Pharmaceutical Market Europe • January 2026 • 12

HEALTHCARE

Brian D Smith
Darwin’s MEDICINE
McNamara’s Fallacy

Why marketing science is harder than you think

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Sometimes, our greatest strengths are our most dangerous weaknesses. We’ve all seen great strategists who miss important details, or superb analysts who get paralysed by the data. We’ve all got positive attributes that hinder us sometimes. But this is not just a trait of individuals – it can cripple companies too. I’ve just watched that happen in real time, and if I share the story perhaps you will learn something from others’ mistakes, which is cheaper than learning from your own.

The good news
The hero of this story is the brand team for a groundbreaking therapy approaching launch. The team members asked me to spend just two half-days with them to stimulate fresh ideas. And they really are heroes. Probably the brightest and perhaps the most academically qualified brand team members I’ve worked with. It was a pleasure to hear them talk about the science behind their brand with obvious expertise and passion. It was equally fun when they led me through the data, even though I had to ask them to slow down to let the professor keep up!

As you might expect, therefore, their current thinking was pretty good. But not perfect. Their strategy was to focus on patients with a certain disease and offer a clinically differentiated value proposition. My challenge was that their target wasn’t homogeneous in its motivations and the market was driven by more than clinical needs. As we got towards the end of the first morning we agreed that, to prepare for the second morning, they would segment their target into prescribing contexts driven by non-clinical needs. And off I went, confident we were halfway to a good result.

The bad news
Paradoxically, the villain of this story is also the same brand team. When we reconvened, the team members had done their homework, slicing and dicing their market a dozen ways. But it hadn’t helped, because all they had done was carve their heterogeneous market into many smaller parts that were neither homogeneous in their prescribing motivations nor distinct from each other in their preferences. As anyone who’s done marketing strategy 101 knows, if a population of customers is not homogeneous and distinct, it is a category and not a market segment and, consequently, not a good basis for marketing strategy.

McNamara’s Fallacy
I was disappointed but not perplexed. Their failure wasn’t due to stupidity or laziness. They did what they did, the way they did it, because they all hold an unshakeable and unconscious belief that only things that can be and have been quantified matter. Consequently, when I asked them to segment their market by customer needs, they equated needs with tangible, quantified factors like customers’ location, education and current prescribing practices. I remonstrated with them, asking: Do you think prescribing behaviour is a function of any of these things? Or are you using these things because that’s the data you have? It was the latter, of course. But they couldn’t see (or couldn’t accept) that other factors, such as the prescribers’ need to feel innovative or safe, might be driving their behaviour. They were examples of McNamara’s Fallacy.

Antagonistic pleiotropy
McNamara’s Fallacy is the error of making decisions based solely on easily quantifiable data, while ignoring harder-to-measure qualitative factors, leading to flawed conclusions. It’s named after US Defence Secretary Robert McNamara’s focus on body counts in the Vietnam War and often summarised as: ‘Measure what’s easy, disregard the rest, assume the unmeasured either isn’t important, or doesn’t exist.’

In marketing, this leads to vital market drivers like prescribers’ personalities, traits and emotional needs being overlooked. In this case, and in many other science-based companies, it’s analogous to antagonistic pleiotropy, because it’s an organisational routine that offers benefits but then cripples the team. Just like the gene for Huntington’s disease. And it happens because marketing science is harder than most realise.

Nuance and layers
Don’t misunderstand me – the questions natural and physical sciences pose aren’t easy. But their challenges can often be distilled into a limited set of variables governed by relatively straightforward relationships. By contrast, the social sciences resist such reduction – they grapple with layered contexts, shifting human behaviours and complex systems of meaning.

In a pharmaceutical company, this means the marketing department must navigate social science dynamics that are significantly more intricate than the pharmacological principles guiding their research and development colleagues. That’s the lesson to learn from this case, especially if, like me, you grew up in the world of natural and physical sciences but now work in the messy world of marketing.

Professor Brian D Smith is a world-recognised authority on the evolution of the life sciences industry. He welcomes questions at brian.smith@pragmedic.com. This and earlier articles are available as video and podcast at www.pragmedic.com


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