Commercialization 3.0: Recognizing And Managing The Human Side Of Change

Everett Rogers' 1962 Diffusion of Innovation remains a foundational framework for understanding how new ideas, products, or practices are adopted. Incorporating concepts from the Diffusion of Innovation framework, RAMP (Realistic Assessment of Market Potential) is a model that provides an early indication of the commercialization potential of a new product.

The RAMPx model is shaped by three broad factors, all rooted in current behavior patterns based on hundreds of interviews with physicians, patients, and payers across more than 50 therapeutic and diagnostic categories.

The visual below describes the framework and how the three broad factors interrelate and influence new product adoption.

The relative importance and emphasis on each of the three factors in the framework will vary by therapeutic category. For example, a new drug that can save or extend a life requires less clinical differentiation to encourage adoption compared to one intended for lifestyle-related, non-life-threatening conditions.

The three factors are further broken down as shown below:

The RAMPx model inputs (usually a target product profile) are anchored against the current customer’s standard of care and the length of time someone has been using their current product is, a key departure from traditional analyses used to assess new product potential.

Once the customer has rated the product based on the input, the physician or patient is asked to assign a number of patients they would put on the product or how likely they would be to visit their physician to ask about the product in a time period. These overall ratings allow us to calculate what is most important and whether they are positive or negative, as shown below.

Incorporating Factors From The RAMPx Model To Accelerate New Product Adoption

Developing a deep understanding of customer pain points, needs, and desires by involving customers early in the product development process allows companies to design products that are more likely to resonate with the market and solve real problems.

Despite the high failure rate of new drugs in pivotal trials, the cost of developing a marketing strategy is minimal compared to the potential time and expense of launching a drug that underperforms commercially.

Customer Input Needs to Go Beyond KOL’s

Key Opinion Leaders (KOLs) often practice in academic settings where they have more resources to navigate challenges like insurance approvals, and have a greater appetite to adopt new products given their intellectual interest in novel mechanisms of action. However, community physicians operate in environments where practical considerations dominate their decision-making process. For widespread adoption, it’s essential to ensure that new products appeal not only to KOLs but also address the practical needs of community physicians, patients, and payers. This means offering compelling real-world data that proves the product’s effectiveness and demonstrates ease of use within typical care settings

Comparator Clinical Trials Can Accelerate Future New Product Uptake

While US Food and Drug Administration (FDA) or European Medicines Agency (EMA) approval may not require comparator trials, physicians don’t treat most patients with placebos.

The first question stakeholders need a answer to is:
How much better is this new product than what I’m currently using? Companies introducing new products that struggle to provide a clear answer to this critical question can face significant adoption challenges, in the form or physician skepticism, payer reluctance to reimburse, and patient reluctance. This challenge is exacerbated if the new product introduces complexities in adoption or higher costs.

Current Utilization Of Products May Not Equal Rapid Adoption Of New Products

Equating high prescribing with high adoption potential oversimplifies a more complex landscape. In the past, high-prescribing physicians operating independently were more decisive in driving new product uptake. However, today’s environment, where physicians are often employees and payers have greater control over access, requires a more nuanced approach.

High-prescribing physicians may not be early adopters. Their established habits, loyalty to existing protocols, and sheer busyness can slow their willingness to try new products. Many are entrenched in routines that have worked for them over years, making them less responsive to new therapies, even if those therapies are superior.

In comparison, physicians who prescribe at lower volumes may represent better opportunities for early adoption. These doctors might have fewer entrenched habits, making them more flexible and open to trying new treatments and using those as a means of differentiating themselves and their practice.

Effortless Excellence: Focus On And Facilitate Ease of Adoption

People will do or use things they’ve done previously because they require little to no effort. Patients and doctors want to know how a new product fits into their practice or lifestyle. The more effort needed to adopt a new product, the greater the probability that status quo bias will set in. Payers are well aware of this and the hurdles they put in place are often intended to achieve the objective of slowing new product adoption.

Hub systems that make it easier for physicians to adopt a new product can be important. Programs aimed at reducing paperwork and patient out-of-pocket requirements that include vouchers are all means of making it easier for new products to be accessible and affordable.

Follow The Money

While money is rarely a sole motivator for physicians, it is an important aspect of their lives. To gain a deeper understanding of the economics of health care amongst physicians, Medical Economics and KevinMD – a blog post that publishes content relevant to the clinical and economic challenges faced by healthcare professionals – are great resources to delve deeper into the economic thinking of physicians.

A survey of 1,000 employed US physicians was conducted by NORC at the University of Chicago in July-August 2023 The survey, commissioned by the Physicians Advocacy Institute, indicated that employed physicians feel their clinical autonomy is compromised under corporate ownership. Three in five physicians reported having moderate or no autonomy to make referrals outside of their practice or ownership system, and nearly half reported policies or financial incentives to adjust patients' treatment options to reduce cost.

While many companies hesitate to discuss the financial implications that may result from adoption of their new product, avoiding it is not a good solution. Companies should:

• Acknowledge the economic impact that adopting new products may have, such as potential changes in reimbursement or procedural costs.
• Simplify the reimbursement pathway by offering support programs or ensuring clarity on insurance coverage.
• Highlight financial benefits of using the product, such as reduced complications, fewer patient readmissions, more patient visits, or cost savings through greater efficiencies, etc.
• Offer training or patient education or other resources that minimize the disruption and show the long-term financial upside.
• Offset operational costs by demonstrating improved outcomes or practice efficiency.

Many patients also have cost concerns and those in the US face financial challenges of affording their medications. There are a variety of cost savings programs available to patients, that companies launching new products wise to identify.

De-Risk Trying The New Product

Even with the advent of social media testimonials supporting the use of a new drug, most patients will still want to hear what their physicians have to say about a new product before adopting it.

Companies need to recognize the importance of real-world data and obtaining endorsements from respected medical professionals , and, most importantly, use by other physicians or patients can reassure both audiences that the drug has been used successfully.

Offering guarantees, free trials, or easy returns can reduce these perceived risks and make both physicians and patients more willing to take the plunge.

Commercialization 3.0 Means Recognizing And Managing The Human Side Of Change

While best-in-class products or innovative mechanisms of action often spark initial interest, many companies mistakenly over-rely on showcasing these benefits to drive demand. This limited approach overlooks critical adoption dynamics that influence commercial success.

Commercialization 3.0 points to a need for new products to not only address their clinical benefits, but also the operational, financial, and risk related factors. Clearly defining and differentiating benefits, shaping messaging to address these key factors like utilization, pricing, reimbursement, and patient activation are critical.

The Diffusion of Innovation framework and RAMPx model offers a systematic framework for helping companies refine a product’s value proposition, identify strengths and weaknesses, and guide adjustments during development. In today’s challenging commercial environment, new product underperformance often results less from a lack of clinical superiority and more from failing to manage the human side of change effectively.

The first part of this two-part series can be found here.