Mike Rea

IDEA Pharma

When you're building with Meccano (or, if you're American, your Erector Set), you learn early on not to tighten every bolt until the whole structure is together - once one is tightened, the room for manoeuvring the other pieces into place is diminished significantly. If, even further, people who didn't talk to each other offered up pre-built pieces of a whole model, just imagine how that might look.  IDEAs are the same - once you've decided on, and tightened, one bolt, such as your target patient, you don't have enough flex left to put it all together comfortably.

So, one might think that pharma companies, with the complexity they need to engage, would be careful not to lock something in before the rest is ready. However, the increasing “siloing” (apologies for the awkward verb…should it be silage?) within larger companies now seems increasingly to be leading to just such behaviour. Things like price, phase III comparator, or the sales forecast, are being handed around as faits accompli, and then bolted together as a 'strategic plan', even though they don't fit.

The logical flaw in the situation is this: solo within a silo, unable to see what everyone else is doing, you are forced to guess (or presume) what the other silos need of you, or to guess what it is that they know that you need to know. And, if you knew it all already, or were capable of going it alone, those other silos wouldn't really be needed…

So, the Pricing people do the pricing research with an early (not yet set) product profile, and deliver The Price. The Analytics group do the forecast model, and deliver The Forecast. The clinical group deliver The Clinical Plan. And so on. And then it is all bolted together, whether the pieces fit or not. Then someone has to go sell whatever is left.

Silos ignore the basic interdependency that is critical to pharma - the tiny, but critically important, details that are worth sharing - after all, how do you know that the subcut analysis detail that you left out of your deck when you were preparing your 10 punchy, pithy slides weren't of huge potential importance to the Market Access team? Interdependency is the enemy of the silo. Unfortunately, interdependency isn't likely to go away any time soon.

"Interdependency is the enemy of the silo. Unfortunately, interdependency isn't likely to go away any time soon."

I recall one presentation (we'd made the whole project team meet, and structured a proper share session) where the Clinical Lead (CL) showed an ordinary looking chart on trial recruitment, among a few other slides. Just before she clicked forward, someone asked what they thought was just a clarifying question - what is that dotted line at the top right?

CL: “That? That means the trial is recruiting faster than we thought.”

Other: “And what does that mean?”

CL: “It means that the study will be completed 6 months earlier than we thought.”

Other: “So, we could be able to present the results at AHA?”

CL: “Yes, no reason why not…”

Other: “Why did you not mention that earlier?”

CL: “I did. I sent this slide around on an email last month…”

Just a small example, but it did have a massive impact on the ability to pre-empt a competitor at the American Heart Association (AHA) meeting, and a whole bunch of other things - no-one else in the room had understood that detail, yet everyone was impacted by it. And it is repeated, in essence, thousands of times each day around global pharma.

It is so easy to forget that providing information isn't the same as sharing, and that vertical reporting (up the reporting line) isn't the same as providing knowledge to people who can do something with it. Sending a chart to the team on email doesn't really allow the team to understand fully, to ask the ‘What Ifs’, or probe the ‘So Whats’, that count.

Versus ten years ago, maybe even five, large pharma has relied increasingly on an oracle model, where line managers are scrutinising the work done within the silo, and so on, until a senior exec listens to it when put together and scratches their head. Unless those execs can see right through what they're looking at, and are able to fully interpret what else they might have seen instead, mistakes will be made.

With so many badly-built Meccano models failing in phase III, and 3 out of 4 of them failing to repay their investment even when on the market, the silo must surely be reconsidered as a bad idea, and busy-ness as probably unproductive.

About the author:

Mike Rea is a Principal with IDEA Pharma, who enjoys taking a look outside the industry to learn how it can think differently. For direct enquiries he can be contacted on mike.rea@ideapharma.com and for more information on IDEA Pharma please see http://www.ideapharma.com/what/default.htm.

The next WAIMO piece will be in a couple of weeks.

Are there still too many silos within pharma?