Written by Will Hind

Will Hind is Agency Principal at Alpharmaxim Healthcare Communications

Why do we need a story?

Storytelling is inbuilt into the human experience. From our earliest origins we have used stories to find meaning in the world and to share and pass on knowledge.

Most importantly, stories are a powerful method of assimilating, understanding and learning new information. Storytelling is a two-way process, helping to bring people together and promoting a strong connection between the teller and the listener.

Put simply, our brains are hardwired to be engaged by stories far more than by a list of individual facts.

From a marketing perspective, having a compelling story to tell is one of the most important tools for success, particularly when you are trying to change ingrained customer behaviours.

That’s why Alpharmaxim developed the Belief Continuum® – a process that helps marketing teams develop a story that resonates with stakeholders by challenging their beliefs with facts and data.

What is the Belief Continuum®?

The Belief Continuum® process is a unique, tried-and-tested approach that provides an effective way to combine your strategy and science – transforming your data into a compelling, evidence-led story.

The concept, at its heart, is that to change stakeholders’ behaviours you need to understand and change the beliefs that drive them.

Who do we mean by stakeholders?

The Belief Continuum® is about developing a compelling story for your stakeholders. But who are they? Many of our healthcare clients have used the Belief Continuum® to develop a story for their product or brand. Their stakeholders may be the physicians who will use their product, the patients who will benefit from it or the agencies that will licence and fund it.

We also work with clients that want to build a corporate story – one that will clarify its scientific direction and financial prospects to investors, to help garner funding for expansion or new scientific endeavours.

Other clients may be interested in an internal portfolio story – one that will bring together affiliates and disparate brands spread across the world under one unifying umbrella brand.

Whatever your needs, and whoever your stakeholders, Alpharmaxim can use the Belief Continuum® to help develop the evidence-led story you need to tell, in the way you need to tell it.

The link between beliefs and behaviours

The reasons why people behave the way they do, and why it is so hard to change those behaviours, have been studied by psychologists for generations.

It is now understood that people’s behaviours are driven by their beliefs. Changing behaviours then requires a change in beliefs, and that is where the problem lies.

Changing beliefs is difficult because of the phenomenon of ‘belief perseverance’ – the concept that people find it easier to maintain their current beliefs than change them.

In effect, people like certainty, and the process of having to learn and integrate new information, shift long-held opinions and internally revise one’s world view is one that creates uncertainty, and is therefore avoided.

This belief perseverance holds true even in the face of seemingly incontrovertible and solid evidence in favour of the belief shift. After studying the phenomenon, psychologists Lee Ross and Craig Anderson remarked that “beliefs are remarkably resilient even in the face of empirical challenges that seem logically devastating”.1

Healthcare marketeers launching new products, particularly those that require a paradigm shift in current treatment practice, will certainly encounter this barrier.

Take, as an example, gene therapy for haemophilia. It has the potential to revolutionise treatment, but getting it accepted as a standard treatment may prove difficult. Current treatment paradigms work effectively for most patients who can access it – factor replacement reduces the occurrence of bleeds and associated complications, and in many cases allows patients to lead a full and active life, despite the need for regular medication. The clinical evidence for gene therapy is beginning to point towards the stage where one treatment will ‘cure’ the disease – leaving the patient producing enough clotting factor themselves to not require regular infusions. But if it is approved for use, will physicians and patients use it? Probably not, because they believe haemophilia is currently well managed, and they believe gene therapy is untested. This means that their clinical prescribing behaviours are unlikely to change on their own.

The Belief Continuum® process allows stakeholders to progress from an underlying inhibitory belief to one that allows them to embrace the real potential of a product. When beliefs change, the new, desired behaviours will follow.


1. Ross L, Anderson CA. Shortcomings in the attribution process: On the origins and maintenance of erroneous social assessments. In: Kahneman D, Slovic P, Tversky A, eds. Judgment Under Uncertainty: Heuristics and Biases. Cambridge: Cambridge University Press; 1982:144

“When I used the Belief Continuum® with speciality products it just worked. My CEO was sceptical about investing in this way, but then he saw the science behind the process.”

Pharmaceutical Marketing Director

The Belief Continuum®: How to identify the belief shifts that lead to behavioural changes

Alpharmaxim are experienced in working with clients to identify current beliefs and behaviours – those that need to be in place for a product to be successful – and the steps necessary to guide your target audience along the way to their acceptance.

Through a tried-and-tested workshop approach, we guide you and your team through a series of exercises that ultimately ends with the creation of an individualised Belief Continuum® that can be used to underpin all your future marketing and education tactics. What sort of steps might we go through in the workshop?

Step 1: Identify the target audience

What is the purpose of developing your story? Is it to launch a new product? Is it to highlight your company story? Do you need patients to adhere to their medication?

Whatever your story, you need to identify the target audience it is designed for first. Understanding who you are going to be telling the story to is important, because it may affect the story. Physicians will need different information to shift their beliefs than patients will, for example.

Step 2: Identify current behaviours

What behaviours are you are trying to change in your target audience? Are patients not using your product properly? Are investors not providing access to funding? Do physicians fail to prescribe your drug to the correct patients?

Whatever the problem, identifying the current behaviours causing it is a vital step towards positively addressing the issue.

Step 3: Identify the current belief(s) that drives that behaviour

What are the reasons behind the behaviours? What is it that makes them act in the way they do? As we have seen, behaviours are driven by beliefs. Look at the behaviours you have identified and understand why they happen. Are those patients not using your product correctly because they are don’t believe in it or don’t understand why it is necessary? Are investors not releasing funding because they don’t believe you understand how the market will change? Do your physicians fail to prescribe to the correct patients because they are unaware of the disease subtypes?

Matching the identified behaviours to the beliefs that underpin them is the core concept of the Belief Continuum®. With that understood, you can move on to changing those beliefs.

Step 4: Identify the desired behaviour

You understand what your target audience is doing, but what do you want them to do? Take your product properly? Release funding? Treat the correct patients?

Often this is the simplest step, but it is still important to discuss and rationalise your expectations. The behaviours you desire your audience to have must be achievable.

Step 5: Identify the desired belief(s) that will drive this behaviour

What do your audience need to understand before they will adopt your desired behaviours? Do patients need to believe that their medication will work best if they take it with a meal? Do investors need to believe that your vision of future medical practice is correct? Do physicians need to believe that your product is not suitable for every patient they see in their clinic?

These beliefs will become your core focus, for these are at the heart of getting your desired behaviours enacted.

Step 6: Identify the individual stages necessary to achieve the belief shifts

Once these steps are complete, you will probably realise that the belief shift you are looking for is significant. Given the difficulty in shifting people’s beliefs to start with, the bigger the belief shift required, the harder the process will be. Often the only way to accomplish a significant shift is to break it down into smaller stages.

It may be helpful to work backwards from the desired beliefs, i.e. what one thing would the audience need to believe before they will start to believe the end goal. Or it may be appropriate to brainstorm the smaller changes needed and then arrange them in a logical order.

Step 7: Sanity check

Ensure your step changes are realistic and achievable. The belief-change process is a gradual one, and it is unlikely you will successfully change stakeholders’ opinions in just one step. By breaking down the process into several smaller stages, belief change is far more likely.

“One thing I appreciate most about the Belief Continuum® is the clarity of thought that comes out of it. Nothing is developed by chance, it is all by design. You get a clear picture of where you are, where you need to be, and a map to get you there – what belief modifications need to happen, what data you need and what tactics will help you drive success.”

Pharmaceutical Marketing Director

After the Belief Continuum®: What next?

Well done! You have a Belief Continuum® and a compelling story you can tell to the stakeholders that matter. What are you going to do with it now?

The next steps often start with a closer look at scientific messaging to support the individual steps of belief change. We said earlier that beliefs are hard to change even with compelling evidence – without that evidence, it is impossible. This means reviewing the literature to see what evidence has already been published and, just as importantly, where the gaps are that need to be filled to support your story.

Based on that research, a message matrix can be developed that helps your sales or medical science liaison teams choose which messages will prove the most effective with each customer depending on where they lie on the Belief Continuum®. Developing effective communications is an excellent way of maximising the impact of your stakeholder conversations.

From there, tactics will depend on your specific circumstances. You may wish to arrange an advisory board to get input from your key opinion leaders on the validity of the story and messaging, or to develop sales aids that will help disseminate the messages to key customers.

“Our market share was stagnant and beginning to drop, but after we developed a Belief Continuum® and used it to align our tactics, we picked up two or three market share points.”

Pharmaceutical Marketing Director

Whatever tactics are used, you can be sure the messages put across will be consistent, compelling and in line with your strategic objectives.

Putting the Belief Continuum® into practice

A novel product for the treatment of a rare disease had launched in the United States, but its initial uptake was compromised by a product story that was focused heavily on the physician rather than on the patient.

When the initial marketing campaign failed to sufficiently educate patients about some of the issues they would face on first taking the product – issues that were not serious from a health perspective, but which led to patient expectations not being met – the product failed to have the expected impact.

With the learnings from the US launch acknowledged and understood, the company asked Alpharmaxim to develop a product story that focused on the needs of both patients and physicians before the product was launched across European markets.

Using the Belief Continuum® process, Alpharmaxim put together a clear and compelling narrative of the belief changes that needed to happen if the US issues were not to be repeated, that would resonate well with physicians and patients alike when taken to market testing.

The story was used to develop a series of tactics for the peri-launch phase, and it soon became clear that patients and physicians were strongly engaged with the developed story, and understood the realities of the product and its effects. This ensured that their expectations were met and, in many instances, surpassed.

The result was a series of successful launches in European countries, with committed and engaged physician and patient communities, and a product that exceeded uptake forecasts.

“The Belief Continuum® helps you promote your marketing plan internally to those who make the ‘go/no-go’ decisions. It shows you are not just taking a punt and hoping it works.”

Pharmaceutical Marketing Director

If you’d like to know discuss more about this topic, please contact Will Hind at will.hind@alpharmaxim.com or on +44 (0)161 929 0400