Diagnosing the Barriers That Shape Adoption

The Challenge

A global pharma company had pivotal data showing meaningful survival benefit in inoperable early-stage lung cancer, but the pathway had never been designed with systemic therapy in mind. Surgery dominated. Radiation was a tolerated alternative. The idea of combining immunotherapy with radiation in early-stage disease was outside the frame of reference for most treating physicians.

The brand needed to understand — across four healthcare systems — who controlled decisions, where the pathway could be entered, and what would have to change for the new approach to become a standard of care.

CONTEXT

Surgery was the default treatment assumption in all four markets.
Radiation was a tolerated second choice, not a curative equivalent.
Systemic therapy had no established role in early-stage disease.
Four healthcare systems with different specialist hierarchies and MDT norms.
No cross-market framework for HCP targeting or pathway entry points.

Our Approach

Two sequential phases: individual depth first, then cross-specialty group dynamics. Phase 1 was 36 in-depth interviews (60 min) with Specialist Physicians across the US, Germany, France, and Japan — chosen for maximum variation in healthcare infrastructure, screening norms, and specialist hierarchy. Japan required a specialty-adapted design.

Phase 2 brought the same cohorts into cross-specialty focus groups (90 min) per market to surface how decisions are actually negotiated in multidisciplinary settings. The target product profile was introduced in Phase 2 to map specialty- and market-level reactions, define the ideal patient profile, and identify the strongest and most fragile adoption entry points.

RESEARCH OBJECTIVES

01
Map the treatment pathway across four markets. Who controls key decisions and where the pathway can be entered.
02
Identify structural and behavioral barriers to adoption by market and specialist type.
03
Define the ideal patient profile and a differentiated engagement strategy by specialist role.

Insights Delivered

KEY FINDINGS

The pathway was organized around surgery in every market — a bias embedded not just in treatment choices, but in how patients were classified and how MDTs functioned.
Entry points existed but varied by market. Medically inoperable patients and those declining surgery were the clearest near-term opportunity; a broader population required clinical legitimization first.
Structural diagnostic barriers — not physician preference alone — limited systemic therapy eligibility, with meaningful variation across markets in when and how tissue confirmation was pursued.
Specialist reactions to the clinical data were sharply differentiated by role, with receptivity, skepticism, and practical concerns distributed unevenly across the HCPs controlling diagnosis and treatment selection.

Strategic Impact

The findings became the organizing framework for global launch preparation. Five leverage points — spanning screening engagement, diagnostic awareness, MDT access, patient population legitimization, and radiation therapy positioning — were mapped directly to commercial and medical affairs workstreams by market.

The ideal patient profile gave the team a common language that aligned commercial, medical, and market access planning. A one-size-fits-all messaging assumption was replaced with a differentiated engagement strategy by specialist role.

KEY DELIVERABLES

Global Treatment Journey Map across four markets
Leverage Point Framework linked to commercial and medical affairs workstreams
Ideal Patient Profile synthesized across specialties
Specialty-Specific Adoption Landscape by role and market

This research didn’t just tell us where the barriers were — it told us why they exist and whose job it is to move them. That kind of clarity across four markets is rare.

Treatment journey research is most powerful when it maps not just what happens — but why the pathway is built the way it is. Talk to us about your next landscape or pre-launch study.