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Watch our Webinar on Market Shaping in Healthcare

Market Shaping in Healthcare

Watch our Free Webinar with Co-Director of Triducive, Nick Williams as he discusses the importance of market shaping in healthcare and how to add real value to your brand.

If you don’t have the time to watch the full webinar, click on the + to read the full transcription of the webinar to ensure you don’t miss out on any key points. For more information on how to differentiate your brand, download our whitepaper for a practical guide.

Otherwise make sure to watch our second webinar with co-founder of Triducive, Tim Warren who discusses how to make your pharma brand more relevant in an integrated healthcare system.

Read Full Transcription

Introduction

Good afternoon, everyone. My name is Tim Warren co-director of Triducive, who are partnering with Pharma Field with this webinar series. I’m delighted to be moderating today’s event, shaping healthcare markets to serve real brand purpose. Thank you all for joining us today. And thanks also to E four H who are supporting the production of this event. This is the third and final webinar in this current series, covering three relevant topics for pharma and healthcare organizations. The way that this webinar will run is that in a moment, I’m going to be handing over to Triducive’s market shaping expert, Nick Williams, who will cover the content that you signed up to hear about for this part of the session, we will mute all participant lines to make sure that the experience is good and clear for all, but please do interact with us as we progress. You can do this in two ways.

Firstly, you can share any comments or thoughts using the chat function in the webinar console. Secondly, you can send any questions that arise throughout this session, using the questions function in the console. We will have time at the end of this session to answer your questions and to share any reflections that you may have to contribute to the conversation in hand. There is also a handout available, a white paper called stand out to fit in and that’s found in the handout section of the console. So it’s with great pleasure that I’m going to hand over to my friend and colleague Nick Williams to lead this discussion. Nick has led a career spanning over 20 years within the industry where he is mastered a number of commercial leadership, marketing and communication roles. Now our co-leading Triducive his focus and expertise with marketing excellence is through supporting our European clients that we’re fortunate to work with Nick and Triducive have developed countless programs that provide practical expertise, that shape market context to help brands gain and remain relevant to customers.

Nick, it’s a pleasure to be able to hand over to you.

Nick Williams

Thanks Tim. And it’s brilliant to be joined by so many of you all today. I’ll do my best to keep you as interested as I possibly can. During the course of my talk, I’ll share views and experience accumulated personally from working on brands within pharma organizations and from a perspective supporting many others, I’ll offer some thoughts across the following areas, drivers and influences of brand uptake, identifying possibilities to increase shared value, and also practical ways to shape the environment or market. With some examples before I get going, though, it would be real, really great to get a sense for your interest in this area and what might be important to you. So to help, I’ve got a really simple question that I’d like you, you to give me an answer on thinking about the brands you are most focused on at the moment, what would you say is its position in its life cycle?

And I’ll give you a couple of seconds to, to give us your response, ah, a really good spread actually. And, and actually interestingly and a number of you with, with pre-launch and, I guess launch brands being, being early growth too. And that’s interesting because the next thing I’m going to do is ask you actually another question but I’m not going to ask you to answer it at this stage. So can you imagine wanting a mobile phone now that started its development in 2000, the NAIA N 95 took 12 months from first drawings to market entry and became the highest selling phone of 2007. Believe it or not, it took less than a year for apple to top NAIA from this spot. And one year later it was obsolete. The world is moving really rapidly and we live in a world where advances in technology, more than double every two years as individuals, we are reasonably fast to adapt to these changes.

I know as I’m getting older, I’m perhaps getting less adaptable, but nevertheless, as individuals we adapt pretty well, organizations are, are perhaps a little slower to adapt and certainly the policies that they’re regulated by move more slowly still. But if an environment where attitudes, beliefs, and expectations of its stakeholders are moving so fast, how on earth can we expect 12 to 13 year R and D cycles to deliver propositions ready for uptake and ready to serve the purpose that they were conceived for in the first place. In fact, HTA agencies are having a hard time with this too. This recent study published in the BMJ is based on products evaluated by the German HTA organization which shows that are whopping two thirds of new products evaluated have uncertain or no additional value versus standard of care. A lack of comparative evidence is one key issue that the, the authors site along with immature or incomplete evidence packs being available. And this is particularly the case as we drive to fast track products to market trying to beat these long R and D cycles. And so this will be one of the factors leading to disappointing market introduction and therefore subsequent in market scales over the course of, the brand life cycle, an average of 45% of products reach at 80% of their sales forecast with many products falling much shorter than this. And this is according to a study published this year by Deloitte products with higher specialization, or if you like a clearer purpose, tend towards greater predictive success, but still with no guarantee,

Poor understanding of market needs and poor differentiation on the other hand are cited as the key reasons contributing to limited access and uptake by the researchers here. And it’s these two factors that, that we’ll talk about some more,

We can learn from the relative success of highly specialist products, perhaps because of their inherent greater specificity and greater clarity as we consider any market and how they respond to propositions. There’s usually room for three or maybe four significant players in a market. And this concept ex helps explain why Michael Porter first defined that there really are three, three ways to win and really only three ways to win, be very different in relation to the most important decision criteria in a market, be lowest cost while still meeting the basic needs of the market, or be most appealing to a particular segment or group within the market. And therefore subdividing it further. All three ways have the potential to create shared value for the brand and for the customer or the market. If we well-conceived and well executed, most markets will have a demand for value from improved performance or utility. Most markets will have a demand for value from low costs and no market is so homogenous that its needs are exactly the same for all groups or segments. Whichever strategy is selected and let’s be clear. It has to be selected. This is because successful execution depends on a proposition that has real clarity and real purpose behind one of these three areas.

And so thinking about the other ways that competition is traditionally seen and certainly in, in our industry is how we communicate this proposition to our customers. We’ve known for a number of years that accessing HCPs is becoming an increasingly challenging problem. And there’s a new emerging acceleration of this trend amongst healthcare professionals on the back of the pandemic that we are living through this recent UK survey by SERMO highlights, highlights that are total 26% of healthcare professionals plan to reduce or cease direct engagement with industry. This piles further pressure on the proposition itself. We need to work even harder now to make sure that it lands clearly.

So when we approach an existing market, there is a big temptation to calibrate our approach in relation to the market leaders, they help define the rules and we play by them. But unless the challenger brand is lot better on this exact same criteria, then we can lead ourselves into a square peg round hole madness, or the Pepsi challenge trap. And I’ll talk a bit about those. Now, the factors that the market leader has helped the customer reinforces importance, maybe in areas where our brand is honestly not as good. And we can waste a lot of effort trying to convince otherwise, this is where we lose. We may be fortunate and have comparable brand performance against the drivers that customers recognize, but aiming to win this battle carries significant risk. And actually when you think about it, very little value for customers who needs two products that do exactly the same thing about as well as each other. Pepsi learned a big lesson here when they ran the Pepsi taste challenge in direct competition with Coke, even when they managed to get Coke drinkers, to agree that they preferred the taste, this still didn’t shift market share appreciably. We still buy Coke four times more often than we buy Pepsi. And we still believe that Coke tastes well like Coke should.

The brave, but often more successful route is to really honestly assess and prioritize the strength of the brand and cons consider how well hidden are the needs that it can uniquely address for customers and think about how it could be possible to bring these needs to the fore.

This framework has been adapted from blue oceans, Kim and Morone and blue ocean is, is a book that talks about how to chart to new and, and, and UN uncompetitive waters or less competitive waters for success. And simply put markets and customers are usually looking to buy products or services that help them do jobs with greater performance, with more simplicity or with lower cost, which usually translates to financial cost. I’ve included here. Some examples that often are con considered in pharma and health tech markets and form the basis of our communication. But of course, these can be added to and broken down further. Still brand propositions are built, not on these features alone, or shouldn’t be, or in I, but as a collection of drivers, that when combined allow our customers to get a job done and the important bit to get this job done relative to their context, these jobs become even clearer. When the context is stronger,

This collection of drivers may ordinarily be filed in a second tier perhaps of importance, maybe for a hospital specialist. But when the context of a contagious pandemic such as the one we are, we are working with at the moment is a recognized factor. Then they become critical to help the specialists get a job done that they need doing really well. If your brand, by the way, delivers in these aspects right now, you are in a good place. This example is obvious, very clear, very obvious, and a very present example of context that influences a job to be done and what the market ultimately will value, context changes, how we see things and how we value things. And in pharma markets is maybe even more important to a large extent. The proper position we have is largely dictated by the length of the R and D process and the molecule or technology that this results in is therefore reasonably fixed.

And so perhaps addressing the context is the most flexible opportunity we have. I could try. I probably fail to convince you that this number that you see now is higher than a seven. And I feel a bit like Bruce Forsyth right now, when I’m saying that, or I could work harder at providing a context that helps you come to that conclusion yourself, like the event of a health pandemic, some context can only be responded to and may be leveraged, but some can be addressed influenced, or even built. Here are some of the most common areas of context thinking about the issues related to them can give us a basis to think about how we might address them and use them to increase the value around our brand. The available evidence that supports the way a disease may be considered managed or treated is a context driver that we are well used to thinking about.

This can be added to over time. The challenge is finding ways to do this quickly and to do this with the appropriate level of quality policy and guidance are either at very high level for example, nice or at a local level protocols or even informal guidance between centers are a set of contexts that change what’s valued as well as the world advances so rapidly. It’s not uncommon to find that these are outdated or incomplete at any given moment. And therefore there’s opportunity treatment situations exist that may demand different or greater thought than is generally applied to them at the moment, for example, types of patients with different needs, stages of disease progression that demand different consider or the stage of the patient in their life stage. These can sometimes be overlooked, broad brushed, or oversimplified by policies and well-meaning guidelines that are looking to simplify or to build in efficiency. The motivations that key stakeholder groups have and the issues that are important to them can play a really big part. The influence on market choice usually depends where the, the balance of power and voice sits at any given time across these various stakeholder groups.

This focus on addressing stakeholder voice was evident in one that Lilly took with S when they battled it out with fire. Pfizer’s Viagra, not by attempting to out shout a well-equipped and well respected team with a strong relationship with healthcare professionals, but by considering the needs of the patient and their partner and raising this voice, linking their brand difference of a longer duration of action to a need that they emphasized and leveraged the need for patients to experience a normal spontaneous sex life. That didn’t depend on planning and organizing their romances, perhaps around a half-life of a drug. They, they achieved this impetus by focusing on educating, supporting, and encouraging consumers to discuss their needs with their healthcare professional. This was counter to Pfizer’s strong, focused directly on healthcare professionals with a relentless message, installing the clinical efficacy and potency of the treatment effect. You can see this in the very different approaches in the healthcare professional ad from Pfizer and an execution from a consumer ad for CYS. The branded war ended in 2014 with Viagra LOE, but the ground that S made up to overtake Pfizer’s dominant market share from a four year market lag and with a price premium was pretty stark. This war was one on shaping context and a brand with a very clear purpose.

So thinking about shared value to a brand is highest when it’s aligned to a strong, well-recognized unmet need from the market. The reward is usually greater use of the product value to a market. On the other hand is highest when the brand offers distinct capabilities against recognized unmet needs, the reward is greater status for the customer and a, and their ability to get the job they need doing done depending on how well recognized the need or how well differentiated the brand is, can dictate the type of value that can exist from unrequired. When both, both factors are low to discovered when both are high and depend bending, depending, sorry, when, where a brand falls on this grid can also determine the approach that may be most useful in generating shared value.

The two areas to the right of this grid, where difference generally exists of some description with, with the brand are concerned with the context, and it’s where we’ll continue the conversation in this talk. There are needs, shape, or, and system shaping jobs that we can do to really build that context. I’m going to focus on these two areas from here, but before I go on, I’d like to ask you another question. It’d be interesting at this stage to understand where you think your brand might fall in relation to this grid. So is your brand in need of system shaping, perhaps need shaping proposition shaping? Do we need to question where the value really needs to come from, or, or is it about yes, the, the proposition shaping itself, let’s, let’s have a look at the results. Interesting. So the majority of respondent think that need shaping is the area that their, their brand falls within. So it has difference. It has you know, a competitive edge, but maybe not quite as well recognized by the market at this stage. And, and that’s interesting for me because the, that this is where most brands that we’ve worked with seem to fit within this, within this quadrant. Let me move on and show you that. So when we’ve analyzed, where we’ve done most work in, in, in this activity, in this part, this type of activity, yes. That the need shaping quadrant is where most brands tend to sit.

And this is where a lot of brands can provide real potential for shared value. Often there are needs that patients or the health system have that can be overlooked until they’re clearly highlighted. Sometimes this can be due to that over simplification of approach that comes from a desire from, for efficiency sometimes because the market has learn to adapt or to live with under performance in this area, and sometimes perpetuated by the emphasis of other market competitors. And of course it’s in their interest for this to happen. There are in almost every market cohorts of patients with specific needs that are not optimally considered, or perhaps until now they’ve adapted to a suboptimal approach. Sometimes the issues already mentioned are compounded by gaps in the, the evidence base, either disease, state evidence, the reason to think this way, perhaps, or treatment specific evidence, the reason to act on that these challenges can, can exist with all brands. And so we see the most commonly in challenger brands who are perhaps at risk of being defined what already exists in the market, but also for launch brands who may be entering markets that have seen little or limited change for some time. And so management practices are ingrained

Products that seemingly have the very best chance of creating value may be a new class of treatment with clear promise against unmet needs can often face limitations that risk frustrating uptake. Often there are pathway bottlenecks. Patients may be living with the fact that now the health system isn’t able to help them further. And so they’re not routinely consulting or the way a new technology is delivered may see patients traditionally managed in a community setting and the specialist service where the intervention is now positioned to support their needs is seeing slow referral rates. Key systems, stakeholders themselves may be to change practice within the pathway. Payers, cautious about costs may look to control uptake until they understand more about outcomes and certain healthcare professionals confident and comfortable with a trusted approach may also be slow to move away from this comfort zone. Secondly, sometimes diagnosing or stratifying, a eligible patients can be incompatible with new types of treatment that demand different tests or different goals that they’re measured by,

For example, and very, for example, this is very hypothetical. If he HDL cholesterol is not routinely measured, then a treatment that provides outstanding results with LDL HDL ratio, for example, will find it difficult to realize value. Even if evidence may suggest this is the right focus to have, and experts agree. These challenges tend to relate more with highly novel brands entering less dynamic marketplaces, or even market leaders with innovative product labels seeking to expand use in new areas, given novel approaches that tend to be involved here almost certainly guidance supporting practice is likely to be incomplete or outdated. The reality of any situation like these is that there will be multiple perspectives at play that can bind to form the aggregate position. Looking a little more closely at how market stakeholders are positioned, helps us not only understand whose beliefs and behaviors, behaviors may need to be supported most, but which stakeholders may be able to help and may also be looking for others to support them too.

It’s this connected assist that stakeholders live within. That’s really important to understand when seeking practical ways to shape market behaviors. This universally applicable social ecological model of behavior applies to societies, to industries, associations, and of course, health systems too. The level of influence on our behavior tends to run from the top down from policy towards the individual, but in the absence of, or perceived absence of applicable or useful policy, the source of influence will come from other accepted community approaches. And then from more informal networks that exist, conversely, the impetus to drive changes to accepted community approaches and even policy at large, usually start gain weight and are adopted due to movements of opinion in the other direct, keeping this in mind helps as the following questions are considered. As we plan to think about how we might change the context around our brand and a brand around the market that considers our brand.

The final point is really important to talk about in a bit more detail, the impetus for change. What’s going to be the motivation, the encouragement, the stimulus. It may be new data that will be emerging soon. It may be a new study that the business considers investing in, or it could be peer and social influence that directly respects this model of behavior. If you consider some of the biggest ways that impetus for change has been developed, you don’t need to look too much further than this one. The climate change debate was raised by experts and built upon by global populations with a growing environmental conscience, to the point where a 17 year old has the platform to press the debate with politicians around the world. Change is considered because the expert experts raise the issue and describe the issue. Change is much more likely to happen because communities around the world are pushing for stronger policies, creating something like something that uses these principles.

Something like this in healthcare can be achieved using a version of the Delphi method. You may have come across this already. It’s a well-accepted iterative approach to generate expert and stakeholder recommendations born during the cold war by a think tank, the Rand corporation supporting the us military. The approach was used to bring multi agency thinking together to help predict and recommend the impact of technology on warfare and has been used since to develop policy around the world in many settings used often in healthcare, when evidence is incomplete or difficult to get, it has been used to develop that professional society, consensus guidelines, such as the latest BSG treatment guidelines for, for inflammatory bowel disease. The power of the approach is its credibility in bringing the experience based opinions of in, in informed and highly engaged audience to a focus that can then be used to drive action.

This is something we’ve worked with on numerous brands to date and are currently running multiple programs with various healthcare and healthcare related organizations. But how does it work? Well, it starts by C then, the approach that we’ve designed starts by defining the goal and the key themes to be addressed. A core group of stakeholders define statements behind these themes that assert a new position that’s needed. These assertions are tested for agreement during a structured survey of a group that is representative of this core group. This amplifies the power of each assertion and leads to recommendations that can be confidently made communication plans and assets to encourage enable and engage stakeholders who may be an audience to build further support with or to stimulate change amongst should be developed and implemented as a result. The power of this approach is not only in the inherent potential to build and galvanize advocacy and social change, but it can be delivered remotely rapidly.

And with the level of credibility that falls within the hierarchy of evidence, grading expected from good quality work in healthcare. Let me share a couple of case study summaries for you. We worked with a UK team marketing, a high tech blood glucose monitor. It had some neat tech features that help patients engage more frequently and more easily with their levels. And it’s demonstrated to have a beneficial effect on outcomes, something the lower cost monitors at the other end of the market couldn’t deliver. The challenge was this commoditization driven by a highly cost focused approach to formulary policy after planning to drive a more considered and stratified approach by raising the voice of experts in the field, through the Delphi method. This led to a publication with over 200 experts calling for this stratification to be considered in policy, by implementing with profiling tools, advocacy, and engagement programs aligned to the messages from this publication. This helped support uptake for the, for the product led by sensible formulary positioning for appropriate patients.

Here’s an example that was more about shaping the system. A low cost D treatment with a strong competitive position was faced with a very stagnant market, long waiting times to see specialists who initiated treatment combined with apathy from healthcare professionals provided challenges for brand uptake, but also for commissioners looking at an expensive to run service, the modified Delphi method managed to create a multidisciplinary consensus of over a hundred professionals that described and recommended greater engagement and involvement from other local authorities, including schools, the subsequent publication pathway tools and education program provided the impetus, the structure and the support needed to start to transfer more responsibility to school nurses, best place to manage and monitor treatment. This helped to revitalize the market and saw the brand increase uptake as a result.

So finally, a, a chance to reflect, please, could I ask you to think about your brand again and let me know what you think, how important do you think changing the context could be for your brand? How strongly do you agree that it could positively drive value if we could change the context around it? Okay. There’s some pretty strong agreement that actually the, the context, if we can shift the con context, it really could help to increase the value of our brand. And, and I’m not surprised there’s some, some folk they’re not, not too sure yet. I’m sure there are other priorities that you are working through as well.

So, so finally, I want to leave you with a few takeaways. We covered quite a bit of ground. Firstly, given the complexity of R and D the pace of change of healthcare and the way that markets behave. It’s difficult for me to believe that any brand wanting to create greater shared, you can ignore the need to shape their market. As brand propositions are tough to change, not impossible, but tough to change. And the way we can communicate them is under more pressure than ever. Context really is king. The Delphi consensus method that I’ve just shared with you, I believe is a really powerful and way to rapidly create impetus that intrinsically leverages social and peer influence as part of its effect. So before I turn it over to you in your questions, I’d like to simply end by offering our support and experience. If you think it could be helpful, we’re very happy to discuss the business that you had.

Questions

You may be facing and help identify how the way your proposition lands could be improved. Maybe also sharing case studies from our back catalog, with examples that may be highly relevant to your brand and situation. Thank you. So do we have any questions, Tim? Well, absolutely. Thank you very much. I appreciate that. You’re able to simplify a, relatively complicated topic area and certainly given our audience plenty of food for thoughts. We’ve had some really great questions that have come through. So if you don’t mind, yeah. I’ll, I’ll jump straight into them. There was a question here about the applicability of highly differentiated products. Surely the effort should go into communicating the value of the brand for highly differentiated products. What is your view? Yeah, so I would agree that a large amount of the effort should go into differentiating the sorry into communicating the differentiation of the brand and the proposition itself.

I absolutely couldn’t agree more. The thing that I point to is, the fact that sometimes it’s not quite enough, sometimes the system itself is not either ready well set up or, or simply is living with a level of inertia. That means that no matter how much we communicate and convey the value of our, our brand, actually it’s true, shared value is not realized unless we think about the text within which our customers are, looking at this brand and considering how it would work for them in their system. So, my argument would be that, yes, of course, you need to think about communicating that, but at the same time, think about how could the context and shaping that really an allow that value to live even better. Okay. Thank you. There’s a question here.

How much of a risk of nicheing a product if the focus of shaping is on a particular patient group? Yeah, that’s an interesting one. And, we’re always quite concerned about this certainly in an industry where we’re used to actually trying to take on the whole market in many cases. So I’ve got a few thoughts that, that spring to mind firstly if this is the right approach for, for a brand and it might not be the right approach to, to consider shining a light, if you like on a certain situation, a certain cohort of patients or people with, with certain needs, if this is the right approach, then it’s about finding the right one. So sometime not all niches are the same, not all groups are the same, certainly not all the same and certainly not all with the same strength of need.

So find the right group first, I guess, is my first point. And, and then the second point would be, would be this, that if you are able to, if your aspiration is to achieve perhaps 20% market share, is it better to try and aim for 20% share from a hundred percent of your audience? So a smattering of use from, from everyone, or is it, more powerful to aim for a hundred percent use where your best position to win? And, and my contention would be to, to go there to aim, to win the part of the market that you have the strongest, right. To own the strongest case to win. And you’ll be amazed at how much spillover business you’ll win because of the clarity that you bring to the market. Yep. Take ownership own the market that you deserve.

Absolutely. That that’s. But, as I said before it does all depend, you know, what the situation of the brand and where the strengths lie, I guess. Yeah. Yeah. We’ve got a question related to that into, I mean, there’s a question here, can this approach work with mature and establish brands with well-known USPS, the approach, the Delphi method, is that yeah. The shaping the shaping approach with, with mature brands. Yeah. well often the challenge with mature brands, well, it’s either to hang onto market share, I guess maybe we’re trying to build in, or to encourage a level of we’re not trying to, to push inertia or to change inertia. So I guess that could suggest that, that this isn’t the way the case, but actually very often.

And I know I’m thinking of a brand that I work with in late life cycle, our best form of defense, if you like was to attack a new part of the market, a new area that we, we had, we believe we had more strength to, to, to offer more value to offer. And actually that might well be the case for many mature brands. I can’t think of one the top of my head. But I, but I think very often the best way to defend a position is to actually to, to innovate and own a new position, which would depend on you know, illuminating and shaping a context for that to then be helpful. Yeah, absolutely. There’s a couple of examples that I’m familiar with, that we’ve worked on where the brands were at a more mature, mature stage of their, their life cycle and the, the advocacy and the, the peer acceptance of that being a good standard of care was an effective way of, of articulating.

You mean that if things aren’t broken, why change them and, and, and to trust. So we’ve certainly seen this work across the life cycle of the brand, but again, in accordance with those, those segments that grids that you, you, you presented, there’s a, there’s a question here. Maybe one of the last ones we’ll have time to, to address, but a question is cropped up about, can we, you move the brand through each segment of that matrix that you shared over time? I, think so, yes. You know, it wouldn’t, it wouldn’t be beyond the, the, the realms of possibility for a brand that has limited differentiation to find way to increase its offer through perhaps an integrated service, maybe through innovating the label. And, and that certainly can be the case, both of those, those two examples that might then lead it to become have difference that isn’t fully recognized which could then be, become more greatly recognized.

And essentially, I guess at that stage, maybe it would be about removing bottlenecks in, in, in that system or, or, or making sure they might itself as even more compatible with, with that, that, that brand and, and, and what it has to offer. So I would think it might be unusual for a brand to go through every quadrant, but certainly move between quadrants. Absolutely. Yeah. Yeah. I think I’d agree with you with it, with that context. I mean, the beauty of this, this approach, as we’ve seen, as you know, is, is the fact that we can amplify the support and the, the drivers that need to be in place for value to be recognized and acted upon. And if, if there’s a, an opportunity for clients to work with those, those stakeholders to raise the debate, to provide a very clear call to action set of recommendations, that it almost does half the work for our respective clients, because they’re such a ground swell as, as you kind of highlighted, which is, which is great.

When would you choose the Delphi approach instead of real world evidence or a formal clinical study and what would be the benefits of Delphi method? Well obviously, if, if we, a formal clinical study carries a level of risk financial risk that the outcome isn’t is not necessarily the, the one that will, will, you know, want to, or, or expecting let’s say, or, or want to be able to communicate. So, you know, I guess that’s, that’s one consideration when, when sort of embarking on a clinical study the other consideration, I guess, linked to that is the time that, that it takes to, you know, I guess, set up recruit and then analyze and report out a study of that sort nature, the Delphi approach, as we said, it, it’s not an absolute substitute.

It’s never going to replace a, clinical study, a you know, a double blind, double dummy randomized study. It’s not going to replace that. It really does help where there are gaps in the evidence base, perhaps where we’ve got to all the pieces, but we haven’t yet been able to pull them all together. And we haven’t been able to get opinion if you like to coalesce around those pieces as yet. And so, in some ways, it, helps to fill those gaps where evidence is perhaps not the right thing to either duplicate or, or to tell in the first place. And, and the second thing is the time sensitivity of this, I’ve seen examples where Delphi’s been used to D develop data, if you like an opinion, which becomes data to support nice submissions around the burden of disease, for example, expert opinion that leads to evidence around burden of a disease.

For example. Now, obviously when we’re thinking about a nice submission, we have a time sensitive event that needs an, an outcome or, or the evidence accumulating ahead of that. So sometimes when time sensitivity is issue that would also lead me towards the Delphi approach. And of course, I mentioned earlier, it can be delivered pretty rapidly and, and, and reasonably inexpensively, if you think of about multi, multi, hundreds of thousands for a clinical study, you’re talking tens of thousands for, for Adelphia approach, low tens of thousands. Yep. And we’ve seen them delivered in as little as sort of three months from, from start to finish, which is great. There’s a number of other questions Nick, that have cropped up. And I know that we were respond via email to, to the people that have submitted them, but I think that’s probably about time for us to let everyone get on with their afternoons, to the audience out there.

If you would like to discuss this topic with us in any more detail in line with your own business goals, Nick and I would, would be more than eager to, to hear from you. There is a handout that’ll be available, and this webinar will be available on demand. And we can certainly make that available on our websites and the PFS website. Thank you again to everyone for joining us today, both PF and Triducive, I hope you’ve enjoyed this session and found value in participating there is feedback form. If you have two minutes to spare, it would be really appreciated if you’d be willing to fill that in for us, it helps us get better and to learn for the future. As I’ve said, we’ll make this video available on demand on our website shortly. So please feel free to let your colleagues know that it’s available if they’re interested and couldn’t attend today, but Nick, thank you, you very much for, for the time and, and clarity you’ve provided, and thank you to everyone for joining us for this and the previous webinars that we’ve enjoyed hosting. Have a good afternoon. Thank you very much.

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