When ‘Good Enough’ Becomes the Enemy of Bette

A specialty biologic was in-market with a well-recognized convenient dosing regimen and strong clinical credentials. But uptake remained significantly below the clinical opportunity the patient population represented. High disease burden was coexisting with low treatment escalation in ways that defied simple explanations.

The brand team needed to understand precisely where and why patients were falling out of the biologic journey. Was it a brand awareness problem? A physician gatekeeping problem? A patient complacency problem? An access problem? A rigorous funnel analysis, grounded in the real patient experience, was required to move from a general sense of undertreated patients to a commercially actionable map of leverage points.

The Challenge

CONTEXT

Specialty biologic in-market with a recognized convenient dosing regimen and strong clinical credentials
Biologic uptake meaningfully below the clinical opportunity the patient population represented
High patient disease burden coexisting with low rates of treatment escalation
Brand team lacked a specific diagnosis of where in the journey patients were falling out
Multiple plausible barrier hypotheses — awareness, access, physician gatekeeping, patient complacency — required direct testing

Our Approach

RESEARCH OBJECTIVES

01
Identify and quantify the specific points in the awareness-to-treatment funnel where patient intent fails to convert into action
02
Distinguish between patient-driven and physician-driven barriers to biologic uptake, and understand the relative size of each
03
Profile the behavioral and attitudinal characteristics of patients most likely to initiate treatment conversations and request a specific brand

Shapiro+Raj fielded a 20-minute quantitative online survey with 125 patients in an autoimmune condition, designed explicitly as an awareness-to-purchase funnel analysis with barrier mapping at each stage.

Rather than measuring awareness and familiarity in isolation, the research mapped specific drop-off points where patient intent failed to translate into treatment action — distinguishing between patients who had never discussed biologics with their physicians, those who had discussed but not requested a specific treatment, those who had requested but been declined, and those currently on biologic therapy. Each stage was analyzed separately to identify whether the problem was awareness, motivation, physician gatekeeping, or access friction.

The research also profiled the behavioral characteristics of patients who had specifically asked about the featured brand providing a precise portrait of the most commercially valuable patient archetype and enabling the brand team to design targeted activation around the profile most likely to drive uptake.

Insights Delivered

KEY FINDINGS

High patient satisfaction and recurring disease activity were coexisting in the same population. The market was stuck not because of contentment, but because patients had normalized a level of burden that should have been driving escalation.
The funnel was not breaking at awareness. Most patients had moderate-to-high familiarity with biologic options. The primary break point was physician non-recommendation and low patient activation before the physician conversation.
Brand awareness for the featured biologic was real but shallow. The convenient dosing regimen was the strongest awareness cue, but dosing convenience alone was not converting into treatment requests.
Four directional behavioral patient segments emerged: those who actively research and request; those who defer to physician initiation; those who need specific clinical proof before escalating; and those held back primarily by access and cost friction.

Strategic Impact

The research produced a prioritized recommendation framework targeting each of the identified break points in the funnel.

For the satisfaction paradox: the recommended positioning direction moved away from disease control as the primary frame and toward what unresolved disease activity was actually costing patients over time. Reframing the relationship between apparent stability and ongoing clinical risk was identified as the most powerful behavior change mechanism for the complacent middle.

For patient activation: the research identified a specific behavioral intervention approach equipping patients with tools to recognize incomplete disease control before their physician appointment. The patients most likely to request escalation were those who arrived at appointments already having identified a reason to have the conversation.

For physician gatekeeping: the recommended strategy centered on a parallel HCP education investment clarifying the patient profile for whom escalation was most appropriate, supported by peer-endorsed clinical case experiences to build prescriber confidence.

The access friction finding produced a specific patient support program brief: pre-emptive navigation tools that reached patients before the first barrier, rather than after it was encountered.

KEY DELIVERABLES

Awareness-to-purchase funnel analysis with drop-off quantified at each stage
Barrier mapping by funnel stage — distinguishing patient-driven from physician-driven barriers
Patient behavioral segment profiles with directional activation implications
Brand awareness and familiarity assessment with cue-level diagnostics
Prioritized strategic recommendation framework across four identified break points
Patient support program brief addressing access and logistics friction

The satisfaction paradox was the most important finding. Patients were adapting to disease activity that should have been driving escalation. That’s not a contentment story — that’s a category education challenge. And it changes how we think about the entire campaign.

Biologic uptake challenges in autoimmune disease rarely have a single cause. Talk to us about funnel research that identifies precisely where — and why — patients are falling out of the journey to better care.