Professional Documents
Culture Documents
Pramod Kumar is a bright young management graduate, who joined Novartis and has successfully
completed the two years Graduate Leadership Development Program. The program provided
him with invaluable learning experience about the Industry and the way Novartis functions,
through structured stints in sales, marketing and a cross-functional exposure coupled with an
international experience for six months. Now, he has joined the Dermatology portfolio which is
working on the launch of a new research molecule of Novartis. He has been able to closely
observe what this treatment could bring about to the lives of patients. He is excited to work on
the launch that is going to set a new standard of care (SoC) in the treatment of psoriasis and will
redefine treatment outcome form a physician and patient’s perspective.
Disease
Psoriasis is a chronic disease that can negatively affect a patient’s life, both physically and
emotionally. Psoriasis is a common dermatological condition that affects 1–2% of the population,
20–30% of whom have moderate-to-severe chronic plaque psoriasis. Having psoriasis can be
embarrassing, and many people, avoid swimming and other situations where patches can show. It
can severely impact day to day Quality of Life (QoL) of the patients. Psoriasis prevalence
estimated is 1–2% of the population (~125 Mio suffers worldwide). It is categorized into mild,
moderate and severe.
https://www.youtube.com/watch?v=QL1X4SaJh_w
https://www.youtube.com/watch?v=tsHq8f9OLCQ
Psoriasis patients may have to go through a cycle of uncertainty and disappointment following
the appearance of their first symptoms. They are now well aware that it is a chronic condition,
and move from doctor to doctor seeking for a solution and symptomatic relief.
Patients may see doctors at different levels of healthcare, family doctor, and then to
dermatologists, and there are many instances of trying out Ayurveda and Homeopathy.
Typically, the early treatment entails application of creams such as topical corticosteroids,
Moisturizers and Vitamin D analogues.
As the disease progresses, most of the patients don’t get relief by topicals (creams) and
they are put on oral first line systemic treatments.
Further, there are Drugs that alter the immune system (biologics). Several immuno-
modulator drugs are approved for the treatment of moderate to severe psoriasis. They
include etanercept (enbrel from Pfizer), infliximab (Remicade from J&J), Alzumab from
Biocon etc. Their administration varies with remicade and alzumab being given as
intravenous infusion and enbrel being given subcutaneously. Dermatologists use these
injections usually for people who have failed to respond to traditional therapy or who have
associated psoriatic arthritis. Biologics work by blocking interactions between certain
immune system cells and particular inflammatory pathways.
A PASI score is a tool used to measure the severity and extent of psoriasis (Psoriasis Area and
Severity Index). In practice, treatment methods are compared on the basis of improvement in the
PASI score.
Also in India most of the doctors are using the method of calculating the BSA (Body Surface Area)
% for diagnosis of mild, moderate and severe cases of psoriasis.
Additionally, Dermatology Life Quality Index (DLQI) used is a simple self-administered, easy
and user-friendly validated questionnaire used to measure the health-related quality of life of
adult patients suffering from a skin disease. The questionnaire requires the patient to answer
Over the last week, how Over the last week, how
itchy, sore painful or embarrassed or self-
stinging has your skin conscious have you been
been? because of your skin?
Current Scenario (therapies do not sufficiently address needs and lead to a high level of patient
and physician dissatisfaction):
Studies indicate that, Dermatologists are dissatisfied with current treatment outcomes in about a
third of cases and 41% of patients are dissatisfied with their current level of disease control. The
following table summarizes the research findings from different stakeholders
Fareto has shown excellent promise in clinical trials as against current Standard of Care (SOC) in
biologics treatment. With Fareto the patients can achieve clear or almost clear skin. On PASI
scale Fareto will provide significantly better results than current available treatment options.
Meaning of DLQI Scores (0-1 = no effect at all on patient's life I 2-5 = small effect on patient's life I
6-10 = moderate effect on patient's life I 11-20 = very large effect on patient's life I 21-30 = extremely
large effect on patient's life).
Looking at all this, Pramod feels very excited and energized; he believes that it is a very
interesting time wherein the power of research will soon transform the lives of psoriasis patients
and the treating physicians will be empowered with a product that can truly make a difference in
the lives of these patients.
So here is a great opportunity to prepare a robust launch strategy for Fareto by addressing the
pivotal questions like:
What should be the key strategic drivers for Novartis to keep in mind while preparing to
launch the drug?
How does Novartis establish the higher standard of care being delivered by Fareto, in the
minds of physicians and patients?
What would be the best ‘Go to Market’ approach for Fareto?
For proper efficacy of Fareto, strict adherence to the required dosage will be required.
How can proper compliance among the patients be ensured?
Pramod has been asked to share his version of launch plan for Fareto with a cross-functional team
in two weeks from now.