In 2007, the pharmaceutical giant; Pfizer withdrew from the market only a year after launching the first inhalable insulin, making Exubera one of the biggest flops in pharma and the whole healthcare business.
I would like to use this example to support the thesis of using a proper VOC to identify customer needs and develop products to solve customer problems.
To make the point clear right from the beginning, I know that in hindsight, it is easy to find the weak points that were not identified or not fully considered during the development process.
Again, the aim of this example is not to criticize. But to bring attention to customer needs and discuss these critical elements in medical device development once more.
Brief Story Of Exubera
Pfizer Exubera, the first inhalable insulin, was supposed to become a blockbuster drug. However, the product didn’t solve customer problems- this is the main reason for the poor sales performance.
Let’s analyze the matter from the perspective of two main customers; the patient and the physician.
The Patient
For diabetic patients under insulin therapy, the multiple daily injections are the manifestation of the disease.
Therefore, Exubera could have solved the customer problem of the injections and the pain related to them.
Besides, since it was stable at room temperature, the storage was simplified compared to insulin injections.
More so;
- The current injection devices with the new needles are substantially pain-free, and the hurdle of the injection is minimal for most patients.
- Conversely, the inhaler of Exubera, designed to optimize insulin administration through the lungs, was definitively too big and cumbersome to handle. And not well accepted by the patients who require a discrete device.
- Using the inhaler in a restaurant or other public space drew a lot of attention from the bystanders to the diabetic patient.
- In addition, inhalation, especially of higher doses, was a time-consuming procedure. And the effort the patient will need to learn how to use the device properly was significant.
- On the other hand, the current injectors are easy to use, and administration of the dose is quick.
Finally, the unit of measurement: the insulin dose of Exubera was expressed in milligrams and not in international units, as for injected regular human insulin; this was another source of complexity and potential errors for the patients.
The Physician
For diabetologists, Exubera was not really solving a clinical need. The progress of insulin therapy and all the different insulin formulations available on the market made the injection a safe and easy-to-use form of insulin application for nearly all patients.
- The advantages of Exubera, seen as just needle less insulin, were not perceived sufficient to compensate for the disadvantages from the physician’s perspective.
- The costs associated to check the lung functionality of the patients regularly were clearly a limit to patients’ enrolment.
- The time and the effort required to explain the use of the inhaler device to the patients was hardly compatible with the clinical practice.
- The fact that it was impossible to select a specific dose adapted to the single patient due to formulation in blisters was another disadvantage.
- And lastly, a more expensive insulin that was not able to provide any substantial improvement on metabolic control compared to insulin injections was difficult to justify.
Although the flop of inhalable insulin is a combination of multiple causes; overall, I think it is a clear demonstration that products that do not satisfy customer needs won’t be successful.
What Is A Customer Need, And Why Is It Important?
There are several definitions and some controversies regarding customer needs.
However, it is not the purpose of this blog to explore the matter in detail and to take a position supporting one or the other thesis.
Different terms are used to define the customer needs, wants, requirements, benefits, motivations, goals, outcomes, jobs-to-be-done, and problems; though not 100% correct, I consider them synonyms.
According to Griffin and Hauser- authors of a landmark paper published in 1993 about the VOC: “a customer need is a description, in the customer’s word, of the benefit to be fulfilled by the product or service.”
This definition can be analyzed with the very simple 5W to find the key elements of customer need.
#1. What = The Benefit
The first component is the benefit, which is the element that brings value to the customer. In our business, the benefit is normally tangible and functional but sometimes could have an intangible and emotional component, also called psychological value.
For example, medical devices with the attribute made in Germany, or made in Switzerland bring psychological value to the customer. Thanks to the perception of high quality of the made in Germany/Switzerland brand.
#2. Who = The Customer
The second component is the customer, who is looking for a benefit to be fulfilled by the product or service.
Often, medical devices are sold to institutions (hospitals, etc) like in a B2B business. So, your customer is a combination of several individuals who may have conflicting positions regarding your product and may perceive its value in a very different way.
This additional complexity, compared to B2C, can make it difficult to understand all the customers’ needs, identify the most relevant, and where to invest limited resources for gathering the voice of the customer.
Creating a stakeholders’ map can help to identify the entire spectrum of customers.
Likewise, performing an analysis of the level of influence of each customer and if they can provide relevant information to influence product design.
#3&4. When and Where = The Context
The context is when and/or where the customer desires a benefit. Customer needs are not absolute but situational.
Meaning that the same customer can have different needs in different situations.
In the U.S, ENT surgeons perform some rhinology procedures in the OR and their offices. Therefore, the need for the same customer could be different according to the location.
In the OR, where he/she operate the more complex cases, the customer need is satisfied by a powered surgical system which comprises: multifunction console, a high-performing powered instrument, and a wide range of consumables, whereas in the office, a monofunctional console, a simpler and economical powered instrument with a limited portfolio of consumables, could better satisfy the customer need in this context.
A benefit only has value if it solves a problem for a customer in a given situation; of course, the context is not relevant for every medical device since the category is so vast.
#5. Why = The reason(s)
The last component is why the customer has a specific need.
The context helps to explain why a customer has a need. And why the benefit brings value and how that value may change as the context changes.
A customer buys a product or service searching for a benefit (what), and he/she believes the product will help fulfill his/her individual values (why).
Why Is It Important To Discover Customer Needs?
The example of inhaled insulin Exubera demonstrated that not recognizing customer needs can be very harmful. And that even big companies with plentiful resources can make mistakes and underestimate the importance of uncovering customer needs through a solid VOC study at the “Fuzzy Front End.”
In my opinion, successful new products are rarely the result of pure science, technology, and inspiration.
Companies that make the voice of the customer (VOC), the foundation of their new product/service development process, understanding who needs what, where, when, and why have more chances to be successful.
And not because they will come up with more innovative and technological solutions, but because they will solve the right problems.
For more information on what you can do to avoid common pitfalls in medical device development, subscribe to this blog and let me know your thoughts.