2025年3月23日日曜日

(3) Pts journey : Qualitative research, dr interview

Insight based Brand Plan

Web searches and desk research allow us to create a rough qualitative and quantitative pts journey.  Quantitatively, I need to know things like “I don't know how many hay fever patients actually go to the hospital every year,” but qualitatively, “Isn't this what doctors think when they select a drug?” “Isn't this why patients don't go to the hospital when they have hay fever symptoms?” I think that many hypotheses like these have emerged.

Once you've reached this point, it is time to conduct pts journey research (qualitative, quantitative) on product X. You may conduct pts journey market research without creating a hypothesis through web search or desk research, but it is better to organize what you know, what you don't know, and what you want to know in advance (I recommend organizing them in Excel in the form of a logic tree). It is better to organize what you know, what you don't know, what you want to know, etc. in advance (we recommend to summarize them in a logic tree format in Excel) so that the purpose of the research will be clear. As with any market research, “brainstorming and identifying what you want to know before the survey” and then asking about it in a qualitative survey is just throwing a list of things you want to know to the doctor-patients to be surveyed, which is not recommended because it will not allow you to dig deeper into the survey and will leave out many things.

Now you are ready to SoW to market research agencies by informing,
  • Research objectives
  • Research subjects
  • Number of people surveyed
  • Interview time
  • Research schedule
Here is the example of product X
新製品Xの場合はこんな感じ

調査目的
  • To know in depth about the true feelings of each moment of the doctor-patient hay fever treatment and antihistamine administration along the pts journey.
Surveyed, number of people
  • Physicians who prescribed antihistamines to 5 or more patients with hay fever (8 patients)
  • Patients taking antihistamine prescription medication for hay fever (5 persons)
  • Patients not taking prescription medication for hay fever (5 patients)
I feel that with this number of people, commonalities will become apparent and new discoveries will not be made if the number of people is increased further. We will discuss this with the survey company.

Interview duration
Ideally, the qualitative survey should be completed in 60 minutes, but the pts journey survey is longer, so 90 minutes is recommended.

Schedule
Let's say you submit a quote on April 1, this is typical schedule
Early April:  estimate → research agency decision, place order
Late April:  discussion guide finalized
Mid-May: interview 
Early June, delivery of transcription
Mid-June, delivery of report

After the quotation was received, the research company was selected and the survey form, or rather, since it is a qualitative research, the creation of the survey form, which is variously called a discussion guide, an interview guide, or I read it as a discussion guide.

I often say, “Our goal is to capture the customer's brain deep inside.” How far do we go to extract the customer's true feelings without bias? It is important to find out how much of the customer's true feelings you can get out of them without bias. So, in the case of the pts journey survey physician survey, I think the major flow is something like this.

Warm-up（5 minutes）
Time to chat and icebreak, including physician specialty areas

Hay fever （5 minutes）
  • Why I came to treat hay fever
  • Level of interest in hay fever treatment and antihistamines
Doctors in internal medicine, otolaryngology, and various other medical departments probably treat hay fever outside of their specialty and prescribe antihistamines, but first we ask them why they do so “unassisted” and “as the doctor says” without bias. Once we have heard all the reasons, we ask, “Why are you treating hay fever even though you are not a specialist in this field?” We will dig deeper. In research terminology, this is called probing.

From here, it is finally time to ask questions along the pts journey. In the case of the physician survey, we will ask what we want to ask around “diagnosis,” “treatment,” “brand choice of antihistamine,” and “continuation of medication,” in order, non-subsidized to subsidized.

Hay fever diagnosis（10 minutes）
How is hay fever diagnosed? (start from unaided Q)
Hypothetically, if I see rhinitis and itchy eyes during the cedar pollen allergy season, I diagnose hay fever as is, and I'm not particularly troubled by it, although I'm not sure.

Hay fever treatment（10 minutes）
It is useful to use presentational material that makes it easier for the physician to answer and make a real statement rather than asking vaguely “What kind of treatment are you doing here?” in this case, prepare Q-sheet something like this, 

Please tell us about your treatment of the last 10 patients who came to your clinic for hay fever

Prescribed some kind of prescription medicine (   )
Prescribed nasal drops (   )
Prescribed eye drops (   )
Prescribed oral medication (   )
Prescribed antihistamines (   )

and ask the reasons for using this drug therapy.  I will also focus on “Why did you prescribe an antihistamine (instead of another drug)?” I will ask mainly “Why did you prescribe antihistamines (instead of other drugs)? Since I believe that antihistamines are the standard of care for hay fever and the direct competitor to Product X is an antihistamine, I may not deep dive too much here.

Brand choice（20 minutes）
I will break down the “number of antihistamines prescribed” further and ask them to break it down by Brand and ask why they prescribed that Brand (first unaided → then aided).  After that, I would like to ask for more details about each brand, "
What are the differences in safety and efficacy within antihistamines?"  .If you don't get many answers, that means that you haven't thought much about the difference in safety and efficacy within antihistamines, and you're not interested, so you may show profile of each drud as aided information like this and deep dive.



Adherance （5 minutes）
Since cedar and cypress hay fever occurs in March and April, many patients come to the hospital once or twice to receive medicine and that's it.
  • How long do you come to the hospital for hay fever?
  • How many days' worth of medicine is given?
  • What is the reason?
I ask them what they want to confirm. So far, it took 55 minutes, and I thought, “Hmm? If this is the case, shouldn't the interview time be 60 minutes instead of 90 minutes? However, since it was a good opportunity, I showed them the product profile of the new product X and asked for their reactions, so that I could keep some “Insight = Current perception” of their true feelings toward the product X, which I would use to create the Desired perception (≒Current perception) and the Positioning (≒Positioning). It will be more useful to have some information at this stage so that you can visualize the Desired perception (≒ positioning) to be created in the future, strategies to fill the gap, and actions to be taken.

Product X profile → Drs' response → Rx intention (30 minutes）
In early stages, we often show very simple product profile like;

Mode of action: Antihistamine
Dosage and administration: Once a month (one dose lasts for one month)
Indication: allergic rhinitis (same as many antihistamines)
Safety and side effects are similar to those of Zyzal
Price per day is 100 yen (patient's co-payment is 30 yen per day at 30% of the cost = about 900 yen per month)
*Reference: Vilanoa = JPY61.9, Desirex =JPY51.7, Lupafin = JPY54.9 (as of April 2022)

"What did you think of these products when you saw them?” And here again, we first ask for spontaneous physician statements. What in particular caught your attention? I want to take my time here.

After asking a few questions, the next step is to present again the sheet that you filled out, “Person (A) for whom you prescribed antihistamine,” and ask, “Would you switch these patients to this product X when product X is released?” and first check how many people will be on product X. There may be various patterns, such as doctors who switch all patients, doctors who switch some, doctors who do not prescribe Product X at all, etc. What is important is not the number, but rather the reason for prescribing Product X to those patients.
  • Why did you want to prescribe Product X to those people?
  • What were the reasons for those who did not switch to Product X?
We will dig deeper until we find out the true prescribing Driver/Barrier of Product X.

To go one more deep dive, it is also effective to create a presentation material like this to get a reaction by presenting “comments from physicians who actively prescribe product X”.

It is important to think qualitatively about the preliminary coarse pts journey in order to create this kind of presentation material, otherwise it cannot be made. I think it is easier to get the doctor's thoughts if you ask for his/her opinion spontaneously first by saying, “The doctor who actively prescribes says this...” and then ask for his/her opinion like, “I agree with this part, I disagree with this part, and the reason for that...

Take the opposite “comments from physicians who do not immediately prescribe product X” as well. It is better to hear both sides of the Pros/cons here.


By showing this, the physician may notice concerns that were not noticed when looking at the product characteristics. Here, for example, it might be, “If the product is effective for one month, the side effects will also last for one month, and I'm afraid of the side effects, so I won't prescribe it.

After asking this much, I ask one last time, “How many of your 10 patients would you ultimately administer Product X?” and ask why. I think that this would be a good way to get something close to the actual prescribing intention after the product is launched, since the prescribing intention is based on an understanding of the Pros/Cons of product X in the form of other physicians' opinions. (This is a qualitative survey, so I am not asking for that.)

(I'm not asking for that, but it is a qualitative survey. Therefore, it is necessary for the interviewer to input the questions that I have written here and the hypotheses behind them. In the past, when I have conducted complex research, I have sometimes secured an interviewer (for a fee, of course) for a day to explain the pts journey, hypotheses, and even to conduct a role play of the interview.

I think that most of the failures in qualitative research can be avoided with the above preparation.

However, it is very important to secure a good interviewer because the interviewer's quality and fit may not be perfect. (Some of them are freelancers.)

The article has become long just for the pts journey survey of physicians. Next article will be the patient survey.
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