By Karen Wilson, Diane Donald and Dave Johnson

The business of marketing pharmaceutical and medical device products is evolving. Prescribing decisions are influenced by a much broader array of stakeholders than in the past. At the same time, managed care and hospital payment systems are becoming more structured and complex. And overarching these trends, the pace of doing business in all industries has increased.

As business issues become more complex, innovative approaches to market research are needed to uncover the insights that can drive product adoption and utilization. Traditionally, qualitative market research has been characterized by one-on-one interviews or focus groups. The innovative approaches described in this paper go further, finding unique ways to bring stakeholders together to interact and engage in revealing dialogs. Using these market research techniques, marketers will discover new ways to affect behavior, overcome barriers to adoption, and develop creative materials and messaging that get results.

Group Revolution

With patients playing an increasing role in treatment decisions, the Group Revolution concept provides a technique that brings physicians and patients together for a unique and insightful discussion. Established by advertising agency GSW Worldwide, Group Revolution is a proprietary qualitative focus group method that enables market researchers to focus on dialogs. While patients/physicians are the most common participants in the Group Revolution scenario, many other dialogs could be worthy of exploration, such as surgeons/anesthesiologists, physicians/sales reps, or pharmacists/patients.

In the typical scenario, physicians are gathered at a traditional focus group facility and prompted to discuss a particular product or healthcare topic. At the conclusion of their discussion, the physicians are taken behind a one-way mirror to become observers as a focus group of patients are brought into the facility to discuss the same topic. The market researcher is afforded the opportunity not only to observe the patients’ interaction but also to observe the physicians observing the patients. Finally, the exercise concludes with the physicians coming back from behind the mirror to join the patients in a free flowing discussion.

The Group Revolution exercise helps market researchers discover discontinuities in perceptions, attitudes, and behaviors among respondent segments and develop hypotheses regarding how these discontinuities might be bridged to the advantage of clients. Researchers are able to explore how most decisions are joint decisions and reveal these dynamics in exciting ways. The exercise fosters a deeper understanding of the values, beliefs, and attitudes of physicians and their patients, or other divergent parties.

For example, the research could potentially be used to uncover ways in which physicians may label patients that can derail a productive dialog. The research can also identify serious symptoms that patients admit they don’t always report to physicians. This would allow the market research team to offer recommendations on ways to enhance the dialog that capitalizes on patients’ lack of awareness of symptoms and treatments, giving clients the insight needed to develop relevant communications that enhance the patient/physician dialog.

Advancers and Blockers

Typically done in a traditional focus group setting, the Advancers and Blockers market research method is best suited for developing strategies for new product or program adoption in hospitals or similar organizations that have multiple levels of approval.

Through the Advancers and Blockers technique, companies can map out the "buying chains" within an organization for a product or program that will either encourage or discourage adoption and uncover barriers to introducing products into hospitals or other multi-level organizations. The qualitative focus group method acknowledges the idea that incorporating new products into hospital protocols involves numerous departments and stakeholders. Surgeons, for example, exert significant influence on the surgical devices a hospital buyer will choose to stock and the administration will choose to fund.

The Advancers and Blockers market research technique involves multiple stakeholders working in teams to understand how the product adoption process works within large organizations. The decision makers themselves are encouraged to brainstorm ways in which barriers can be

overcome as well as help discover ways to support champions. The market researchers can then develop hypotheses regarding how champions might be encouraged to the advantage of their clients’ products.

Past research has consistently shown that opposing forces frequently exist within organizations responsible for adopting new products or systems. Therefore, recruiting appropriate representatives is an important first step for the success of this method. Once underway, the initial discussion is meant to gather basic information about roles within hospitals. It is similar to a traditional focus group.

Next, respondents are divided into opposing teams: one devoted to advancing a new product/ program, and one devoted to blocking it. Teams are then asked to "present" to one another, debate product merits, and physically "draw" what the adoption process would look like within the organization.

Because of the variety of participants and status levels, it is important to have a qualified moderator manage the group dynamics. The more advanced moderator will be able to manage the workshop style of this group, including brainstorming and team presentations. It is useful to take a workshop tone while using this technique since respondents will be teaming up and brainstorming in the breakout sessions.

As an example, a top-tier medical device company in the beginning phases of launching a new surgical product recently used the Advancers and Blockers technique to better understand the hospital approval process. CEOs, surgeons, nurses, and P&T committees were all believed to play roles, but the roles were undefined. Therefore, the market research exercise was intended to reveal the "chain of influence."

The market research team conducted multiple role-playing workshops in which key influencers at the hospitals (e.g., CEOs, nurses, surgeons, P&T members) were divided into opposing teams: one devoted to advancing the product, and one devoted to blocking the new product. Teams presented to one another to debate the scenarios and physically "draw" the adoption map.

The result for the client company was a greater understanding of multi-stakeholder decision making. The research team provided a detailed report outlining the inter-relationships among groups with specific "tactics" devised by each. The researchers were also able to explore the contrasting decision processes of small vs. larger hospitals and to provide highlights of beliefs and behaviors needing modification to favor new product adoption. The client gained the insight needed to begin to develop a relevant and persuasive launch plan.

Patient Education Simulation

Patient Education Simulation is a qualitative focus group method that simulates a physician office setting in which a healthcare provider and patient simulate an actual appointment. This allows a pharmaceutical marketer to see its materials in action in order to test the usability of a patient education program in its early stages in terms of both design and content.

From a content perspective, the research technique reveals which portions of an educational brochure physicians tend to use the most and whether there are images or sections that seem to help patients better articulate questions to the physician. It also shows what, if anything, is confusing or discredited by the physician as he or she uses the materials during the simulated discussion.

From a design perspective, the Patient Education Simulation shows how physicians might plan to store and use the item(s). Marketers will also get insight into what format is the most appropriate (e.g., spiral bound, a pocket folder).

Patient Education Simulation is appropriate for companies that are in the early stages of materials development. Unlike a one-on-one interview with either a patient or physician, this method shows how the materials might actually be used during an appointment.

Gallery Review Research

Established by GSW Worldwide, Gallery Review is a proprietary qualitative focus group method that enhances creative development by allowing respondents to evaluate materials that are set up as though at an art gallery on easels or TV monitors. This technique can be used with rough mood boards, initial print sketches, or TV animatics to help pharmaceutical and biotechnology companies and their advertising agencies adjust very early creative ideas by discovering reactions to strategy, execution, and messaging.

The Gallery Review is an affordable first step leading up to formal testing, quickly getting the reaction of 10 to 20 respondents in a matter of a few hours. Gallery Review is appropriate for clients that are in the early stages of creative concept development, helping them get a sense of whether they are headed in the right direction with their creative ideas. This method is not in-depth concept testing, which is typically a one-on-one, rather than group, approach.

Online Research

Online market research methods are most appropriate when recruiting is particularly difficult, such as with rare diseases, widely disbursed patient populations, or extremely busy respondents. They are also advantageous when anonymity is useful, such as when dealing with competitors or sensitive topics.

Online chat, Webcams, and video diaries are three tools that bring a new dimension to market research. These Internet-based techniques can be used to overcome common research obstacles like travel costs, recruiting, and allowing respondents to be anonymous.

The prevalence today of texting and IM communication makes online chat feasible for nearly all respondent types and is ideal for sensitive health topics. Online chat is fast-paced, providing an abundance of insights in a very short amount of time, and because it can be anonymous, chat participants tend to be very frank in their responses.

Webcams, meanwhile, offer the ability to see the respondents’ reactions, and this method does not have the travel costs associated with in-person interviews. Webcams can be used with individuals or with a group. Because the respondents are at home, some elements of "ethnography" can come into play.

Video diaries also have an element of "ethnography" about them because they are typically filmed at home. They are another powerful way to observe respondents in their "natural habitat" without disrupting the environment by sending in an ethnographer. Inexpensive disposable video cameras are easily shipped to respondents, or they can use their own home video device.


Whether it’s bringing people together online, in a multiphase focus group, in a simulated physician office, or even an art gallery, these innovative approaches to qualitative market research are all about listening to and observing the broad array of stakeholders who impact prescribing and product adoption decisions in today’s healthcare environment. In this complex and evolving industry, new and innovative approaches are needed to reach market insights that lead to more effective and stronger creative brand messages.