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THE

CHOICE-DRIVING NARRATIVE

January 2011

Derek Fetzer (Director, Global Strategic Analytics / Global Strategic Marketing & Market Access, Janssen - Pharmaceutical Companies of Johnson & Johnson)

Noah M. Pines (President, Gen., LLC)

I. INTRODUCTION

Establishing the brand communication narrative - the decisive product messages that activate a customer’s interest and preferential selection of a product – is a critical juncture in the branding process. This crucial step lies at the crossroads between brand strategy and tactical execution.

An effective brand narrative is the culmination of a multi-faceted process of understanding the market landscape and identifying the optimal placement of the product within that

paradigm – or even how the product might shift the treatment paradigm.

Ideally, this narrative should take the form of a logical, persuasive argument that succinctly delivers the reasons a customer should take action. The narrative serves as the blueprint for professional communications media (esp. the visual aid) as well as the verbal pitch that sales representatives can use to activate interest and driving Rx behavior. Ultimately, the narrative should resonate during the few undistracted moments afforded by a customer – especially against the backdrop of competitive noise and in the face of potential counter-detailing.

Previous primary marketing research methodologies aimed at establish the story “architecture” have been effective in identifying choice-driving messages, optimal message sequence or “story-flow,” and rationale for message selection. However, these methodologies are lacking in their ability to accommodate alternative message wordings (often to the consternation of brand team and their advertising agency partners).

Wording, or the language in which the messages are rendered, matters greatly as any agency copywriter will attest. The difference between an effective versus impotent message can come down to the specific

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lexicon that is used. Within the course of a primary marketing research study, messages may be selected or discarded by physicians due to wording or language preferences. Subtle nuances in phraseology and emphasis can make an enormous difference.

Because wording can have such an impact, it becomes difficult to discern whether an idea is included or rejected based on its wording.

This article will elucidate an efficient, systematic qualitative methodology aimed at optimizing the brand narrative – from start to finish – both sequence or “architecture” and wording/language. This approach represents a natural evolution from previous techniques and has been applied extensively and with success in numerous domestic and global projects.

II. Before Getting Started

Building an effective narrative can only occur once certain fundamental questions have been addressed and high-level strategic decisions, especially brand positioning, have been rendered. More specifically, there are four essential pillars that must be firmly in place prior to the development of an effective brand narrative:

1. Landscape/Market Understanding: First, it is critical to have established a rigorous portrait of the current and future market landscape, especially key competitors, unmet needs and therapeutic trends in the category. As part of this investigation, companies should also grasp the critical “choice drivers,” i.e., attributes that are likely to motivate (or alternatively take

away from) preferential brand selection.

2. Customer/Segmentation: Secondly, one must understand the customer audience for the product and whether there are groups or segments within this audience that may have different needs vis-à-vis the product. The question of segmentation must be addressed prior to either brand positioning or narrative development since the existence of sub-groups could explain inconsistent or variable reactions to promotional stimuli and could thereby necessitate alternative tactical approaches.

3. Brand Strategy/Positioning: Stemming from the previous two categories, it is essential to have established the overarching brand strategy and positioning, i.e., the prime placement in the mind of the customer that the team intends for its brand to occupy through its marketing efforts. This is typically an internal, “aspirational” statement encapsulating the advantageous, unique, singular space the brand will occupy – an internal statement of brand “purpose.”

4. Clear Strategic Objectives: Is the brand team attempting to sway brand choice versus direct competitors? Versus indirect competitors? Or is the brand team attempting to drive treatment adoption altogether?

All of these basic questions spring from effective, well-conducted prior marketing research and business analytics and set the stage for the creation of an effective brand narrative. The effective conduct of these four prior steps is essential to

the success of building an effective choice-driving narrative.

Step One: Creation of Research Stimuli

There are several important inputs that the brand team (and its partners) needs to produce/create prior to the conduct of primary marketing research with customers. These items are:

A clear & straightforward abridged articulation of the brand positioning and/or the behavioral objective;

The full spectrum of potential brand messages which may be included in the narrative, categorized into distinct “buckets”;

3-4 alternative wordings of each message (to the extent needed);

3-4 hypotheses as to the 6 key messages and the structure/flow of these messages which best tell the product’s “story”;

A succinct product profile (or in the case of an in-line brand attaining a new indication, a profile of the new indication);

Our experience has proven that the best approach is for the advertising agency of record to produce these materials, and for the team to convene a half-day session to provide group commentary on stimuli. Subsequent fine-tuning can be executed subsequently via small group meetings/teleconferences or via e-mail.

One pitfall to the process that occurs frequently is the desire to “word-smith.” Part of the reason why we created this methodology is to permit the evaluation of alternatives, thus satisfying a team’s desire to ascertain whether specific language will drive customer preference for a message.

Following are some important “rules” to which the advertising agency should adhere so that the output of

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the process is most conducive to the research methodology:

In creating the full spectrum of brand messages, it is crucial that each message represents (to the extent possible) a singular thought, concept or idea. Multiple ideas contained in one message could complicate the analysis of their inclusion, exclusion and/or placement in the narrative.

The agency should endeavor to distinguish between messages that represent a distinct idea (Group A) from those which are re-wordings or nuances of the same idea (Group B). The messages in Group A would then become the “base case” messages. Group A Messages should be tested first at a conceptual level. As respondents may reject certain messages encapsulating the ideas, the moderator may show the respondent the alternative messages from Group B and through the dialogue understand whether the idea of the initial message was rejected because of its concept or because of it wording. This helps physicians stay focused on the concept itself as opposed to simultaneously arbitrating between the best version/language for that concept.

In creating this pool of “base case” messages, the team should endeavor to create no more than 25 for testing. We have found that if there are more than 25 “base case” messages, this typically means that there are different wordings of the same basic idea or multiple concepts grouped within the same message.

In (rare) situations where a brand team finds it impossible to hit the “magic number” of 25 messages, we recommend a primary marketing research process, detailed later in this article, to cull down to the best messages for testing.

There are several other important pieces of guidance for the brand team and agency in the creation of brand messages for testing in marketing research.

Most importantly, there is a difference between a message and a product attribute or “reason to believe.” A message is a succinct articulation of the benefit that the customer derives from a particular attribute. For example, “broad-spectrum coverage” is an attribute, the benefit of which, to a physician, is being able to use a single product to address multiple infections (thus simplifying the physician’s choice). When structuring a message, the copywriter might include below it (in bullet points) 2-3 references to the clinical data which support that message.

Secondly, the team also should consider including non product-specific messages: messages which are not in the actual product labeling but which are relevant to constructing the narrative. For example such messages may include key epidemiological facts or other market-based information (such as Synovate brand utilization data). These facts may be essential to

establishing the rationale or need for a product.

Third, prior to embarking upon a resource-intensive marketing research process, it is

important that claims that are utilized in a marketing research testing environment should be evaluated and approved by the pharmaceutical company’s regulatory department to ensure that they are possible to be used in external promotion. Ideally, the messages should derive from the most accurate and updated potential labeling. This is a question of whether the message is “executable?” By “executable” we mean: Will the regulatory affairs department approve them for usage in promotional materials? Are they messages that truly can appear in promotional materials?

Fourth, when launching a product that has “game-changing” potential, i.e., one that represents a dramatic advance or paradigm shift in a

given market, the team also needs to produce a profile or portrait of what that future will look like. Ideally, this portrait should address:

o (1) How the landscape is likely to change in terms of relevant future choice drivers, and

o (2) Which other/additional options will be available when a given new product is launched

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This is a critical point. Respondents typically are entirely rooted in the present with little foresight as to what the future may look like.

Generally, the pharma company will have a better read of that future than the actual respondent. Responses from the interviewees, especially with game-changing products, need to be considered in the light that the respondent may actually be unable to relate to very different state of affairs, even with significant potential benefit to their patients. For example, it would be difficult for MDs to be talking about a “better quality of life” for a drug to be launched in 3-5 years time, if the imminent new drugs (less than 1 year to launch) are addressing the unmet need of just sheer efficacy. The issue of efficacy would be so salient that discussing other eventual benefits. Getting respondents to place themselves in a future substantially different from today takes considerable time and effort within the interview.

In producing these messages, the advertising copywriter should keep in mind that physicians tend to prefer messages that are “short and sharp.” Word economy. Since most have little time to dedicate to pharmaceutical sales representatives, long-winded message tend to be

overlooked and/or dismissed. Complex ideas to be succinctly distilled – although not too simple as to be insulting their intelligence. Excellent copywriting – where a message is immediately understandable and meaningful with minimal effort on the part of the audience/customer – is rare and is an art form.

From a logistical standpoint, following is important guidance as to how the advertising agency should produce the materials for use in marketing research:

Each primary/base message should be on a PPT slide, with the overall message being the headline & support bullets below

Each primary/base message should be coded in a non-sequential manner to avoid biasing respondents

Each alternative message should also be on a PPT slide, same format as above, but the headline should differ; nonetheless, the supportive data (reasons to believe) should be the same

Each alternative message should be coded in a similar way as the primary/base message; that is, if a primary/base message is "E1," the alternatives should be "E1a," "E1b," and so on

Step Two: Primary Research

Selecting the Right Respondents

Once the stimuli have been created, the first consideration in executing a successful primary marketing research process is: which customer types to include? Based upon our experience, the creation of the brand narrative should primarily be conducted among physicians who are either: (1) welcoming of the specific attributes

offered by the brand in question, and/or (2) at the very least, open/receptive to new products in general.

The main reason to include doctors who are likely to be the first adopters is that they are more likely to recognize the value and to be able to translate that into a compelling, persuasive narrative. At the same time, doctors who may not discern value in the brand attributes or who are not receptive to new modalities probably will not be able to “sell” others since they are not themselves convinced.

Nonetheless, these more recalcitrant, “hesitant/challenging” customers would be included in down-steam aspects of the process, especially the development of the master visual aid (MVA) as well as in the process of producing “objection handler” messages for reps to use in the field.

Simple screening criteria can easily be applied through the recruitment process to ensure that customers enrolled in the study are “likely loyals” or at least “open/ receptive.” This can often be established using a segmentation “typing tool,” an algorithm for categorizing customers that typically is a key output of market segmentation analysis.

The Interview Process

Our experience has shown that this type of marketing research endeavor is most efficiently executed using 1:1 in-person depth interviews. In-person depth interviews are ideal because they permit the direct, on-site display, sharing and hands-on manipulation of study materials by respondents.

Face-to-face individual interviews also permits a focused, efficient, methodical discussion that can be replicated across different medical specialties, and if need be, across different global markets. Typically, these are 60-75 minute interviews.

Following is the general flow of the conversation:

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1. After a brief introduction, the moderator would query the respondent as to current prescribing habits and preferences, usage volume within the category, distribution of patient types and (when appropriate) knowledge of investigational products.

a. This introduction is not only an effective warm-up but also affords the moderators and viewers a context against which to consider the respondent’s subsequent answers. For example, if a physician is a very high prescriber within a category, or treats more severely ill patients, this is likely to influence their reactions to the research stimuli.

2. The next stage involves the respondent being shown a product profile (in the case of a new product) along with a very straightforward and “down-to-earth” articulation of the brand promotional objective (either the positioning, the behavioral objective or a combination of the two). The goal is to quickly educate them about the product itself as well as how the brand team intends to change customer thinking & behavior such that they can react to the research stimuli – especially the messages, through this “commercial aperture.”

a. As mentioned earlier, if the product in question represents a true paradigm shift or a major advance in the category, it is useful at this juncture – even before showing the promotional objective – to display 1-2 slides delineating important therapeutic trends and/or the profiles of likely future competitors. This helps “migrate” or project physicians into that future mind-space so that they can more effectively craft a compelling message suited to the future realities of a given market.

3. In the third stage of the process, respondents are exposed individually to the stack of “base case” product messages and asked to segregate them into two piles: one pile would include messages which are “supportive” of the promotional objective, while the other is not supportive of the objective.

a. Throughout this process, the moderator would ask probing questions as to why the message is or is not supportive of the promotional objective, with the goal of

learning which messages are most compelling to the respondent.

b. Once all of the messages have been segregated, the moderator will go through each individual “unsupportive” message and show the respondent the alternatives to determine whether a wording change would cause them to change their mind. This helps to ensure that a particular concept is not discarded simply for reasons of poor or unclear wording.

c. Next, the moderator will proceed to do the same exercise for all of the “supportive” messages, trying to determine which is the optimal wording of each message. This process often can cause physicians to re-consider their selection of a message since they will have a better sense of its meaning and intent.

d. Throughout this process, the moderator should encourage the respondent to employ a highlighter pen in order to pinpoint critical words and language which jump out; this helps to identify the lexicon of terms which are resonating with the respondent.

4. Having established a final set of optimally worded messages which are supportive of the promotional objective, the moderator then asks the physician to select “as many as necessary, but as few as possible” messages to support the promotional objective.

a. Based upon our experience, it may be necessary to limit the respondent to 5-6 top messages since they may select a large number, or even all, of the messages in the “supportive” pile.

5. Having selected the 5-6 prime messages, the respondent is then instructed to place them into a “logical” sequence so that they follow a persuasive narrative.

a. Once they have laid out on the table the top 5-6 messages in a logical sequence, the moderator would then ask the respondent to explain why the narrative is persuasive to them, and what kind of action would result from the narrative.

6. At this juncture, it is often useful to show the respondent the 3-4 brand narrative hypotheses that were created by the brand team and

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agency. These are fully-constructed stories using the same messages as the respondent considered; “off the top of our heads” stories that the team might consider optimal if it had to make decision without the benefit of research;

a. Here, the moderator would ask the respondent to compare the narrative s/he created against the one created by the brand team. Typically, as would be expected, the respondent prefers the one that they themselves created; nonetheless, displaying an alternative set of messages often provokes the respondent to re-consider their own choice and/or to admit that the story flow created by the team is more compelling.

7. At the end of the exercise, all of the materials are removed from the table and the respondent is asked to summarize, quickly, how they would convince a colleague to use the medication in question if only afforded the time it takes to travel one floor in an elevator.

a. This “elevator story” articulation, ideally, should tie back into both the promotional objective and can help to validate the effectiveness and logic of the story flow the physician has created (or selected).

Following are some other important considerations that should go into the interview process:

o Based upon our experience, it is best not to pre-sort the messages into specific categories or “buckets” during the interview process. The main reason is that if a respondent assumes that a message is in a given “bucket,” e.g., “efficacy,” this biases them towards trying to balance the story flow by including at least one message from each bucket (even if that message is not compelling to them). Hence, we recommend that messages be presented to respondents “bucket agnostic.”

o Throughout this process, a good moderator will constantly challenge the respondent, not out of disrespect, but more than anything to ensure

that the resulting story contains the most persuasive elements and is sequenced in a logical manner. For example, if in building their brand narrative the respondent selects a safety message prior to an efficacy message, the moderator should challenge this since efficacy (even if undifferentiated) is something a product can’t do without more than safety. If a product is not efficacious, it doesn’t matter whether or not it is safe. At the same time, there may be good reason why safety should come before efficacy, i.e., that is the most distinguishing attribute of the product. So it is always important to challenge.

Analysis of Results

The most common question that brand teams and advertising agencies ask when this process is described is how the results are analyzed such that a consistent brand narrative recommendation would emerge (given that each respondent has the opportunity to create their own story flow).

Typically, the best way to look at the results is to analyze them visually using an Excel-based instrument that can display the messages in an X/Y plane according to the frequency and sequence of message selection. Visualizing them in this X/Y plane can help the brand team and advertising agency ascertain not only which messages are “rising to the top” in terms of promotional effectiveness but also the different roles that these messages play within the narrative.

For example, messages which speak to novel mechanism of action, or to epidemiology, often are selected at the outset of the narrative since they might serve to get the

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audience’s attention, or to somehow “set the stage” for a discussion of the product in question.

Efficacy messages often are the next grouping, even if they are non-differentiating, since they are the sine qua non of a customer’s choosing to use the product. Product safety, dosing and administration typically are placed next in the sequence, followed by most “ancillary” concerns such as cost/reimbursement, pricing, and/or support programs offered by the manufacturer. Importantly, while this archetypal flow often is assumed, the process outlined in this article still is necessary to validate both (1) which specific articulation of a message is most powerful, and (2) which specific elements form the essential “backbone” of the brand narrative.

Other important aspects of the analysis may include:

o Raw frequency of selection of messages, which can help to parse out which is overall most persuasive to customers outside of the consideration of the narrative;

o Frequency of selection of message categories or “buckets” to determine the overarching story emphasis, i.e., whether efficacy, safety, dosing convenience, etc.

o Frequency of selection of message alternatives, to determine which version of a given message is most convincing;

o Where applicable, whether

selection of messages differs by physician specialty, location/market and/or based upon a priori segments;

The numerical outputs of the exercise aside, the most important aspect of the analysis is the “why” – why respondents elected a given message versus why another one was discarded. This is extremely important in the team’s establishing a recommendation as to the narrative recommendation that results from the process. Here, it is useful to weigh both the strengths and weaknesses of each message, including both those that “won” as well as those which “lost.”

What If There Are Too Many Messages to Test?

Earlier in this article, we referenced the rare circumstance where a brand team and its agency are unable to select 25 individual, distinct “base case” messages to take into testing. Again, this process generally can be addressed by critically evaluating message redundancy/overlap and/or combining of messages.

In cases where the brand team and agency are unable to hit the magic number, we recommend a qualitative process to identify or “harvest” the best messages based upon customer input. Specifically, we recommend conducting a series of 4-6 focus groups with target respondents where they are exposed to each and every message individually and asked to “vote” each one in or out of the brand story (given the promotional objective).

During the research, the moderator gets a hand-count vote for each message and then would probe quickly as to why each should be included or excluded from the brand narrative. The resulting analysis can show both numerically (based upon number of votes) and qualitatively how to limit the number of messages down to 20-25.

III. Conclusion

Marketing managers face an absurdity of time vs. task: effectively educating medical professionals about the myriad advantages of their brand during an increasingly limited period of face time reps are afforded by customers.

This challenge is central to establishing the product’s positioning in the market and in driving appropriate and optimal brand utilization.

In this article, we have outlined a systematic approach to developing the choice-driving narrative. Essentially, this narrative comprises both content and language of indispensible messages that will drive a customer’s choice of a given product, maximally leveraging the limited time that a representative has in front of the physician. This narrative can be used to structure promotional materials and the agenda of key messages conveyed by the sales representative.

This methodology can help to identify not only the choice morsels of information that support the brand positioning and which drive behavior, but which also can guide the choice of wording (and avoid eliminating worthwhile concepts due to wording/language).

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To our knowledge, this process is unique within the field of pharmaceutical marketing research. Unlike previous approaches, this technique:

Permits the evaluation of alternative wordings of each message; Accommodates the assessment not only of why certain messages are included in the narrative, but why certain

messages are not included (whether it is wording or the idea that is being discarded); Pinpoints vital language (words, phrases) that resonates with customers Measures the contribution value of each message within the scope of a customer’s decision-making process.

This article also has identified critical considerations both at the level of message development and interviewing, both of which are critical to the creation of a successful, effective brand narrative. Ultimately, it produces an output that can be judged on the following criteria:

Get the customer’s attention Reinforce the brand positioning Educates the customer about key reasons to change behavior Ordered in a logical manner that makes sense Motivates appropriate and optimal usage of the product

AUTHORS

Mr. Pines has been working as a marketing research supplier to pharmaceutical companies for the past 18 years. He is a skilled, methodical qualitative moderator with extensive experience interviewing physicians and other HCP types. He also has significant experience as a quantitative researcher. He has conducted studies in the US, G5, Asia and Latin America.

Mr. Pines has managed hundreds of qualitative and quantitative MR projects across a broad scope of therapeutic areas, including infectious diseases, respiratory, cardiovascular, diabetes, smoking cessation, and CNS illnesses.

Mr. Pines has co-authored and published numerous articles in marketing magazines (such as MMM, Product Management Today, Pharmaceutical Representative) and journals (including The Journal of Medical Marketing). He has written about topics ranging from brand positioning, message development, creation of visual aids, testing of promotional materials, to the treatment of such viral diseases as HIV/AIDS and Hepatitis.

Mr. Pines holds a BA degree from Haverford College in Philosophy and Political Science. Prior to founding Gen., LLC, Mr. Pines was Executive Vice President within a top-5 global marketing research firm where he had worked for 10 years. Prior to that, he worked as a marketing research consultant within a major pharmaceutical company and has prior experience in health care public relations.

Noah M. PinesPresident, Gen., LLC

Mr. Fetzer has worked in market research, marketing, and strategy over the course of the last 20 years, working primarily in the pharmaceutical industry.  Originally from Peru, he has worked and lived in the US, Latin America, and Europe. For the last 6 years, he has been working for J&J in the area of market research for HIV/AIDS and HCV.  He has directed the market research for and been engaged in the commercial development of Prezista, Intelence, TMC278, and Telaprevir. Mr. Fetzer holds a BS in Industrial Engineering from Universidad de Lima (Lima, Peru), an MS in Industrial Engineering from Purdue University, and an MBA from Purdue University.    

Derek FetzerDirector, Global Strategic Analytics / Global Strategic Marketing & Market Access, Janssen - Pharmaceutical Companies of Johnson & Johnson)