In early 80s a new deadly disease came into existence, first in some gay men, then in injection drug users followed by users of blood related products. Most of the patients affected by this pandemic has suppressed immune systems and were falling severely sick with diseases that people with a decent immune system would never get. This caused alarm for National Institute of Health (NIH) and they started funding research projects to figure out the basic science behind the disease which we refer to as Acquired Immunodeficiency Syndrome (AIDS). They demonstrated that Human immunodeficiency virus (HIV) causes AIDS and funded basic and clinical research to discover drugs that could treat the HIV infection. They have also funded clinical trials to figure out the drug combinations for slowing down, halting and preventing the HIV infection.
Over the last three decades, NIH has had phenomenal success in fighting one of the biggest pandemic of our lifetimes. And when it started on this mission, its primary focus was not to wipe out the disease, not the price points at which it can sell the drug and definitely not making a blockbuster profitable drug. Its primary focus was to provide baseline cure that would enable us to slow down the progress of the disease and its impact on our society. The primary target customer for NIH supported research institutes and private companies working on HIV drug research was Food and Drug Administration (FDA), as they had to get FDA approval for releasing drugs that could slow down the progress of HIV infection. Drugs were quickly approved by FDA, even if the drug had minimal impact on HIV infection. Social need for baseline cure to HIV infection was the single most important focus of all the players in the ecosystem (NIH, research institutes, private companies and FDA). Hence FDA’s customer experience expectation was as depicted in the figure below:
FDA had the social responsibility to provide baseline cure for HIV infection and hence it had such high social responsibility expectation. It relied on NIH funded/supported research to help discover the drug and hence its expectation was high on brand. Its focus initially was not to eliminate the pandemic but to take the right steps in slowing down the impact of HIV infection. So it was fine with approving any drug that had minimal impact on the infection but with sufficient quality, hence the low to medium impact on requirements and quality. And FDA wanted to make the drug available to a contained population of AIDS patients so that it can understand the impacts of the drug further, which ranks the availability factor between low and medium.
This type of social responsibility based customer experience is not uncommon in pharmaceutical industry, rather this is what makes treatment for many non-common diseases possible.