Video: Purple Cows, Otaku and Pharmaceuticals

If there is any one thing we know in pharmaceutical marketing, it’s that the pressure to differentiate has never been greater; whether it’s with physicians to encourage change, or with payers to prove value.

We all say this, but do we really mean it? Do our organisations fully understand it, and do we “put our money where our mouth is”?

Here’s an edited version of a talk that marketing guru Seth Godin at TED (you can see the full talk here). I believe it superbly captures the nuanced reasons why we need to change our approach to product development and commercialisation.



Seth’s key point is that products can no longer just be very good or better, they need to be remarkable; what he would call a “purple cow”.

I believe this is superbly relevant in modern pharmaceuticals.

In developing products, so much of what we do is driven by attaining regulatory approval; which by it’s nature looks to measure products by established, often composite, parameters – like an ACR score in rheumatoid arthritis, or an Overall Survival score in oncology.

However, with so many disease areas now well served by existing treatments, being very good, or maybe even marginally better than what’s already out there is simply not good enough to warrant access from payers and adoption by prescribers. You need to be remarkable, or what the French Transparency Commission would call innovative.

This means that, for example, bringing yet another product to market for RA with a “TNF-like” ACR score is simply not good enough, regardless of how hard that benchmark is to attain. For products to succeed they must find a remarkable benefit backed by a plausible rationale applied to a discrete patient population.

While this has always been the formula for success, in the past products were able to succeed with only one or two of those three elements. Not anymore. If you want to tap into the Otaku that can break your product into a satisfied market, you need to give them something to be excited about.

To create such remarkable products there are two things that we need to do and Seth spells both of them out:

1) Employ better design 
With respect to the pharmaceutical industry this refers to the development programme. It means that instead of settling for what will secure regulatory approval (not necessarily easy in the first place) we need to go beyond and find other ways of communicating the remarkably different benefit that our product can provide within well defined patient groups. It means that just showing better FEV1 scores in respiratory or Relative Risk Reduction in cardiovascular disease is no longer enough; you need to find novel or unconventional parameters to express how what you’re bringing to the market is remarkably different.

No doubt this translates into extra cost and resource, as realistically this data needs to be generated in addition to what regulators will demand. It also requires more thought, planning and ingenuity to pick what those new parameters should be. However, that’s the modern cost of success, and as Seth says “Design is free when you get to scale” (i.e. the marginal cost of this is incidental compared to the value it creates).

2) Take more “risks” 
Spend more money on endpoints over and above what is required, and that are not guaranteed to add value.

Rather than bringing out a mass market product “for everyone” within a given disease area, create a medicine that will have Otaku; that will have greater benefit in smaller, discrete patient populations and that may at first only be adopted by sub segments of your customers. Flagrantly and intentionally risking, dare I say it, being niched (shock)!

But while his philosophy does have elements of inherent risk, it is by no means as risky as the conventional industry standard “safe” approach: to show that a new medicine is marginally better than what has gone before it on established parameters, and that it is appropriate for use in as many patients as possible.

This is modern pharmaceutical development suicide, yet lemming after lemming continues to line up.

If you were a payer, would you replace a functioning standard of care (SoC) in all your patients for a new premium priced product that was only marginally better? I suspect, that like many payers do, you would at best reserve it for use in SoC failures and look for patient sub-groups in which to restrict its usage.

If you were a clinician, would it really be worth braving the risks and hurdles of adopting a new product for one that is at best marginally better than what you already have and know? Even if you were an innovator, would the “safe” product I describe ignite the Otaku within you?

As Seth describes, the truth of this complex and cluttered modern world is that only Purple Cows that can ignite Otaku give themselves a chance to cut through and succeed. Is your ambition to be risky, or very good? The choice is yours.