating a process of self-discovery for the physician that goes beyond what any researcher, ethnographer, or even the physician himself can know or relay.

Self-discovery assignments might include paper journals, real time reporting (digital recorder), or blogging. The amount of time needed for the process may depend on the depth of self-revelation needed, or the number of options that are available to the physician. For example, less time may be required for a neurologist prescribing an anti-epileptic than for a PCP prescribing an antidepressant. Letting the physician become the ethnographer allows for a more authentic and complete view of his world- exploring and observing his own behaviors, attitudes and perceptions with the researcher’s guidance. In other words, it allows the physician to take a revealing journey with the brand’s marketing team along for the ride.

A research framework that reveals the ‘visible’ and ‘invisible’ aspects of the physician’s reality provides a foundation for a marketing strategy that truly addresses the factors influencing the physician’s decisions. Digging deeper yields those coveted, unexpected insights, with which innovative strategies can be developed that physicians will respond to, in spite of their habits.

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