The COVID-19 pandemic fundamentally disrupted pharmaceutical launch strategies in 2020, creating unprecedented challenges for companies introducing innovative medicines. According to IQVIA's Launch Excellence research programme, 2020 ranked among the lowest of the last six years for launch sales uptake in three out of five leading European countries, highlighting the urgent need for companies to adapt their launch strategies.
Pandemic Impact on Launch Performance
IQVIA's comprehensive analysis of New Active Substances (NAS) launches in 2020 revealed a complex picture of pandemic impact across four critical levels: regulatory approval, commercial availability, health technology assessment access, and commercial achievement.
Despite widespread disruption, regulatory bodies demonstrated remarkable resilience. Both the FDA and EMA successfully addressed COVID-19 treatment and vaccination needs while maintaining standard medicine approvals. Taking a seven-year perspective, 2020 was actually a strong year for innovative medicine approvals in both the US and Europe, improving on 2019 performance even when accounting for COVID treatments and vaccines.
However, the story differed significantly for commercial performance. Using MIDAS sales data, IQVIA found that orphan medicines dominated successful launches in 2020, with gene therapy Zolgensma and cystic fibrosis treatment Trikafta leading European launches according to list price sales data.
Market Access Challenges
Health Technology Assessment (HTA) decision-making experienced notable disruption in key markets. In the UK and France, HTA decision-making slowed considerably, while Germany's resilient system maintained productivity above historic 2015-2019 averages. Where reductions occurred, prioritization favored cancer treatments, which maintained historic decision levels, while non-cancer treatments saw decreased output.
Commercial availability showed mixed results across European markets. With the exception of Spain and France, the number of New Active Substances entering EU4+UK markets was at or above historic levels in 2020, suggesting companies generally avoided delaying commercial launches despite pandemic challenges.
Success Factors for 2020 Launches
Analysis of outperforming launches revealed distinct characteristics that enabled success during the pandemic. All documented outperformers were orphan medicines with exceptionally strong clinical stories. Tepezza, the best performer, became the first pharmacotherapeutic for Thyroid Eye Disease, while Trikafta represents state-of-the-art treatment for 90% of cystic fibrosis sufferers.
Many successful launches also reduced patient facility visits. Adakveo reduces vaso-occlusive crises in sickle cell anemia patients, typically preventing emergency room visits, while Reblozyl treats transfusion-dependent anemia in myelodysplasia, reducing or eliminating blood transfusion requirements.
Timing provided another advantage for successful launches. Products already approved in 2019 had completed most launch preparation before pandemic impact, creating patient pipelines that could continue treatment initiation despite lockdowns.
Three Pillars of Post-Pandemic Launch Excellence
Understanding Changed Patient Journeys
The pandemic severely disrupted patient journeys to effective diagnosis and treatment through telemedicine adoption, remote treatment protocols, and missed or sub-optimal treatments. Complex patient journeys proved most vulnerable to pandemic disruption, creating treatment gaps and patient backlogs requiring attention.
Sarah Rickwood, Vice President of European Thought Leadership at IQVIA, emphasizes that "getting as many patients as possible back to effective diagnosis and treatment is something on which the interests of patients, healthcare systems and pharmaceutical companies see alignment."
Redesigning Commercial Models
The shift to socially distanced healthcare environments with reduced face-to-face opportunities necessitated fundamental commercial model changes. Early indicators suggest that live e-detailing in major European markets and the US delivers meetings as long or longer than face-to-face interactions, with equivalent or better doctor intention to prescribe.
The most commercially successful pre-pandemic launches were also the most digital, providing a foundation for hybrid multichannel approaches. However, representatives remain central to the hybrid model, requiring new skills for effective in-person and remote engagement.
Companies may increasingly utilize contract sales and customer-facing teams for greater agility, combining appropriately skilled representatives, medical and payer liaison, and nurse support teams to meet rapidly changing needs.
Building Real World Evidence Strategies
Investment in competitive Real World Evidence (RWE) strategies will prove crucial as economic consequences tighten healthcare spending from 2022 onwards. Medicine budgets face growth constraints while cost relief from Loss of Exclusivity remains smaller than historically typical, with biologic and biosimilar markets not yet yielding cost savings as efficiently as small molecule generics.
Payers will increasingly prioritize spending based on evidence, advantaging launches with superior RWE demonstrating differentiation and value. Since RWE studies require significant setup and execution time, companies must begin investing immediately to develop appropriate evidence dossiers.
Future Launch Environment
The launch environment continues evolving from the primary care, share-of-voice driven world of the early 2000s to today's specialty product-focused landscape. The pandemic has intensified rather than fundamentally changed the need to understand and anticipate launch environment changes.
As Rickwood notes, "launches will still succeed, but success will be built on a robust strategic plan with the three pillars of post pandemic Launch Excellence at its heart." Companies must adapt their strategies to address the complex, disruptive forces while maintaining focus on the fundamental drivers of launch success.
The pharmaceutical industry's ability to navigate these challenges will determine which companies achieve launch excellence in the post-pandemic era, with success increasingly dependent on strategic adaptation rather than traditional approaches.
