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HELP PHARMACEUTICAL INDUSTRY TO BUILD MEANINGFUL
PERSONALIZED HEALTHCARE PROFESSIONAL EXPERIENCE:
THE APPLICATION OF THE BRAND LEADERSHIP CIRCLE TOOL TO
OPTIMIZE AND INNOVATE ACROSS THE VALUE CHAIN AS PART OF A
SUCCESSFUL BUSINESS MODEL
Amilcar Barreto1
António Pé-curto2
Gillian Tachibana3
Luigi Lavorgna4
Pedro Gouveia5
Elisabetta Maida6
Conceição Sousa7
Rui Pedro Melo Lopes8
Pedro Joel9
Patricia Bela Cardoso10
Eduardo Ribeiro11
1 PhD(c) Universidade Católica Portuguesa
2 PhD Instituto Universitário de Lisboa ISCTE-IUL
3 MsC Université Geneve
4 PhD, MD in Neurology, Universitá di Napoli
5 PhD, MD Breast Surgeon Universidade Nova de Lisboa
6 MD in Neurology at Università degli Studi della Campania “Luigi Vanvitelli”
7 MD in Gastroentrology Universidade Nova de Lisboa
8 MD in Sport Medicine Universidade do Porto
9 MBA Universidade Moderna
10 PhD(c) Universidade Catolica Portuguesa
11 Paediatrics Universidade Nova de Lisboa; Master in Pharmaceutical Medicine at Universida-
de de Aveiro
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Norberto Guerra12
Joana Lopes Camilo13
Ines Moital14
Hugo Pedrosa15
David J. Pinato 16
Rita Santos17
Abstract: Unlike the consumer industry, biopharma, medical technology, and wellness companies have
struggled to build meaningful, personalized patient and healthcare professional (HCP) experiences.
The increase in drug launches and growing competition across therapy areas has made it challenging
for brands and organizations to stand out from the crowd, whether for new molecules vs. legacy brands
in an established treatment area and their generic counter-parts or for new molecules in a rare disease
where trust is not yet earned. The customers’ needs and preferences are changing at lightning speed.
The hierarchy of engagement has transformed, disrupting the dynamic between patients and healthcare
professionals. Studies (1, 2) show that drug marketers too often turn various aspects of their product
prole into signals – and may inadvertently “reinforce the habitual behavior the marketer is trying
to change”. We encourage pharmaceutical companies to use a “data-driven approach to uncover new
opportunities for growth” and improvement, and we’re committed to delivering results that make a
dierence for the patient, HCPs and for the system (value-based healthcare approach). Applying the
Brand Leadership Circle, a new strategic tool, will help understand the patients’ journey and other
stakeholders’ needs to implement successful approaches in marketing, communications and services
12 PharmD, Universidade Católica Portuguesa
13 MsC Instituto Superior Técnico
14 PhD Universidad Pompeu Fabra
15 MBA Universidade Nova de Lisboa
16 PhD Imperial College London
17 MsC Universidade Catolica Portuguesa
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using systematic research methods and techniques.
Keywords: Pharmaceutical Industry, Brand Leadership Circle, Brand Communications, Pharma
Marketing, patient journey, Healthcare Professional needs, Patient needs, Strategic Tool, Stakeholders,
value-based healthcare
Introduction
It is an increasingly dicult task for pharma marketers to support healthcare professionals
(HCPs) in their clinical practice to nd the right product for individual patient proles. This behavior
is increasingly reinforced by “corporate medicine,” which encourages healthcare professionals to
maximize prots by limiting patient interaction and treatment options. The Brand Leadership Circle
study shows that drug marketers too often turn various aspects of their data-driven approach to uncover
new opportunities for growth and improvement, and to deliver results that make a real dierence for
patients and consequently the healthcare ecosystem.
While patient proles can be a powerful tool to represent certain types of patients,
Pharmaceutical Industry must follow compliance and medical guidelines. Patient characteristics must
be consistent with those of the patients for whom the treatment or therapy is approved; specically,
products studied in clinical trials and regulatory authorities-approved for labeling. Medical societies
are increasingly limited in providing guidance or features to patient proles. As with our customer-
centric positioning approach, the Brand Leadership Circle framework tests patient proles. The focus
is to understand how healthcare professionals perceive the brand story and the boundaries of what
is possible in the Pharmaceutical industry, and to always be on the lookout for new and innovative
ways to ensure successful communication. This framework’s systematic and disciplined approach
combines primary market research and data analytics to ensure that the brand team communication and
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business objectives are aligned with ecosystem. The emphasis on the patient journey not only highlights
the unique experiences and challenges faced by each patient but also underscores the importance of
personalized care and tailored interventions.
The primary aim of this review is to provide a comprehensive overview of the Brand
Leadership Circle framework, exploring its applicability and implications in the context of healthcare
communication and combine perspectives and insights from dierent disciplines. Specically, we will
focus on identifying the ideal patient proles for a given product, and strategies to positively inuence
the prescribing behavior of HCPs, aiming to improve access to treatments, optimize clinical outcomes,
and promote patient-centered clinical practice.
Communication through platforms
Brand strategy and insight selling (a concept extensively covered by Matthew Dixon, in “The
Challenger Sale”, 2019 and also author of “The Challenger Customer”,2015) can be translated in a
constant need to build opportunities to advance in the business by meeting customer needs. These
needs are dependent on and identied by the customer journey, supported by omnichannel strategies.
Having an in-depth view of this process, as well as the unmet needs, is fundamental to the brand’s
success. However, this requires a deep understanding and adaptation of the objectives and strategies
of both companies and its brands... in addition to the initiatives to be taken in this process of constant
improvement and learning (closed-loop). Throughout this process, the main objective is to have
customers aligned with the brand’s value, likewise, the brand values aligned with the customer needs.
Whoever ensures this balance with this type of platform, will certainly build a meaningful, personalized
experience for the customer. Macnamara and Zerfass (2012, p. 17) argued that in a digital environment,
strategic communications contrast with traditional, non-digital approaches. The study further states that
online social media is characterized by increased public participation and openness to share experiences,
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requiring governance and organizational planning that align with the networked characteristics
of stakeholders. According to Bachmann & Ingenho (2016), the strategic treatment of corporate
communication by a company is mainly inuenced by the community. In strategic communications,
dierences are demonstrated depending on a company’s internal and external stakeholders (Cornelissen,
2014). The latter categorization is based on the intention of a corporate communication strategy and
what the communication provokes in the recipients.
The emergence of social media has had a critical impact on how businesses communicate with
their internal and external stakeholders (Reyes-Menendez et al., 2020). Microblogging tools like Twitter
(now called “X”) and Instagram, social networks like Facebook, and sharing tools like YouTube all
contribute to turning the internet into a platform partially dependent on user participation. In addition,
these platforms support organizations and stakeholders in engaging in symmetrical communication,
that helps build strong relationships (Darshika et al., 2021).
An initial strategy includes several dierent components, which are considered as (a)
preparatory, (b) implementation and (c) evaluation. The preparatory components of a digital strategy
involve researching and planning a digital campaign or an overall communication program for an
organization. The components for implementing a digital communication campaign are the tactical
elements available to stakeholders. The execution components of a digital strategy include the use
of real-time data to inform decisions about the digital distribution of messages, and the evaluative
components of a digital strategy include the use of analytics and metrics in a reexive way to inform
future campaigns or change ongoing communication programs (Overland, 2016).
Nevertheless, digital transformation and the use of technology are ingrained in today’s lifestyles
(Orekhov, 2020). This unexpected transition into the virtual world, which diers signicantly from
classic communication models, has brought with it new challenges and opportunities for companies
(Navaridas-Nalda et al., 2020). New digital business models and user-generated content allow consumers
to interact with others freely and openly in digital environments. In this context, globalization and
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changes in the technological and social sectors have altered conventional thinking about brands digitally
(Saura et al., 2023). Branding is dened as a methodological discipline that deals with the process of
building, creating and managing the brand, with the main objective of communicating the brand’s value
to customers through digital communication channels that companies use to explain and promote their
brand and value proposition (Avalos, 2013). According to Foroudi (2019), branding consists of creating
value through dierent media, resulting in customer experiences that cause repeat purchases.
The application of the Brand Leadership Circle tool
The Brand Leadership Circle is a platform that involves institutions, universities, schools and
companies with a high purchasing power, exerting a signicant economic inuence on the producers.
Similarly, the Brand Leadership Circle primarily focuses on preparing leaders for the needs and
challenges of this century, such as balancing short- and long-term protability in a sustainable manner.
The Brand Leadership Circle prole is an important evolution between the more comprehensive
360-degree patient proles and the dierent journeys, and the rst to interconnect a set of skills that have
been researched, underlying mental habits, and motivating factors. It also demonstrates the relationship
between patterns of action and the assumptions that motivate behaviors for change.
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Figure 1 - Brand Leadership Circle
The Leadership Circle Prole (LCP) is a single tool that measures two main domains of
leadership: creative skills and reactive tendencies. The rst are the researched competencies that
measure how the professional achieves the results, elevates the best, leads with vision, improves their
own development, acts with integrity and courage and improves the organization’s systems. The second
relate to leadership styles that privilege care over results-giving, self-preservation over productive
involvement, and aggression over alignment-building. Leadership circles are a type of professional
learning community that is focused on building specic skill sets while also supporting other leaders
facing the same challenges. A group of small to medium-sized leaders meets monthly to discuss a
specic topic. Each circle has a dierent focus and is moderated by one or more participants (Chang &
Ko, 2014).
Figure 2 - Leadership Circle
The outer circle displays the results of each dimension measured by the LCP, while the inner
circle dimension summarizes these dimensions in 8 summarized scores. Similarly, the dimensions that
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are on opposite sides represent the opposite behavior patterns that are inversely correlated. The top half
of the circle indicates the Creative Competencies that contribute to a leader’s eectiveness, and measure
the key behaviors and assumptions of leadership that lead to the high level of satisfaction and leadership
of great achievements.
According to Andersen (2018), the LCP has proven to be reliable and correlates as predicted
by the theoretical basis of the prole. His study also demonstrated that all the data support the main
theoretical foundations of the LCP, with the inner part consisting of dimensions of the Inner Circle
include the expected directions.
The 4C Leadership Capability model suggests that there are four main capabilities that are
important for an eective leader: connection, trust, knowledge, and persuasion. In this context, leaders
have a circle of connections and a brand image between those connections, pose issues to solve, and use
various styles to inuence their connections (Baek & King, 2011).
The notion of brand leadership was also introduced by Aaker (1996) and was later dened as the
process of supporting the brand as well as the brand’s ability to achieve excellence continuously (Aaker
and Joachimsthaler, 2000). The authors proposed a strategic brand management system employing
a brand leadership model to explain market dynamics. They also discussed the main methods for
developing and maintaining a competitive position of a given brand in a highly competitive market
environment.
Although there are few studies on this topic, some studies have used a one-dimensional
approach and the use of numerous items and measures to identify brand leadership (Aaker, 1996; Cheng
et al, 2007; Miller and Mills, 2011), ignoring the conceptual richness of brand leadership. As a result,
there was no common agreement on the conceptual framework.
In the realm of brand management, the concept of brand leadership, according to Aaker &
Joachimsthaler (1999), uses organizational structures, processes, and cultures to distribute brand-
building resources globally, to create synergies, and to develop a global brand strategy that can coordinate
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and leverage the country’s brand strategies.
More recently, Miller & Mills (2011) dened brand leadership as a consumer evaluation factor
in which the brand is successful, visionary and up to date with the latest trends, and in this case, the
concept of brand leadership helps to understand market dynamics and develops strategic perspectives
on the business environment and competitive perceptions in a given industry segment. In this sense, it
can be said that the concept of brand leadership reects the competitive advantage of a company over
other brands and is dependent on the specic actions of the company.
In this context, researchers have dened brand leadership as consumers’ perception of
a brand’s distinctive ability to continuously achieve excellence through the association of sucient
trends and brand positioning in the industry segment (Chang & Ko, 2014). Several traditional theories
of leadership, such as situational, contingent and charismatic trait theory, provide a comprehensive
conceptual basis for understanding brand leadership, namely, trait theory assumed that leaders have
the right to combine certain characteristics if consumers have those same characteristics (Yukl, 2006).
In this context, the leading position of the brand also requires a brand to have the right combinations
of positioning and eectiveness of brand communication. Finally, contingency theory assumes that the
leader’s action depends on situational factors.
Brand Leadership Circle in Healthcare
Branding is a cost-eective way to reproduce yourself as an entrepreneur as well as a leader, an
ecient and simpler method of leading. The biggest problem with leadership today is that there is a great
divide between corporate intentions and corporate branding, personalities of individual leaders and
personal brands. Thus, to bridge the management communication gap between the business strategies
initiated by the managers, people and processes in the organization, the brand can be used as a highly
ecient tool
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Brand strategy is how, what, where, when, and to whom you plan to communicate to deliver
brand messages. Thus, to build a brand story, companies must develop a brand-specic strategy,
including its positioning, personality, values, appearance, and perceived qualities that are based on
product specicities such as reliability (Budac & Bultador, 2013). In this context, value is recognized
as one of the most vital arts of branding, and it has three types of values: functional, expressive, and
central.
In today’s competitive environment, a good brand that represents the identity, credibility and
rememberability of all functions of the company’s interaction with its customers plays an important role.
In this context, branding is currently one of the main approaches in healthcare industry organizations
(Hosseini et al., 2013). The transparency of the organization’s brand leads to a specic type of change
in the behavior of its employees. And, if a particular organization is willing to make a name for itself,
branding provides a transparent denition, leading to a better understanding of the organization’s
identity and goals, facilitates recognition, and makes the organization better known
In the medical eld, patients’ perception of their treating physician’s knowledge and experience
increases their condence, and this condence allows for greater satisfaction and a favorable image in
their mind (Dalaki et al., 2019). Most pharmaceutical organizations consider targeted branding as a
competitive strategy and aligns with their specic purpose or social issue (Mirzaei et al., 2021). In this
context, a pharmaceutical organization can increase its market share and ensure greater protability by
creating personal identity through brand image (Zhan & Meng, 2015).
Because the branding of Pharmaceutical Industry services is dierent, especially in healthcare
centers and hospitals, as well as due to the importance of brand management and related value extraction,
Pharmaceutical Industry should be directed towards branding initiatives based on Gao perseverance
(Elrod & Fortenberry, 2018).
Studies have shown that product damage to a particular brand reduces consumer valuation of
competing brands in the same industry, referred to as negative eects (Zhang et al., 2021), and in this
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case, medical group branding can be an eective way to create a competitive advantage and provide
opportunities to attract more patients.
However, because they are unfamiliar with the science of marketing and do not address the
related topics, they do not have the power to become a brand (Gao & Lan, 2020). A strong brand can
help an organization achieve its goals, which often include lower costs, higher patient satisfaction, and
higher return on investment and protability (Kalinska-Kula & Staniec, 2021).
The study by Bastug et al. (2020) demonstrated that for branding, geographic location plays a
signicant role in brand image. Similarly, the study by Odon et al. (2021) also introduced four dimensions
of the health brand, and included the brand elements, tangible elements, quality of medical personnel,
and critical services eective in brand promotion. Poor branding can lead to a mismatch between the
patient who expects it and what reality presents (Yadav et al., 2020).
Regarding the “purpose of the brand”, the author Sinek (2009) created the golden circle
structure, which consists of three circles with three distinct terms: “what, how and why”, with the
outermost circle being “what” one of the easiest to identify and refers to what the brand does or sells
specically in the sector. the “how” refers to the following circle that describes the brand’s strategies
that dierentiate it in the market and includes the purpose and reasons for its existence. According to
Mainwaring, et al. (2020), this communication strategy allows consumers to be inspired not by what
brands do, but by the purpose and reason that drives them to do so.
In this context, the various healthcare companies that are purpose-driven reveal the power of
this purpose in the minds of patients, resulting in more loyal patients who are more willing to pay higher
prices for services (Narayanan & Das, 2021). Thus, brands feel the need to explain the reasons that
motivate their actions and the commitment they have to society, with the aim of improving the quality
of services (Gros, 2019).
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Methodology
The current study aims to, access, analyze and synthetize the Brand Circle Leadership
framework. During deep interview process with Pharmaceutical companies, we have found that teams
have often dedicated time to collecting data and implementing technology to facilitate omnichannel
experiences. However, they struggle to develop the processes and internal structures needed to optimize
and innovate across the value chain as part of a successful strategy.
Understanding the patient journey is crucial in enhancing customer experience and promoting
value-based healthcare. By mapping out the various touchpoints and interactions a patient has with the
healthcare system, providers can identify areas for improvement and implement strategies to streamline
the process, reduce wait times, and enhance communication. A well-designed patient journey not only
leads to higher patient satisfaction and loyalty but also contributes to better health outcomes and cost-
eective care delivery. By focusing on the patient experience throughout their healthcare journey,
providers can create a more patient-centered approach that ultimately leads to improved quality of care
and overall value in healthcare delivery.
Step 1: Decision Architecture and Ecosystem Chart Review
The rst step in developing eective lasting relations is to create a comprehensive analysis
of current HCP behaviors, typically conducted by market research and data analysis teams. Taking
this rst step creates an opportunity to signicantly advance the brand team’s understanding of how
HCPs think about therapeutic approaches through the market research project. To support its strategic
goal of becoming more Patient-centric, the client needed to better understand the information channel
preferences of HCPS and Payer customers.
Communications shouldn’t just get your message out there. To make a lasting dierence,
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communications need to bring a change in beliefs and behaviors. Our passion for stories that change
behaviors is what sets us apart.
In order to change these long-held beliefs, we need to understand the current and desired
behaviors, potential barriers and facilitating factors to determine the steps that will bring about desirable
change – something we identify through the Brand Circle approach.
Changing beliefs isn’t easy, but employing a theory-based perspective that’s informed by
behavioral science increases your chances of success – and that’s what we’re passionate about.
Step 2: Strategy testing on an interactive digital platform
Taking this rst step creates an opportunity to signicantly advance the brand team’s
understanding of how stakeholders think about therapeutic approaches through the market research
project. In addition to their own data, market research groups commission research market studies
or rely on expert panels to understand these decision-making factors and dynamics in more detail. A
patient mapping study is also an eective way to learn more about actual treatment decision-making
behavior. Patient proles created for testing are typically given a name and a picture to convey a sense
of authenticity, personalization and empathy. These include the patient’s medical history, laboratory
and/or imaging results, non-medical information about their personal life, and even their hobbies or
other preferences. Healthcare professionals may also consider nonclinical characteristics such as the
patient’s family situation, caregiver support, personal preferences, lifestyle, and insurance coverage
when deciding on treatment. Co-morbidities and co-medications also aect how the HCP considers
a patient’s eligibility for a particular medication. For example, when considering whether a patient is
likely to adhere to an oral medication, an HCP may be more willing to prescribe it if he or she realizes
that the patient regularly takes other oral medications for another condition and that the other condition
is good - checked from there, the team creates a series of prototype patient proles to test initial market
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research and validate critical decision criteria. We recommend that teams include a variety of potential
patient types, from more obvious cases where the HCP may use their brand, to contact cases where the
HCP may not use the brand but still want to. extent of labeling or clinical trials. This allows customer
facing to select the proles most relevant to the HCP’s performance and tailor the conversation to the
treatment the HCP approves, in line with the strategy.
Step 3: Applying Brand Leadership Circle Framework to “Crack the Case”
This framework is often iterative, especially as the team learns which features are important
to the strategic decision.
The team must also consider how these proles will ultimately be used to drive targeted HCPs
in a multi-channel campaign. While sales representatives have historically presented patient proles
in personal selling, more and more advertising are shifting to impersonal and digital advertising. It
emphasizes that the suggestions and tips presented in the patient case must be realistic and unmistakably
clear.
Fig 3. Representing a possible outcome from the framework analysis
Conclusion
The main goal of the Brand Leadership Circle framework is to support the Pharmaceutical
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industry, regardless of the size, in understanding their stakeholders and implement successful strategic
approaches through systematic research methods and techniques. To help ensure that the cues embedded
in the proles are addressed strategically and purposefully. Our research shows that every company
has a unique value chain with its particular strengths, weaknesses, and opportunities. That is why it is
critical to take a highly customized approach to every project, using this framework to uncover new
opportunities for optimization and growth.
Overall, the Brand Leadership Circle provides the pharmaceutical business model with a
structured framework for assessing the strength of their brand portfolio across dierent patient proles,
identifying areas for improvement, and formulating strategy enhancements to maintain a competitive
advantage in an evolving market.
In the context of patient-centered care and value-based healthcare, it is imperative to explore
the intricate nuances of the individual’s journey through the healthcare system. The emphasis on the
patient journey not only highlights the unique experiences and challenges faced by each patient but also
underscores the importance of personalized care and tailored interventions. Value-based healthcare,
with its focus on maximizing the outcomes that matter most to patients while minimizing costs,
further accentuates the signicance of understanding and optimizing the patient journey. By aligning
healthcare delivery with patient preferences and outcomes, value-based care aims to enhance the
overall quality and eciency of healthcare services. Therefore, in the realm of value-based healthcare,
a comprehensive understanding of the patient journey serves as a cornerstone for improving patient
outcomes, enhancing patient satisfaction, and ultimately driving value in healthcare delivery. By
acknowledging the individuality of each patient’s journey and tailoring care to meet their specic needs,
healthcare providers can truly deliver patient-centered care that is both eective and ecient.
Theoretical and Managerial Implications
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The present study oers a number of contributions to both theory and practice. This study
suggests several meaningful implications for managers that can help improve their strategic decisions.
Managers, therefore, can incorporate the Brand Leadership Circle model with other methods such as
SWOT, the PESTEL framework and the ve forces model, by which more accurate and benecial results
can be obtained. Besides, the results obtained from dierent contexts suggests that Brand Leadership
Circle is an important source of information. Hence, businesses may regularly Brand Leadership Circle
analysis, providing a continuous ow of information or strategic planning.
Limitations and Future Research
Even though this review provided an integrative, comprehensive, and synthesized view of
the Brand Leadership Circle model, it has its limitations. As the aim of this study was to provide
an overview of the framework knowledge base and combine insights and perspectives from dierent
elds, an integrative review approach was considered appropriate and was accordingly adopted. Future
studies may employ other approaches to assessing the Brand Leadership Circle, for instance, with
systematic and semi-systematic review approaches. Also, the concern of this study was the use of
Brand Leadership Circle in various major elds of healthcare Industry. However, other contexts are no
less important; therefore, future research might choose to investigate the use of Brand Leadership Circle
models in other contexts and industries. Finally, future research might also examine the inclusion of
other variables and techniques with the Brand Leadership Circle model.
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