The Challenge
A new epilepsy therapy entered a crowded market with highly differentiated clinical results, including compelling seizure-freedom data.
Yet adoption among some sophisticated epilepsy centers did not appear consistent with the strength of the clinical evidence.
The important question wasn't whether the clinical data were strong.
It was why strong clinical data weren't translating into expected market behavior.
Look at the Market, Not Just the Clinical Trial
Clinical trials tell us whether a drug works. Study investigators provide invaluable insight into the disease, the patients and the clinical evidence.
But that doesn't necessarily tell you how the market will behave after launch.
The analysis therefore started with the market—particularly the non-adopters.
What distinguished centers that were not adopting an apparently differentiated therapy?
Patterns of adoption were considered alongside other indicators of how difficult-to-control epilepsy was actually being managed.
A potentially important pattern emerged: the real competitive pressure might extend beyond other anti-seizure medications.
The Insight
At sophisticated epilepsy centers, pharmacotherapy exists within a broader treatment environment that can also include neurostimulation and surgery.
The competitive landscape therefore looked different:
Pharmacotherapy → Neurostimulation → Surgical Evaluation
The commercial question changed from:
Why isn't the physician choosing this drug?
to:
Where does another pharmacologic option fit for patients who continue to experience seizures?
That focused attention on an important population: patients who remained uncontrolled but were not currently proceeding to neurostimulation or surgery.
The Strategy
The resulting strategy acknowledged the legitimate role of advanced interventions while focusing attention on this unresolved patient population.
The conversation moved beyond promoting another medication and toward understanding the patient's treatment journey.
The analysis also identified an evidence opportunity: HEOR research examining the clinical and economic value of seizure freedom within the broader treatment pathway.
The Commercialization Lesson
Clinical development tells you what happened in a controlled study.
Commercial strategy has to determine what is happening in the market.
When clinical differentiation isn't producing expected adoption, look beyond the traditional competitor set. Examine non-adopters, treatment pathways, institutional behavior, access barriers and alternative interventions.
The market may be telling you something the clinical trial cannot.
About Joseph McCoy
Joseph McCoy is Founder and Principal Consultant of PharmaKonsult and an executive commercial strategy advisor with more than three decades of pharmaceutical and biotechnology commercial leadership experience across neuroscience, rare disease, endocrinology, institutional healthcare and specialty pharmaceuticals.
