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Thought leadership

Orchestrating success for multi-Indication franchises

Jeff Greene, VP, StrategyBy Jeff Greene, VP, Strategy

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Pharma leaders dream about having a pipeline-in-a-pill—a single molecule with many potential indications. However, harnessing the power of these products requires complex maneuvering. Common in categories such as immunology, metabolic diseases, and especially oncology, multi-indication drugs are an increasing feature of the pharma commercial landscape. Each indication can vary widely, as can its limitations of use, approved age groups, and dosing. These are unique products—even managed by separate brand teams—yet joined at the hip by a single name. They require a different promotional playbook, which becomes acutely apparent during multichannel planning.

The key is to create orchestrated systems

No matter how many new indications it receives, a brand still needs to connect with the people treating and managing these conditions. For brand leaders seeking their first new indications, it’s helpful to think in terms of ecosystems—the interconnected web of channels and tactics where physicians and patients find information, resources, and product support. Multi-indication launches are successful when the overlaps among ecosystems are tightly orchestrated, allowing the brand to coordinate its messages across all channels.

Steps for success include:

    1. Discover. When Evoke works with multi-indication brands, we spend a lot of time in the Discovery phase to understand the brand’s bigger picture: not only business objectives and audience needs, but also algorithmic baggage, cannibalization watch-outs, and current user experience. These pitfalls are unique to drugs adding a new indication, since the brand already has a website, digital campaigns, social media chatter, and a search footprint at launch. When searching the generic name of a popular immunologic, for instance, the very first organic (SEO) Google result takes me to a page about Crohn’s disease. None of the other results lead to indication-specific content. Additionally, negative product reviews in social media for legacy indications can dampen perception of the new indication even before it launches. Auditing the current state helps us ask the right questions, which can lead to increased promotional effectiveness.

    2. Find the overlap. The brand director for a new indication must be careful not to compete with her own colleagues while planning media, paid search, field activity, and non-personal promotion. Understanding where indications #1 and #2 have overlap will help her avoid problems later on. Consider programmatic media buys, which often attempt to reach audiences through customer models. Though useful, programmatic targeting is not an exact science. Without the right attention to detail, ads for lung cancer and melanoma indications could inadvertently be shown to the same person. Similarly, NPP deployments for different indications often intersect. A brand team I once worked with unintentionally sent emails touting different indications on the same day to the very same physicians. This brand would have benefitted from finding the overlap and preventing a poor experience for its customers.

    Multi-indication brands should identify overlaps

    3. Design new ecosystems that work together. Multi-indication brands require a single master vision for their multiple ecosystems—not only to avoid conflicts, but also to ensure they are maximizing their return on channel investments. Sometimes, the needs of one indication must be prioritized over another. One of the first pharma brands I worked with was an antipsychotic, approved for both bipolar disorder (BPD) and schizophrenia (SCZ). The brand team wanted website visits to start with a landing page where patients could choose their condition. Research revealed people with BPD were markedly against the idea. They were nervous taking a drug “powerful enough” for SCZ, which they perceived as more severe than their own condition. This feedback, combined with sales projections that were heavily reliant on BPD, quashed the landing page in favor of a website that “defaulted” to BPD upon first visit. Thanks to deliberate orchestration and some clever UX design, visitors were still able to toggle to SCZ content.

    4. Test and learn. Once tactics are live, simple A/B testing techniques can help you map the right indications to the right customers. When educating about a product’s second indication, for example, we sent physicians emails linking to content about both indications. While 80% of targets clicked on the new indication, about 20% clicked on the initial indication. Reps for these “indication naive” specialists were notified and encouraged to start details with the larger brand picture, leading to more effective calls.

When brand leadership recognizes the power of orchestration, multi-indication products can achieve their full potential—scaling from one single molecule into a franchise of many successful products. Along the way, leadership will need to ask many questions to realize that vision. Will there be a single, cross-indication support program? How will technology infrastructure, from the call center to branded apps, scale with each new approval? Do reps detail from a single IVA or is a new one built for each indication? If you’re fortunate enough to work on a multi-indication brand, our team would love to begin a virtual dialogue and share our approach. We think the answers to effective orchestration are within reach.

The Evoke Franchise Marketing Center of Excellence helps pharmaceutical marketers effectively launch and grow successful franchises. Our cross-disciplinary experience includes category branding, customer experience strategy for multiple-indication treatments, and FDC launches. To request case studies or more information, contact


1. Mestre-Ferrandiz J, Towse A, Dellamano R, Pistollato M. Multi-indication Pricing: Pros, Cons and Applicability to the UK. Office of Health Economics. October 2015.