Evidence without context is difficult to interpret. For an audience to properly understand the value of a drug, evidence needs to be put into context. Take, for example, a fictional line about the efficacy of a product:
“Product X increases performance on the 6 Minute Walk Test by 10%”
This immediately leads the audience to question:
- “What does the 6MWT measure?”
- “Is this manifestation a significant factor in the burden of disease for the patient?”
- “Is a 10% improvement a clinically relevant increase?”
- “How does improving a patients endurance save me money?”
A value proposition is a carefully constructed story that helps an audience understand a drug’s clinical, economic and societal merit in the wider treatment landscape. An effective value proposition convinces the audience that the clinical/societal benefits are worth the economic cost.
The basic premise of a value story is: Evidence + narrative = value
Pharmaceutical companies are very comfortable collecting and communicating the clinical benefit for their drug. This could include the efficacy, safety/tolerability, dosing and/or route of administration. However, payers, healthcare professionals (HCPs) and patients are likely to have vastly different perceptions of what makes a drug important. Therefore, the value proposition needs to consider the varying requirements of different audiences. For example, while a convenient route of administration is important to patients and HCPs, it is often not considered by payers.
In a value proposition, the audience will require more than clinical benefit to understand the overall value of the drug. Economic evidence is extremely powerful to payers. To fully understand the economic value of a drug, payers will want to see convincing data that the product has positive implications for their wallet. This can be in the form of budget impact modelling, or resource optimisation studies (e.g. use of Product X will reduce the likelihood of heart surgery by 25%). If applicable, health economic studies (e.g. cost-effectiveness modelling) are also a powerful tool in some markets. In an increasingly savings-driven market, being able to tie clinical benefit to positive economic outcomes is an important consideration for a value proposition. Some audiences may also consider wider societal benefits to be an important part of the value proposition, although these benefits can be far more difficult to quantify.
Therefore, it is important to clearly determine who the new treatment will benefit: this helps from both a clinical (i.e. which patients will benefit) and economic perspective (i.e. allowing the payer to know the number of patients requiring treatment).
However strong the clinical and economic evidence is, there is potential for it be maximised through a compelling narrative. As previously mentioned, the story of the value proposition should be crafted to convince the audience why the drug is required within the treatment landscape, and what unmet needs the drug can fulfil. This is typically done by first presenting the unmet need within the treatment landscape, and then highlighting how the new drug can address this unmet need better than the market comparators.
It is therefore important to consider in what order the evidence and associated information is presented. There is no set structure a value proposition should take: the value proposition of a drug for a previously untreated orphan condition, for example, is likely to differ significantly from a drug that is entering a very competitive space such as asthma.
An effective value proposition needs to be visually engaging, especially in our increasingly digital world. Graphs and charts are easier to interpret at a glance, and far more compelling, than solid blocks of text. It is therefore key to keep the audience in mind when developing both the content and format of the value proposition.