Indian Pharma Leadership: A Glimpse of Changing Mindset Post Pandemic

Posted on April 10, 2023 by Tapan Ray

A recent survey of physicians, published by the CMI Media Group, provides fresh evidence that Medical Representatives meetings with the physicians that have become trickier to arrange since COVID-19, still continue. This was also reported in the March 29, 2023, edition of Fierce Pharma.

The survey objective was to capture what are physicians’ preferences, when asked whether they want to meet with pharmaceutical reps in person more often, less often or in equal frequency as pre-pandemic. Some of the key findings of this recent study include the following:

25% of the doctors, reportedly said they are reducing face-to-face interactions.

With 10% of doctors responding never seeing reps, it could be challenging for many pharma players to call on these doctors via the traditional in-person route.

However, another 51% of physicians replied that the frequency of their in-person interactions is unchanged from pre-pandemic and 14% seeing reps more frequently than before.

It also found that digital channels have potential to compensate for the pullback from in-person meetings.

Most of such doctors prefer receiving resources for talking to reps via video or phone.

Interestingly, 70% and 78% of physicians said digital resources are more convenient, educational and valuable than remote rep visits.

Let me hasten to add that the above study was carried out mostly in the European countries. Thus, in today’s deliberation, I would focus mainly on two areas:

1. How is this situation evolving in India and the way some of the Indian majors are gearing up to convert this challenge into opportunities to gain a competitive edge, and

2. What, in my view, needs to be a pharma marketing leadership mindset change, alongside its traits for effective change management, to excel in the changing market dynamics. More importantly, whether or not this trend is also visible within some of the Indian pharma majors.

The comparable situation in India:

I find some interesting data on the Indian pharma industry in this regard, from several public domain. These indicate that while some physicians may be open to virtual interactions with medical representatives during and after the COVID pandemic, there are also examples of physicians who were not too keen to meet with pharma reps. These seem to be for several reasons. Some reported examples are as follows:

Delhi Medical Association (DMA), which represents more than 15,000 doctors in the Indian capital, has banned pharma med reps from entering hospitals or meeting with doctors in person. The DMA has cited concerns about the influence of pharma reps on prescribing practices, besides potential conflict of interest.

With over 3.5 lakh memberships, the Indian Medical Association (IMA) appears to have discouraged physicians from meeting with MRs. Instead, the association has urged them to rely on evidence-based information and guidelines while prescribing drugs to patients.

Some private hospital chains in India have also restricted or banned pharmaceutical sales representatives from interacting with physicians. This includes Fortis Healthcare, which has banned pharma reps from its hospitals in Delhi and Mumbai, and Max Healthcare, which has restricted interactions to virtual meetings only.

The Indian Psychiatric Society (IPS) has issued guidelines for its members recommending that they avoid interactions with pharma med reps. The IPS has stated that interactions with pharma reps can create conflicts of interest and bias in prescribing practices and may not always provide accurate and reliable information.

Some physicians in India are increasingly turning to online platforms to access unbiased information about medications and treatments, rather than relying on information provided by reps. Online platforms such as Medscape and Docplexus provide physicians with access to up-to-date medical information and peer-reviewed research studies.

With a changing mindset, some Indian players are facing this challenge:

Evidence suggests that there is a growing awareness among several physicians in India about the potential biases and conflicts of interest that can arise from interactions with pharma representatives. While virtual interactions and non-promotional information may still be acceptable to some physicians, others may prefer to rely on more objective sources of information or avoid interactions with pharma reps altogether.

There are several examples in this area highlighting how some Indian pharma majors are trying to stay ahead of the technology curve. As reported, some specific responses of Indian pharmaceutical companies to the restrictions on interactions with physicians

include, Cipla’s launch of a digital platform called CiplaMed to provide healthcare professionals with access to non-promotional medical information and education.

Post-pandemic changes in the mindset and outlook of marketing leadership:

As I see, the COVID pandemic experience has brought significant changes in the mindset and outlook, especially, in the marketing leadership of several Indian drug companies. One key reason could be the success requirements in contemporary pandemic market dynamics are going through a metamorphosis. Which is why the emerging situation demands new approaches and strategies for success.

Many pharma marketing leaders are now trying for early identification of even the nuanced change requirements relevant to their respective organizations for sustainable business success in the current paradigm. Some of these requirements were identified as:

Agility and Adaptability: The pandemic has highlighted the importance of being agile and adaptable. Pharma marketing leaders must now be able to quickly pivot their strategies and tactics based on changing market conditions and consumer needs.

For example, Cipla adapted quickly to the changing market conditions during the pandemic by ramping up the production of essential medicines and medical supplies. The company also developed innovative product solutions, such as a portable mechanical ventilator, to address the critical shortage of medical equipment during the pandemic.

Similarly, Lupin demonstrated agility by diversifying its product portfolio to include COVID-19 testing kits, PPE, and other pandemic-related products, besides helping to develop innovative solutions to address the pandemic, such as a telemedicine platform that enables patients to consult with doctors remotely.

Digitalization: The pandemic has accelerated the shift towards digitalization in the pharma industry. Marketing leaders must be able to effectively leverage digital channels such as social media, online advertising, and telemedicine to reach and engage with consumers.

For instance, Dr. Reddy’s Laboratories leveraged digital technologies to enhance its customer engagement efforts. The company developed a mobile app called - ‘Medznat.’ It is touted as a one-stop solution for physicians, medical students and other healthcare professionals to stay abreast with the latest medical knowledge. It offers an umbrella of offerings, such as news, scientific articles, case studies, regulatory updates, medical events, drug flashcards, and many more. The app offers some key features, such as: personalized quality content, any time, anywhere and patient education materials.

Customer-centricity: The pandemic has increased the need for customer-centricity in the pharma industry. Marketing leaders must now prioritize customer needs and preferences and tailor their marketing strategies accordingly.

Sun Pharma appears to be another leading example that, reportedly, demonstrated customer-centricity by developing patient assistance programs that provide financial support to patients who cannot afford their medications. The company also partnered with healthcare providers to develop disease management programs that improve patient outcomes and reduce healthcare costs.

Data Analytics: The pandemic has highlighted the importance of leveraging data science and data analytics in the pharma industry. Marketing leaders must be able to effectively analyze data to understand customer behavior and preferences and to measure the effectiveness of their marketing campaigns.

The name of Glenmark Pharmaceuticals comes to the top of mind in this area. The Company is now using data analytics to analyze sales data and identify trends in the market. The company is also using analytics to track physician interactions and ensure compliance with government regulations.

Continuous Innovation: The pandemic has created new opportunities for innovation in the marketing domain. Thus, marketing leaders must be willing to experiment with new approaches and technologies to stay ahead of the competition and meet changing customer needs.

As is known to many, Zydus Cadila has developed a COVID-19 vaccine and has also been working on the development of a COVID-19 drug. The company has also been involved in the development of new drugs to treat various other diseases.

Collaboration: The pandemic has underscored the need for collaboration across the healthcare ecosystem. Pharma marketing leaders need to work closely with other stakeholders, including healthcare providers, payers, patient advocacy groups, and government agencies, to develop solutions that meet the needs of all stakeholders.

In this area, Biocon, for instance, collaborated with government agencies and NGOs to distribute COVID-19 vaccines and treatments to underserved communities. The company also worked with healthcare providers and patient advocacy groups to develop education and awareness campaigns that promote better health outcomes.

Similarly, Dr Reddy’s Laboratories partnered with IQVIA to rollout IQVIA’s OCE application to its entire field force and marketing users in India to drive more meaningful and impactful customer engagement.

Conclusion:

These are a few areas with examples from a few Indian pharma majors that would give a sense of how the mindset and outlook of their marketing leadership teams are changing. This is happening, as is widely believed, after having experienced the last two years’ unprecedented disruptions in business and customer behavior.

It’s equally interesting to note that our domestic drug industry, which was not traditionally well known for effecting significant proactive changes – is transforming itself while stepping into the post-pandemic world – in pursuit of excellence.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Focus On All 3 Areas of Innovation For Affordable Access To Innovative Drugs

Posted on November 29, 2021 by Tapan Ray

Medical treatment has made astonishing advances over the years. But the packaging and delivery of that treatment are often inefficient, ineffective, and consumer unfriendly. This was articulated in an article on innovation in healthcare, published in the Harvard Business Review, way back, in its May 2006 issue.

Highlighting soaring healthcare cost, including ‘out of pocket’ health expenditure, and its impact on public health, the paper recommended innovative solutions for every related aspect of health care. These encompass – healthcare delivery, unleashing the power of technology, and customer-centric business models. Interestingly, despite enormous investment in drug innovation, the access to affordable health care for all, continued over the years.

The consequential scenario was well articulated in another paper on rising consumerism among healthcare consumers, published in the Deloitte Review issue 16, 2015. It noted, the existing business models are increasingly being challenged by all concerned. The aim is to find new sources of value – as expected by patients and deliver them effectively with innovative approaches for better outcomes. This has, initiated a recalibration of the healthcare system, as it were, in many parts of the world, including many -both developed and developing countries, across the globe.

In this article, I shall try to explore this area, especially from the perspective of relevance of innovative business models for affordable access to innovative drugs in the new normal. Let me start with three basic innovation needs in the pharma business that may help chart out a meaningful pathway to attain this goal.

3 innovation areas to make health care better and cheaper:

In pharma industry, people mostly talk about product or treatment innovation. Although, this is of paramount importance to make healthcare more and more effective with time, but may not help save or heal more patients, commensurately.

Going by the ‘health care innovation catalog,’ as charted by the above Harvard Business Reviewarticle, ‘three kinds of innovation can make health care better and cheaper.’ These innovations are primarily related to:

Use of ‘technology’ to develop new products and treatments or to improve care
Bringing in innovative changes the ways ‘consumers’ buy and use healthcare.
Generating new ‘business models’, particularly those that involve the horizontal or vertical integration of separate health care organizations or activities.

As I have deliberated in the past, related to the first two areas, this discourse will deliberate on the third type of innovation to explore the above specified area. Let me hasten to add that several studies published in the later dates, echoed similar approach.

Subsequent studies reinforce the point:

One such example, is the paper titled ‘Innovative Approaches to Increase Access to Medicines in Developing Countries’, published in the Frontiers in Medicine on December 07, 2017. This study also captured: ‘Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics) is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries.’

The paper highlighted, several innovative approaches, based on partnerships, intellectual property, and pricing, can further stimulate innovation, promote healthcare delivery, and reduce global health disparities, significantly. It underscored: ‘No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs) in an effort of making them available at affordable and acceptable conditions.’

Changing business model concept gaining steam during Covid pandemic:

The issue of affordable access to innovative medicines drew attention of all stakeholders, even the common man, during the Covid pandemic – more than ever before. Several publications raised a flag on this barrier to public health, especially amid a pandemic or epidemic like situation.

One of these papers, titled ‘COVID-19 and the global public health: Tiered pricing of pharmaceutical drugs as a price-reducing policy tool’, was published in the Journal of Generic Medicines, on October 07, 2020. The paper emphasized, COVID-19 has raised serious concerns about affordable and equitable access to critically needed innovative medicines and other health technologies. It pointed out: ‘Patent exclusivities add to the cost of healthcare by allowing supra-competitive prices of protected technologies’, it commented. At the same time, ‘the prices and availability of drugs also depend on certain other factors that are not related to IP protection.’

Here comes the concept of ‘differential pricing’ or ‘tiered pricing’. This is a voluntary price-reducing policy option of the innovator to sell innovative drugs at lower prices in developing countries – compared to developed nations. The study articulated, more and more innovators imbibing this option in the future, could be a way forward to address for the future. Could it be a win-win solution for this critical issue?

Is it a win-win solution to this critical issue?

Since, at least, the last decade, the concept of differential pricing or tiered pricing ‘has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to these life-saving products.’ This was also noted in the paper - ‘A critical analysis of tiered pricing to improve access to medicines in developing countries,’ published in the journal Globalization and Health, on October 12, 2011.

Even at that time, the paper said: ‘International tiered pricing has been proposed as an alternative to high prices when separable high- and low-to-middle-income markets exist for a medicine and when the seller exerts significant power over pricing, such as when there is limited or no competition due to patent protection, data exclusivity, or other market-entry barriers.’

Interestingly, despite above findings, tiered pricing has not been a widely followed concept in the old normal to ensure affordable access to life-saving innovative drugs, for all. One of its reasons could possibly be commercial considerations. Company specific business threshold of tiered pricing may not necessarily be able to offer a price that is equitable or affordable for all. That said, there are a few laudable initiatives of some major innovator companies in the past.

Some laudable past initiatives for affordable access to innovative drugs:

Since the beginning of this millennium, one can witness some laudable pricing initiatives for affordable access to critical, innovative drugs to save lives in developing countries and poorer nations. Let me give a few reported examples below:

Abbott Laboratories – the patent holder of lopinavir and ritonavir had initially announced a tiered price of $650 in 2001 for African countries and 16 non-African least developed countries. In 2002, the Company reduced the price to $500 for these countries and in August 2009 dropped it to $440 – slightly below the lowest generic price.

In 2001, Novartis offered “at-cost” tiered price of $2.40 per adult treatment course for artemether-lumefantrine FDC to WHO for developing countries After 5 years when a generic version of the same was available, Novartis decreased its tiered price to $1.80, thereafter to $1.50.

Eli Lilly’s two key DR-TB drugs, capreomycin and cycloserine were not widely available from other suppliers even after it went off patent. In 2002, Lilly transferred the drug manufacturing technology to several generic drug companies in TB-endemic countries. Eli Lilly’s tiered price has consistently remained below the generic prices for these drugs.

More examples of voluntary licensing during Covid pandemic:

Gilead signed non-exclusive voluntary licensing agreements with generic pharmaceutical manufacturers based in Egypt, India and Pakistan to manufacture remdesivir for distribution in 127 countries that face significant obstacles to healthcare access.

Notably, the licenses are royalty-free until the World Health Organization declares the end of the Public Health Emergency of International Concern regarding COVID-19, or until a pharmaceutical product other than remdesivir or a vaccine is approved to treat or prevent COVID-19, whichever is earlier.

On May 11, 2021, several media reports revealed that ‘US pharma giant Eli Lilly has issued royalty-free, non-exclusive voluntary licenses to three Indian drug makers – Cipla, Sun Pharmaceuticals and Lupin – to manufacture and distribute Baricitinib, which is being used to treat Covid-19.

As announced on October 27, 2021, the global drug major MSD and Medicines Patent Pool (MPP) entered into a voluntary licensing agreement to facilitate affordable global access for molnupiravir, an investigational oral COVID-19 antiviral medicine. This agreement will help create broad access for molnupiravir use in 105 low- and middle-income countries (LMICs) including India following appropriate regulatory approvals. The Indian companies, reportedly, include, Sun Pharma, Cipla, Dr Reddy’s, Emcure Pharma and Hetero Labs.

On November 16, 2021, Pfizer Press Release stated: Pfizer and MPP has signed a voluntary license agreement for Pfizer’s COVID-19 oral antiviral treatment candidate PF-07321332, which is administered in combination with low dose ritonavir (PF-07321332; ritonavir). Under the terms of the license agreement, qualified generic medicine manufacturers worldwide that are granted sub-licenses, will be able to supply this combination drug to 95 countries, covering up to approximately 53% of the world’s population.

Conclusion:

Covid Pandemic, which apparently, is refusing to vanish anytime soon, makes the issue of making affordable access to critical innovative drugs for all, more intense. Since long, researchers, academicians, practitioners, and the stakeholders involved in addressing this healthcare challenge for the majority of the population have suggested several innovative approaches.

These include, focus on three kinds of innovation simultaneously, and with similar zest, can make health care better and cheaper. One such area is changing pharma business models for critical innovative drugs. The good news is a few pharma players have already charted on this pathway in the past, successfully, by extending royalty-free, voluntary licenses to manufacturers in the developing countries and poorer nations. Some of them even tried to match their tiered pricing with equivalent generic drug prices. But the overall response was rather lukewarm in the old normal. Interestingly, the new normal signals a mindset change in this regard within a larger number of global innovators.

The current trend gives a hope to many that an increasing number of global innovators will sincerely explore – not just one, but all the three areas of innovation for affordable access to innovative drugs. This could possibly reduce, if not eliminate the future need for the grant of compulsory licenses for such drugs, as happened during the peak of Covid pandemic, especially in India.

By: Tapan J. Ray

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Unleashing Pharma’s New Potential In Changing Market Dynamics

Posted on June 7, 2021 by Tapan Ray

Several pharma majors have started pondering in this space. This is evident from several recent developments, both in India, and also in other places of the world. One such articulation can be heard from the very top of the domestic pharma industry, which could be a pacesetter for many others.

The founder and Managing Director’s Message of India’s top pharma company – Sun pharmaceuticals, was released to the media on June 02, 2021. This speech is a part of the company’s Annual Report 2019-20. It is indeed interesting from overall pharma business operations’ perspective in India amid Covid-19 pandemic. It is also in sync with what many of his global counterparts have also expressed in recent times. To give a sense of Sun Pharma Chief’s reading and understanding of the fast-changing business dynamics, I am quoting below a few critical points of his above message:

There is a gradual realization that the COVID-19 virus is here to stay and that all of us will have to learn to coexist with the virus till an effective treatment or vaccine becomes available.

There will be far-reaching changes in the way in which organizations are likely to operate going forward.

Consumer behavior and consumption patterns are also likely to change due to the global pandemic.

Social distancing and maintaining individual hygiene (like using masks and hand sanitizers) have become imperative.

Work-from-home (WFH) option has been exercised by most organizations for certain functions and there is a likelihood that it will continue for some more time till the viral infection comes under control.

There is a possibility that WFH may become the new-normal for certain categories of corporate work force even after COVID-19 comes under control.

Also, there is a higher focus on automation, digitalization as well as an increased dependence on analytical tools for decision making.

Overall, in the global pharma and biotech arena, one can now witness a varied response to opening-up – some quite bold, others are flexible and cautious – as the scenario unfolds. In this article, I shall dwell on the importance of framing a well-thought-out plan, with clearly stated Plan B, C and D in this area, to prevent any business opportunities to slip by due to delayed action.

Key questions to answer – what to open and when to open:

It goes without saying that remote working or WFH for all pharma employees can’t remain in-force for any indefinite period. It will mostly depend on two critical drivers, mainly to avoid any reckless decision with grave consequences. One – how fast several – reasonably strong preventive measures, such as, vaccinations, can provide a reasonable herd immunity to most people around. And also, how most other similar businesses successfully start carrying out their commercial operations in the same environment.

Pharma players would then need to have a clarity on the business functions where selective personal presence of the qualified staff is necessary, as no extent of technological interventions can compensate it. Then follows the question, when to start opening – without being reckless and following all prescribed Covid related health norms. The answer to these questions should be addressed along with Plan B, C and D ready – just in case something doesn’t work out or because of competitive reasons.

To elaborate this point, let me first give an example of what an Indian tech behemoth is planning to get back some employees in the workplace, based on a sophisticated digital model. Thereafter, we will have a glimpse on how several pharma and biotech players are planning in this space. The basic assumption is – the grand show must go on – with collective scientific learnings on how to coexist with the virus, for an indefinite period, if inevitable.

Integrated digital plan to get back more employees at the workplace by TCS:

Lilly, Amgen, PfizerAs reported on June 02, Tata Consultancy Services (TCS) are working on a plan to get back more employees to the workplace. The tech giant is focusing more ‘on increasing talent fungibility as global clients increasingly require associates with niche skills to be deployed on projects at short notices.

Thus, to evaluate how it will get a certain percentage of people back, TCS has drawn up a risk assessment model, Intelligent Urban Exchange (IUX). To effectively address the new requirements for employees’ safety, regulatory compliance, and operational efficiency, the company has devised this system. It will help TCS to get real-time insights that will help restore operations and ensure safety, while becoming nimbler and more resilient in the new normal.

What some global companies are planning now:

One will witness a mixed approach of global pharma players to get back employees at the workplace, soon. This will be evident from a few examples, as below.

A Bloomberg report on April 27, 2021, highlighted: ‘As vaccine drives ramp up and open the possibility of a return to the office, a growing number of companies have pointed to a continued role for remote work — and less of a need for pricey office space.’ It quoted Novartis CEO saying: ‘“We’ve all learned from the pandemic that we can work from home and work from the office, and it will always be a combination going forward.”

Thus, in Novartis, “hybrid-based working environment” – at-home and in-office work, will persist for the long term – extending beyond the pandemic. The Company CEO also reiterated: “We think this is the future.” The flexibility should allow Novartis to “access talent pools we would not have been able to access in the past,” he believes.

Similar approach, but with specific dates for returning to the workplace:

By an open announcement on Linkedin, the Chairman and CEO of Eli Lilly declared the Company’s plan at the current stage of Covid pandemic. He said: “More than a year later, I’m pleased to say that we’re actively planning Lilly’s return to our workplace in downtown Indianapolis, and other facilities around the world.”

He further said, on June 1, 2021, Lilly will begin reopening their Indianapolis offices, inviting 25 percent of our workforce back – with masking and distancing indoors, and a requirement for vaccination. Barring a change in the steady downward case rate in the community, the Company will then open to all Indianapolis-based employees on July 12, 2021.

The company’s new work model will be based on the requirements for each job. Some employees will be on site all the time, others most of the time, and some will have even more flexibility. As ‘individual work’, and some ‘transactional work’, is easier done remotely, employees in those roles can choose that option in consultation with their supervisor. But collaboration, innovation and learning are best done in-person at the Company facilities, the Chairman and CEO said.

He reiterated, Lilly is not taking these steps casually, but based on a data-based approach, and will continue to do so. If external factors change, Lilly will adapt. In other countries, the Company offices will continue to follow local guidelines and open as they are allowed based on local circumstances, the Company clarified.

More remote working being planned by many other global majors:

According to another report of May 07, 2021, many other global pharma and biotech majors are now planning in favor of long-term remote working for several critical business than ever before. For example, on May 07, 2021 Amgen announced that the Company will make working from home a permanent policy for much of its international workforce, including locally.

It said, “Most of our employees who are currently working remotely will continue to do so for a majority of their time, even after the pandemic ends. Our intent is to create a more flexible environment that intentionally combines the benefits of remote and in-person working.” The statement further added. “We are not initiating any changes to our Thousand Oaks campus at the time. Though some staff may come to campus less frequently.”

As reported on April 27, 2021, Pfizer has put its large Philadelphia-area campus up for sale, as it considers the future of work. According to the company, as revealed by Fierce Pharma, “The decision to do so is primarily being driven by the company’s evolving – flexible working model, providing employees with greater flexibility to work remotely while still maintaining the ability to connect and collaborate regularly on-site.”

Conclusion:

It’s over a year of business disruptions within the pharmaceutical industry, at varying intensity and in different phases, though. For example, after more than a year since the pandemic hit India, Covid 2.0 has, reportedly, pushed up Indian pharmaceutical sales to a new high. It recorded an exponential growth of 59% year on year in April 2021, against 16 per cent – year on year in March 2021. This is obviously an outlier and is apparently unsustainable. Thus, for a sustainable good growth with greater certainty, Indian pharma players would require working out a well-researched digital blueprint of the future working framework of business operations with ‘what if’ options.

As has been revealed, remote working, wherever it makes robust business sense, will help getting hard-to-reach talent pools regardless of geography. This opportunity needs to be leveraged. However, it’s also a fact that for various reasons, everyone may not be too comfortable to work from home. Thus, the future work plan may call for a balanced and employee specific approaches.

Which is why, the process will require in-depth analysis of key functions where the personal presence of qualified staff is necessary, mainly because, no extent of technological interventions can compensate the human presence. Then follows the question – when to start opening in a responsible way – following all prescribed Covid related health norms. A representative pilot trial may help in this area.

Some of the key factors to consider will include speed of getting the staff vaccinated. Besides, arrangement for quick identification of breakthrough Covid infections among staff through quick tracing, testing, and provisions for appropriate hospitalization, if necessary, need to be put in place. Thus, I reckon, it’s time for the domestic pharma companies to diligently plan for unleashing the new potential of the respective organizations – amid the pandemic-triggered changes in market dynamics.

By: Tapan J. Ray

With Changing Customer Behavior Pharma To Leverage AI For Better Engagement

Posted on April 5, 2021 by Tapan Ray

More than 55 million doses of Coronavirus vaccines were administered in India, reportedly, at the beginning of the last week of March 2021, in what is the world’s biggest inoculation drive. Notably, amid this mega initiative, the news media simultaneously reported that ‘India is facing a second wave of coronavirus because it let its guard down too soon.’ I also reiterated in my article of November 16, 2020 that in the thick of ‘Covid Vaccine Challenges – Abidance To Defined Health Norms Stays As Lifeguard.’

From the pharmaceutical industry perspective – as I had written on July 06, 2020, in the midst of this pandemic, there appears to be a break in the clouds that pharma should effectively leverage. There isn’t an iota of doubt that Covid pandemic, for-all-practical-purposes, has propelled healthcare into a virtual world, primarily for survival of business, maintaining the continuity.

Most pharma players, especially in the sales and marketing domain, either were not or, were using e-marketing, in a selective way, as a key strategic tool in their brand prescription generation process. The pace of this shift in the digital space is now getting accelerated to more than neutralize the long-term impact of unprecedented business disruptions that overwhelmed the industry, last year.

Interestingly, a large number of pharma marketers weren’t focusing much beyond syndicated retail and prescription audit data, in the old normal. Whereas, to make digital strategies work effectively during rapidly changing customer behavior and business environment, ‘customer centricity’ is no longer an option today. It’s rather a key business success factor for effective customer engagement, in the prevailing environment. Thus, unlocking the ‘Herculean Power’ of targeted data of many types and genre, is a pre-requisite for acquiring deep insight in this area, while moving in this direction.

Alongside, comes the need to unleash the power of Artificial Intelligence (AI) to ensure pinpoint accuracy in targeted strategy formulation for the same. Well before Covid struck, I wrote on April 01, 2019 – ‘A New Pharma Marketing Combo That Places Patients At The Center of Business,’ flagging a slowly emerging need. Covid, unexpectedly, has provided a strong tailwind to it, increasing its urgency manifold in the new normal.

Consequently, pharma marketers should have, at least, a working knowledge in this area – such as ‘machine learning’ and other analytics-based processes of AI that can help them enormously. In this article I shall discuss, why it is so important for today’s astute pharma marketers to hone their knowledge in this area for making a strategic shift towards ‘real-life’ Patient-Centricity. No wonder, why top pharma leaders now consider this transformation so critical for pharma strategy formulators, to acquire a cutting-edge in the digital marketing warfare.

Patient needs aren’t really at the center of a business strategy, today:

Despite so much hype on patient-centricity – in a true sense, patient-expressed needs aren’t generally placed at the center of a business strategy, as on date, unlike most non-pharma companies. That pharma players, by and large, don’t have a robust online feedback mechanism in place to capture ‘patient-experience’ with medications – directly from patients, vindicates the point.

As I reiterated in my article of March 21, 2021: ‘Measuring patient-experience has always been an integral part, virtually of all types of sales and marketing using digital platforms. We experience it almost every day, such as, while buying a product through Amazon, buying grocery items through D-Mart, scheduling a doctor appointment through Practo, buying medicines through PharmEasy, or even for availing a service through Urban Company.’

Thus, patient-experience, in their own words, with prescribed medications, is generally expressed to the physician, if at all. The process, generally, doesn’t get extended to drug companies’ strategy formulators for taking a patient-centric amendment, wherever needed.

However, assuming that doctors would convey the same to concerned medical representatives, it becomes a third hand (patient-doctor-Rep-Company) feedback, with commensurate distortions in each verbal transfer of communications. The outcome of this strategic gap has been captured in several research studies.

Outcomes of absence of online direct ‘patient experience’ feedback system:

Let me elaborate this point by quoting an example from a contemporary research in this area. This study was conducted by DrugsDisclosed.com in August 2020 with a total of 3,346 patients all taking medicine on a daily basis – aged between 18 and 80. The key findings are as follows:

72% of patients feel ignored by pharma companies.
76% don’t trust advice from them.
81% feel that drug players influence prescribing decisions.
63% would like to give product feedback to directly to companies.
69% find their medication effective.
81% feel their medication is needed.
77% feel confident with their medication.
82% don’t feel bothered by side effects from their medicine.
73% take the medicine as agreed with their doctor.
74% feel that the benefits of their medication outweigh the disadvantages.

The study concluded – the above insights show the need for patients’ voices to be heard by the pharma companies. If medicines are to solve health problems for billions of people who need them, listening to real-life patient-experience with medication, is the key to unshackle the full potential of the world’s health systems. Thus, pharma companies need to directly listen to what patients experience and express with their medicines. It will help them earn customer-trust and greatness in business, while gaining new and important insights for performance excellence.

I hasten to add, although, this study was conducted among patients residing in the UK, Ireland and Denmark, the core issue, even in India, is unlikely to be much different from what appears above. This genre of pharma marketing approach would warrant extensive use of AI, much more in the coming days – than ever before.

The above genre of pharma marketing calls for extensive use of AI:

The above genre of pharma marketing calls for extensive use of AI, much more in the coming days than ever before. For example, as new generations of Covid vaccines will come – with some without the use of needles, like a nasal drop, machine learning tools may be necessary for pinpoint accuracy in market segmentation. I reckon, there will be many such areas, where those companies who would use AI to orchestrate a cohesive customer experience, will drive stronger differentiation, better customer access and higher sales impact.

In that process, creating opportunities and empowerment for deserving marketers to reap the benefits of AI based digital tools and systems, such as machine learning with human integration within sales and marketing, will be the need of the hour. Gaining actionable insights from this endeavor, marketers need to go whole hog to unleashing the power and value of AI for achieving business excellence. I wrote about it, even during pre-Covid days – on July 15, 2019. But, this approach has assumed much greater importance in the new normal, when innovative e-marketing is gaining momentum to gain a competitive edge. However, this would require more investment in AI than what it is today.

The process has accelerated during the Covid pandemic:

This has come out clearly in the results of McKinsey Global Survey 2020 on AI. The paper is titled – ‘The state of AI in 2020’ and was published on November 17, 2020. The findings of the study ‘suggest that organizations are using AI as a tool for generating value. Increasingly, that value is coming in the form of revenues.’

Although, the number of these companies is small, they are planning ‘to invest even more in AI in response to the COVID-19 pandemic and its acceleration of all things digital.’ The paper emphasizes that this could create a wider divide between AI leaders and the majority of companies who are still struggling to capitalize on the technology.

Pharma’s increasing use of AI during the pandemic:

The above trend gets reflected in the ‘AI In Pharma Global Market Report 2021: Covid-19 Growth And Change.’ The report underscores, the global AI in pharma market is expected to grow from $0.91 billion in 2020 to $5.94 billion in 2025 at a CAGR of 47%. The initial spurt in growth was mainly due to companies resuming their operations and adapting to the new normal while recovering from the COVID-19 impact, the report underscores.

Although, the number of pharma entrants in this space isn’t yet very many, major players includePfizer, Novartis, IBM Watson, Merck, AstraZeneca and Bayer. Gradually, some Indian drug companies are also testing water in this area, as discussed in the article – ‘The Increasing Use Of AI In The Pharmaceutical Industry,’ published by Forbes on December 26, 2020.

Conclusion:

“Patient-Centricity” emerging as a hallmark, fueled by rapidly changing expectations and behavior of pharma customers, especially doctors and patients. To be effective with such changes in market dynamics – capturing ‘patient experience’ with medication – directly from them – to the respective companies online, is a necessity today.

Most other industries involved in digital marketing are already doing so. Pharma companies while embracing e-marketing can’t just wish it away, any longer. Today, when digital marketing has commenced in the pharma industry, with accelerated speed – machine learning alongside the creative application of AI powered analytics, can immensely help gaining actionable insights on customers. These include customer experience, their perception and pattern of usage of brands, besides channel preferences, preferred contents for effective engagement.

Thus, the consequences of not directly listening to patients’ voice on structured digital platforms – supported by analytics, can be ignored at pharma marketer’s own peril. Many of them may not yet be able to fathom the depth of its potential, opportunities and possible roadblocks, or simply unable to figure out where to begin with and – how. Experts’ hand-holding will be pivotal for them in the transition phase of this endeavor. From this perspective, I reckon, to keep pace with fast-changing customer behavior, pharma marketers need directly listen to patients’ voice online. And based on which, develop customized strategies by leveraging AI – for more productive engagement with them.

By: Tapan J. Ray

Changing Doctors’ Practice Dynamics With Covid-19 And Beyond

Posted on May 11, 2020 by Tapan Ray

Unexpectedly, the answer to an onerous question surfaced just around a year’s time. In my article on this blog, written on April 08, 2019, I raised a question – “Would ‘Connected Healthcare’ Catch Pharma Players Off-Guard?” Interestingly, an unexpected and abrupt turn of events in the global healthcare space, including India, triggered by Covid-19 pandemic, signals an early dawn of an evolving reality, related to ‘Connected Healthcare’, in India.

Never ever, I reckon, the Government realized so well that continuation with a fragile public healthcare infrastructure is self-defeating for the country. Allocation of financial resources, at least 2.5 percent of the country’s GDP, for its rejuvenation – powered by AI-based modern digital technology, would help avoid overburden on the healthcare system. This will mean, saving more lives and also a significant reduction of morbidity, especially in a situation, like Covid-19 pandemic. Good health can propel good economy, more effectively.

That’s why, ‘connected healthcare’ – by effectively linking requisite ingredients of all health-related information that medical professionals and the patients would need, appears to be the new reality. This process is being facilitated by rapid acceleration of usage of various digital platforms, by both healthcare consumers and providers. Thus, it is becoming increasing clear now that leveraging digital technology with innovative mindset and a fresh pair of eyes, will be the way forward, in India, as well. It seems very likely, when considered from two angles:

What several research data reveals about an increase in usage of digital platforms by healthcare consumers and providers, before and during Covid-19 pandemic. Especially because, this struggle appears to be for a long haul.

Most countries are currently struggling to navigate through highly contagious Covid-19 outbreak and simultaneously trying to chart a workable pathway for avoiding similar eventualities in the future.

In this article, I shall try to focus on Covid-19 induced changes in doctors’ practice dynamics – based on research studies, while revisiting the subject on ‘connected healthcare,’ and its relevance now – also in the years ahead.

Research studies capture a new and growing awareness:

The recent findings from the “Digital Doctor 2020” survey, which is a ‘21-country study of Doctors’ perspectives on digital and connected health, highlight some interesting points. This study was conducted just before the global outbreak of Coronavirus. Some of its findings were also deliberated inan article published in the PharmExec.com on April 23, 2020. The paper is titled, ‘How Prepared Were Physicians for the COVID-19 Digital Upswing? Some of the key points, as reported, are worth noting:

Although, the awareness of drug prescribers of different digital technologies related to healthcare is high, how these technologies work in healthcare was unknown to many doctors at the time of the Digital Doctor 2020 survey. It came out that clear benefit statements, will be welcomed when there is such a steep learning curve.

Regardless of face-to-face interactions still remaining preferred choice before the pandemic, online channels are on the rise and accelerating with COVID-19 lockdown.

Benefits of using connected health devices for patient management and treatment are widely recognized and is believed to play a key role in the future. The respondents agree, even their patients are now more interested in their own health data, as they are gaining control over their weight, diet and physical activities.

Highlighting that their research data over the last few weeks showing increasing usage of digital solution to respond and adapt to the new realities of Covid-19 pandemic, the author of the article concluded: ‘For a long time, digital solutions have often been considered an option; now they have become a necessity.’ To understand the emerging scenario, let us now look at the preferred communication channels of the doctors – pre-Covid-19 outbreak.

Preferred channels of doctors pre-Covid-19 outbreak:

According to the Ipsos survey of pre-Covid-19 outbreak, face-to-face communication with Medical Representatives (MR) used to be the most favored channel of the doctors, as follows:

Channel	Med. Rep	Speaker Program	Conf.	E-detail	Journal Ads	Med. Liaison	E-mail	Direct mail	Pharma website
Pref. %	35.2	11.7	10.0	8.4	8.4	8.8	8.4	5.0	4.1

However, on April 14, 2020, Ipsos shared the results of their interim research conducted, together with M360, among doctors, conducted during Coronavirus outbreak. The preliminary findings indicate, Covid-19 will permanently alter physician practice dynamics. A clear shift in the engagement model with them – away from in-person detailing, throws several significant questions on the traditional physician engagement template of the pharma players.

It also signals another fundamental change in the physicians’ practice dynamics, as Covid-19 seems to have changed practicality of having face-to-face communication between the representatives and doctors, as before. This situation makes ‘connected healthcare’ a reality – as we move deeper into the everyday- evolving scenario.

Some unexpected and significant changes surfaced in a month:

The above research also flagged, the following two important changes, among several others, triggered by the Coronavirus outbreak:

The mean number of sales representative visits dropped from 15.7 before the Coronavirus outbreak to 1.3 in just the following month, during the pandemic

Overall preference and effectiveness of e-detailing also improved, significantly, where any non-personal communication and interaction with drug companies, either through sales representatives or by others, were considered as e-detailing.

This brings me back to the question, how are doctors feeling about this never before shift in their practice dynamics?

How are doctors feeling about a never before shift in their practice dynamics?

The ongoing research on this critical area captures a new reality, where many doctors, especially those who are not directly engaged in combating the Covid-19 pandemic, are clearly feeling a shift in their practice dynamics. Curiously, the new feeling of a shift also includes, the way these doctors interact with different drug companies, mostly through their Medical Representatives.

These inklings of the doctors are expected to get translated into some fundamental changes in the real-life situation, as we all sail through the life-changing time caused by Covid-19. Especially, considering the requirements of a new normal – social distancing, wearing a mask always while on outdoor, and several other norms as prescribed from time to time.

‘Connected healthcare,’ is expected to take its place on the center stage:

In this situation, ‘connected healthcare,’ which used to be more discussed than practiced, is expected to take its place on the center stage. It is necessary in the present situation for remote consultations, primarily for chronic ailments – for effective disease management and treatment. More so, as in the current situation individual health awareness of a large population, even in India, is increasing with an accelerated speed, perhaps more than ever before.

Thus, this is the right time to focus on ‘connected healthcare’, powered by AI-based digital technology. It has immense potential to help the Indian population getting immediate medical attention at a lower cost, with an improved access, for all. Though these are early days, it appears the ball has started rolling in the right direction, as the recent draft guidelines of the Indian Council of Medical Research (ICMR) indicates: ‘Patient can WhatsApp, SMS or email consent for Covid-19 clinical trials.’

Conclusion:

Still today, there is no sign of even temporary flattening the disease progression curve in India. As on May 10, 2020 morning, the recorded Coronavirus cases continue to climb sharply to 62,939 with 2,109 deaths, which is rising in India faster than most other countries. On May 07, 2020, AIIMS director again warned that Covid-19 pandemic is yet to peak in the country. “According to modeling data and the way our cases are increasing, it is likely that peak can come in June and July,” he added.

But is it getting worse? Despite stringent lockdown, there has been a surge in cases, which can also be attributed to higher levels of testing. However, from a doubling rate of 11.5 days on May 3, it has shortened to 10.3 days, which means that cases are doubling in quicker time. Each set of 10,000 cases is now increasing at a more rapid pace than the preceding set, highlighted an editorial of a leading news daily.

With a vaccine still elusive, the government had been banking mostly on the lockdown to break the chain of transmission of the virus. Meanwhile, the World Health Organization (WHO) has said: ‘Deliberately infecting healthy people with Coronavirus may speed Covid vaccine studies,’ reflecting more uncertainties in this area. It is also not likely that the country will cease to have any problems with its fragile public healthcare infrastructure and delivery system, even after flattening the disease progression curve.

Along with many other Covid-19 induced life-impacting changes, doctors’ practice dynamics are also expected to undergo a metamorphosis, lasting for an indefinite period. Consequently, I reckon, it’s about time, even for the pharma industry to voluntarily adopt ‘connected healthcare’ as a future way of life. One can get a glimpse of it in the Covid-19 clinical trial draft guidelines of the ICMR. Nonetheless, ‘connected healthcare’ comes with a clear signal of reducing the cost of healthcare and improved patient access, having the potential to effectively mitigate a sizeable part of the precipitated healthcare crisis, caused by Coronavirus.

By: Tapan J. Ray

Changing – The Key Differentiator To Boost Pharma Market Share

Posted on July 8, 2019 by Tapan Ray

Health problems, affecting populations of any country, are many. So are the issues related to the delivery of effective health care solution, that most patients would consider satisfying and meaningful. From this perspective, prevention, treatment and effectively managing any disease is basically a problem-solving situation, for all, as we see around.

Interestingly, an ailment, per se, may not necessarily be the only problem that needs to be solved by a doctor, hospital or a pharma company with its drugs. Other associated factors, playing a key role in the process of patients’ search for a meaningful solution – could often post to be tougher barriers in finding the solution. Therefore, patients’ problem during any disease treatment process, is much more than the disease or availability of required drugs.

Consequently, it is very important for all, especially the pharma marketers, to properly understand what these specific influencing factors are, for each patient-groups or types, if not each patient. Obviously, it would call for generation of relevant data to precisely define the problem, or a set of problems, as the patients feel and envisage. Conversely, these problems should not be defined by the company, based mostly on gut feel, just as it’s so difficult to fathom how another person would feel in a distressing situation. Thus, the need to chart a strategic roadmap to provide a solution to those problems will arise only thereafter.

In pharma context, there are several critical elements in this problem-solving process. However, in this article, I shall focus only on two areas. As these could provide a cutting edge, if used in creative ways by drug manufacturers in arresting patients’ and other stakeholders’ attention on this crucial process.

Three critical elements to the problem-solving process:

Among several others, I reckon, the following three elements would play critical roles in the problem-solving process that is specific to the pharma industry:

The mindset to follow the problem-solving approach with all sincerity.
Communicate the problem-solving process in a creative way to patients and others.
Walk the talk, earning patients’ delight and enhancing the corporate reputation.

Since, the third element, although very important, is involved with the strategic roadmap of the organization, let me discuss here the first two elements to justify the need for this stratagem.

The key differentiators are changing:

A clear shift is underway that will influence what drug will be prescribed and the treatment process that individual patients would prefer.

Not so long ago, and to a large extent even today, one of the key differentiators to sell high price patented products used to be the narrative of ‘billions of dollars’ of investments that go behind time-intensive and high-risk R&D. Nevertheless, this age-old recital now finds lesser and lesser number of takers, largely within patient groups.

Alongside, run several other product-centric differentiators, such as claims and counterclaims on technological and clinical superiority, or how a new drug prolongs life of some cancer patients by a few months over other drugs. These are the old workhorse of differentiators, which are just not enough to increase brand market share, in today’s fast-changing environment.

Brand differentiating factors should reach much beyond the product:

As more patients are getting increasingly interested in their personal health interests and rights, the differentiating factors should reach much beyond products. Some drug companies are already sensing that more patients have started looking for a desired and effective solution, whenever they face a health-related problem. Accordingly, the ability of a pharma player to provide a custom-made solution, as it were, to patients, is emerging as a crucial differentiating factor. This has immense potential to boost the brand market share faster.

Let me underscore, yet again, that this change is surfacing due to changing demands of patients in this area. Thus, soon pharma companies would require shifting their focus from product-centric brand differentiation to patient-centric ones, with problem-solving offerings for patients in creative ways.

Communicate the problem-solving offerings in creative ways to patients:

That the core purpose of pharma business is to prevent, cure or effectively manage illness, is known to many. However, that doesn’t explain one critical parameter that patients now value most. This is, how a drug company provides effective solution to specific health problems of individuals – making the company’s product and services most meaningful to him or her.

Encouragingly, some top pharma advertising companies dealing with pharma, healthcare and wellness products, have started advising so, to their respective clients, as reported by Fierce Pharma on June 17, 2019.

One such ad agency honcho said: “The reality is that pharma and health are closer to doing good anyway, that’s just part of what they do. Looking for opportunities to serve the patient in a creative way is what we need to do in pharma as well, not just, ‘let’s go and sell this drug.’ Admitting the current issues with most pharma players, he further articulated: “But there’s a huge trust gap because people think pharma companies are just out to make money. The more they can do that supports their customer base, which is patients, the more quickly we’ll erode that.”

As reported in the same article, this advice was given to the pharma industry at the Cannes Pharma Lions Awards function on June 17, 2019. It is one of those top award functions, where one gets to know about the best creative communications of pharma and health care companies, designed to facilitate understanding and awareness on various health problem-solving processes for patients.

An interesting platform to know about pharma’s problem-solving offerings:

One of the well-respected platforms where one can witness creative and innovative communications in the pharma industry, is during Cannes Pharma Lions Awards. This ‘is considered the largest gathering of the advertising and thecreative communications industry. The five-day festival, incorporating the awarding of the Lions awards, is held yearly at the Palais des Festivals et des Congrès in Cannes, France.’

New age creative pharma communication, bringing science and innovation to life, compete in the Pharma Lions award functions. These facilitate not only disease awareness – both mitigation or management, diagnosis and patient’s-need-based prescriptions, but also add value while engaging with healthcare professional and patients, more effectively.

Some of the entries vindicate that creativity in pharma communications has started moving ahead and faster than expected, with special focus on patients’ problem-solving. As an illustration, let me cite the example of top Pharma Lions Winner at Cannes 2019.

GlaxoSmithKline GSK) and its ad agency McCann Health picked up this coveted award in pharma advertising with a mobile application called Breath of Life. This is a diagnostic tool for COPD developed for GSKand is aimed at raising awareness and increasing diagnoses of the disease in China. COPD affects an estimated 100m adults in China, but only around 7 percent is properly diagnosed, as the report highlights.

Now, an example from the wellness area:

This specific approach for a Vitamin D fortified dairy product, is also equally innovative, as quoted in the above Fierce Pharma article. Many may be aware that Vitamin D deficiency is not uncommon in India – 80 percent of children in Delhi, reportedly, suffer from this deficiency. The manufacturing company launched its campaign in schools to move the traditional, outdoor morning assembly to noon, when brief sun exposure could have a big effect on vitamin D levels. The campaign invited schools to a launch event, providing a solution to the problem of Vitamin D deficiency in children. The idea clicked with excellent media coverage.

As the ad agency said: “We didn’t make a TV commercial or run print ads. We looked at a problem and how we could solve it and showed that the brand cares about kids.” Nevertheless, he added, make no mistake, it was also an ad, which made parents want to buy the brand.

India and Cannes Lions Awards in health and pharma categories:

The good news is, Indian companies are also participating to showcase their creative communication skills, in problem-solving areas of health, wellness and pharma domain. Although, one doesn’t find the names of any large domestic pharma players in the list, India had put up a good show by bagging a total of four awards, including a gold, two silvers and a bronze in the health and pharma categories on Day 1 of the Cannes International Festival of Creativity, in 2018.

In the years ahead, one hopes that Indian drug manufacturers will show greater interest in this area, to sharpen their critical differentiating tool in disease awareness, brand marketing focused on problem-solving for patients, who search for an appropriate solution while addressing a disease condition.

Is pharma in search of a different approach?

Instances, such as, Cannes Pharma Lions Award, indicate that an increasing number of pharma players have, at least, started recognizing that old ways of differentiating brands, would no longer fetch desired outcomes, as patients’ mindsets are changing – fast. Patients’ outlook for prevention, treatment and managing chronic ailments are also changing – empowered by a plethora of unlimited free information – as and when they require.

Accordingly, drug companies who are partnering with creative pharma ad agencies are being persuaded more to look for a radically different approach to be on the same page with their customers. It also requires the top management mindset to be in sync with this fundamental change, inviting full commitment from all. The new communication package, then becomes a fine blend of top-class creative inputs and modern technology platforms for delivery. The core purpose is to effectively connect with patients, doctors, hospitals and governments, being an integral part of their problem-solving process in health care.

Conclusion:

The article titled, ‘Solving Problems Is More Important Than Selling Your Differentiators,’ published in Forbes on June 14, 2018, highlighted a very important point. It wrote, if a company keeps zeroing in on its traditional brand differentiator, as discussed above, the business is likely to miss out on potential new customers and the revenue they could bring with them.It then elaborated: ‘The real trick to getting noticed comes down to shifting your focus. It’s not about you. And it’s definitely not about you versus them. It’s all about solving problems and evoking the right emotions.’

The short list of Cannes Pharma Lions Awards, signals that this process has just begun, but yet to gain a critical mass within the industry. In this area, as yet another head honcho puts it: “Given the shortlist for the Innovation Lions, you can already see a trend where agencies have focused on making work that impacts patient lives on a day-to-day basis, through more meaningful use of technology for practical and life-changing purposes.”

Thus, it is important for new age pharma marketers to note that their business environment is changing – faster than ever before. The traditional brand differentiators, however much honed, may not fetch desired increase in the market share, in the future.

The new crucial differentiator in this area, isthe ability of a pharma player to conceive, design, provide and effectively communicate, virtually a custom-made disease treatment solution to patients. Equally important is the skill to communicate this ‘problem-solving process’ to the target audience in creative ways, for top of mind recall, at least, the company’s name. In turn, it would also facilitate the prescriber choosing a company’s brand, that rings a bell to the patient. And that’s the new way for pharma marketers to boost their brand market share, faster.

By: Tapan J. Ray

The Game is Changing: Ensure Better Treatment Outcomes: Leverage Technology

Posted on June 3, 2019 by Tapan Ray

Today, several pharma players, mostly ‘encouraged’ by many non-pharma tech companies, are trying to gain, at least, a toehold in the digital health care space. It is visible even within the generic drug industry. Such initiatives, as they gain a critical mass, will remold the process of doing – almost everything in the pharma business, catapulting the concerned drug companies to a much higher growth trajectory, as many believe.

This is quite evident from an interview of Fierce Pharma with the senior management of Sandoz – the generic drug arm of Novartis, that was published on May 14, 2019. The honchos said: “We’re looking across the whole value chain to make sure we’re embracing digital and technology wherever we can. So that means from the way that we innovate, to the way that we sell and the way that we operate and do day-to-day business.” The process covers “a whole range of activities from how you use AI and automation, all the way through to prescription digital therapies.”

I discussed about leveraging technology in the pharma space to address many burning issues – both for patients and the pharma industry. One such article, “Focus on Patient Compliance To Boost Sales…And More…”, was published in this blog on May 20, 2019. It establishes that even world-class sales and marketing programs can, at best, ensure higher prescription generations, but can’t prevent over 50 percent revenue loss from those prescriptions, due to patient non-compliance.

Interestingly, the issue of ‘nonadherence to treatment’ is being debated, since several decades. Various conventional measures were suggested and also taken. But the problem still persists in a huge scale, with probably an increasing trend. Thus, fresh measures, preferably by leveraging modern technology, are of high relevance in this area.

In this article, I shall illustrate the above point, with one of the most exciting areas in the digital space – the digital therapeutics. This is a reality today and marching ahead at a much faster pace than many would have anticipated.

Unfolding another disruptive innovation in healthcare:

One of the articles that I wrote on this subject is ‘Unfolding A Disruptive Innovation in Healthcare,’ which highlights a different facet of the same subject. Thus, let me begin today’s discussion with a recapitulation of some important aspects of a drug, particularly the following ones:

A large number of patients don’t find many drugs accessible and affordable during the entire course of treatment.
Drugs have to be administered orally, systemically or through any other route
Alongside effective disease prevention or treatment, many drugs may bother patients with long and short-term side-effects, including serious ones.
Treatment outcomes can’t often be easily measured by patients.

These are, of course, known to many, but several questions come up in this area, which also deserve serious answers, such as:

Are drugs indispensable for the treatment of all types of disease?
Can a holistic disease treatment be made more accessible and affordable with radically different measures?
Can the same effectiveness of a drug, if not more, be achieved with no side-effects with a non-drug therapy?
Can outcomes be significantly improved following this process, as compared to drugs?

In search of answers to these questions – arrive digital therapeutics:

In search of answers to the above questions, a number of tech savvy whiz kids. dared to chart an uncharted frontier by asking themselves: Is it possible to treat a disease with a software – having no side-effects, but providing better cost effectiveness and treatment outcomes to patients?

Today, with the signs of healthy growth of the seed – sown with the above thoughts, ushers in – yet another game changing pathway for disease treatment. The quest for success of these pathfinders can benefit both – the drug innovators and also the generic players, in equal measure, besides patients. Digital therapeutics is an upshot of this pursuit.

Its ‘purpose’ outlines – why it’s one of the most exciting areas in digital space:

The Digital Therapeutics Alliance well captures the purpose of digital therapeutics, as, “Improving healthcare quality, outcomes, and value through optimizing the use and integration of digital therapeutics.”

What do digital therapeutics actually do?

There are several, but quite similar descriptions of digital therapeutics. For example, Deloitte described digital therapeutics as software products used in the treatment of medical conditions, enabling patients to take greater control over their care and are focused on delivering clinical outcomes. It also highlights, ‘digital therapeutics are poised to shift medicine’s emphasis from physically dosed treatment regimens to end-to-end disease management based on behavioral change.’

Digital therapeutics offers all positives of a drug and more:

In indications where digital therapy is approved and available, the new approach offers all positive attributes of an equivalent drug, with no side-effect. There isn’t any need of its physical administration to patients, either. Deloitte elucidated this point very aptly: “As software and health care converge to create digital therapeutics, this new breed of life sciences technology is helping to transform patient care and deliver better clinical outcomes.” More importantly, all this can be made available for better compliance and at a cheaper cost in many cases.

For example, according to the article published in the MIT Technology Review on April 07, 2017, carrying the title ‘Can Digital Therapeutics Be as Good as Drugs?’: “Some digital therapeutics are already much cheaper than average drug. At Big Health, people are charged $ 400 a year, or about $ 33 a month to use the insomnia software. The sleeping pill Ambien, by contrast, costs $ 73 for six tablets of shut-eye.”

Two basic types of digital therapeutics:

The Digital Therapeutics Alliance also underscores: “Digital therapeutics rely on high quality software to deliver evidence-based interventions to patients to prevent, manage, or treat disease.” It further elaborates: “They are used independently or in concert with medications, devices, or other therapies to optimize patient care and health outcomes.” In line with this description, the above MIT Technology Review article, as well, classifies digital therapy into two basic categories:

For medication replacement
For medication augmentation

It also says that the digital therapy for sleep (sleep.io), belongs to the first category, making sleeping pill most often unnecessary and with outcomes better than those of tablets. Whereas, the second category includes various disease specific software apps that improve patient compliance with better self-monitoring, just as co-prescription of drugs.

Nonetheless, the same MIT article gave a nice example of ‘medication augmentation’ with digital therapy. The paper mentioned, Propeller Health – a digital company, has inked a deal with GlaxoSmithKline for a ‘digitally guided therapy’ platform. The technology combines GSK’s asthma medications with Propeller Health made sensors that patients attach with their inhalers to monitor when these are used. Patients who get feedback from the app, end up using medication less often, the study reported.

The first USFDA approved digital therapy:

Let me give one example each of the launch of ‘medication replacement’ and ‘medication augmentation’ digital therapy, although there were other similar announcements.

On November 20, 2018, by a media release, Sandoz (Novartis) and Pear Therapeutics announced the commercial availability of reSET – a substance use disorder treatment that was the first software-only digital therapeutic cleared by the US-FDA, for medical prescriptions.

Closely followed by the above, on December 21, 2019, Teva Pharmaceutical announced US-FDA approval for its ProAir Digihaler for treatment and prevention of bronchospasm. Scheduled for launch in 2019, it is the first and only digital inhaler with built-in sensors that connects and transmit inhaler usage data to a companion mobile application, providing insights on inhaler use to asthma and COPD patients – for prevention and better treatment of the disease.

Many other projects on digital therapeutics are fast progressing.

Conclusion:

Stressing a key importance of digital therapeutics in chronic disease conditions, McKinsey article of February 2018, titled ‘Digital therapeutics: Preparing for takeoff’, also underlines: ‘Digital therapeutics tend to target conditions that are poorly addressed by the healthcare system today, such as chronic diseases or neurological disorders.’

It also, further, emphasized that digital therapeutics can often deliver treatment more cheaply than traditional therapy, by demonstrating their value in clinical terms. It illustrated the point with US-FDA’s approval for a mobile application that helps treat alcohol, marijuana, and cocaine addiction, well-supported by clinical trial data. The results showed 40 percent of patients using the app abstained for a three-month period, compared with 17.6 percent of those who used standard therapy alone.

I now come back to where I started from. The pharma ball game is changing, and that too at a faster pace.Ensuring and demonstrating better treatment outcomes for patients – both for patented drugs and the generic ones, will increasingly be the cutting-edge to gain market share and grow the business. Thus, leveraging technology to its fullest is no longer just an option for pharma companies. The evolution of digital therapeutics as a game changer, vindicates the point.

By: Tapan J. Ray

Adopt A Hybrid Business Model For Better Sales – Not A Large Field Force

Posted on April 29, 2019 by Tapan Ray

For aggressive business expansion or to attain greater market access, creating a large sales force has been the thumb rule in the pharma industry, since long. To meet the challenge of changing market dynamics, going for a thorough re-engineering of even a rattling sales and marketing machine, is still considered a risky proposition.

Many studies have captured the common reasons of such hesitations. For example, the McKinsey article titled, ‘Cutting sales costs, not revenues,’ finds that field force being a major growth engine for sales, since long, the thought of overhauling it fills senior executives with dread. Thus, to keep sales flowing, companies will make piecemeal ongoing repairs as long as they can – ‘no matter how patched up or spluttering that engine may be.’

Nevertheless, some compelling business reasons have now prompted several pharma players to accept the ground reality – fast-evolving over the last one and half decades. Many of them have realized that in today’s changing market dynamics, a leaner and smarter sales force (or field force or medical rep, or MR) will fetch the desired results than ‘flabby’ and larger ones.

In this article, I shall not discuss the obvious reasons of downsizing, such as to record profit under trying circumstances, or when per rep productivity keeps declining consistently, or during a change in the promoted product-mix, or a decision to reduce focus on volume intensive-low margin generic brands. But, what I shall discuss is, the reasons for an urgent need of creating a hybrid sales and marketing model, during this changing paradigm.

It begins with accepting a change in the business environment:

If the objective of sales force size reduction remains limited to cost-cutting for short-term improvement of the bottom-line, it could be grossly counterproductive, possibly with many unforeseen consequences. Field staff will continue to remain one of the key growth drivers in pharma and biotech business, but not the sole mechanism to increase brand prescriptions. Finding a well-integrated alternative model would begin with acceptance of a significant change in pharma business environment.

Undoubtedly, a perceptible change is noticeable today in pharma stakeholders’ mindset. This change is being further fueled by rapid increases in their usage of various digital platforms and networks. For example, many patients are trying to be reasonably informed of even various disease treatment options and the cost of each, much before they visit a doctor’s clinic or a hospital. The nature and quality of their interaction with health care providers, including doctors, are also changing. Patient-experience during a treatment process, and the value offerings that come with a pharma brand, will have increasing relevance to business performance – more than even before. Anything going against the patient-interest will possibly be shared with all, mostly in social media, which has a potential to precipitate serious consequences.

As this trend keeps going north, pharma market dynamics would change, commensurately, making pharma’s key business success factors significantly different with medical reps no longer being the sole prescription generators. A new hybrid – digitally empowered sales and marketing model is, therefore, the need of the hour. In this new ball game, as a growth driver, the role and size of the field staff will be quite different, where the senior management warrants a new vision for pharma business.

The situation warrants a new vision for pharma business:

In this changing situation, to generate more prescriptions from doctors by deploying a large field force, could prove akin to swimming against a strong tide. Whereas for achieving business success at this time, pharma players would require creating a well-oiled augmented value delivery system for enhanced customer experience, primarily for patients during their entire treatment process.

While creating this sleek and effective system, it would be necessary to cut unproductive or less productive flab in the frontline, with great precision. However, this process must be dovetailed with implementation of other communication and customer engagement platforms, mostly digital, to achieve the set objectives.

The new strategy being augmented value delivery to customers, the process would entail, besides innovative and modern tools, a different genre of field staff members, possessing some critical skill-sets. The goal of need-based field force downsizing complemented by new synchronous measures for operational synergy, must not only be clear to senior management, but also be explained to all concerned.

What would ‘augmented value delivery’ to customers lead to?

Another McKinsey article titled, ‘The few, the proud, the super-productive - how a smart field force can better drive sales,’ articulated: ‘Indeed, our perspective on the past five years is that leaders that used field reductions to actually rethink the commercial model – rather than taking a “blunt instrument” approach to cuts – are reaping rewards.’

As the current pharma sales and marketing models are undergoing a metamorphosis, globally – this transition phase throws several tough challenges – from defining new roles and capabilities for field staff to creative use of various interactive communication platforms. As the McKinsey article underscores: ‘new capabilities need to be added even as we continue to use the tried and true current model, albeit with less success. It further adds: ‘The inconvenient truth: we will have to sweat the current model and build the capabilities for the future in parallel. Those hoping for a ‘flip the switch’ transition, are likely to be disappointed.” With his, I reckon, will emerge a robust ‘augmented value delivery system’ for the business leading to:

Higher profitable sales through satisfied customers
Increase in sales per employee ratio
Containing/reducing sales and marketing spend as a percentage of total revenue.

Several initiatives to translate this concept into reality is now palpable, globally. A few examples may suffice to drive home this point.

Downsizing field force complemented by new measures for synergy pays:

Here also there are several research studies to bring home this point. One such is the paper titled, ‘Big pharma proves that oncology pays as workforces shrink,’ published in ’Vantage’ of Evaluate on July 23, 2018. The researchers touched upon this area while discussing the workforce productivity for Bristol-Myers Squibb (BMS). It found that a substantial shrinking of its workforce, alongside some other important measures, has given BMS a big boost in sales, with a dramatic impact on its overall performance. As the study indicated, even investors will find this fact hard to ignore. Let me hasten to add that ‘downsizing workforce’ mainly involved sales and R&D staff in this analysis.

The article further highlighted, during the period of 2007 to 20017, the management teams of some other pharma majors, as well, such as GlaxoSmithKline), AstraZeneca and Eli Lilly, either reduced their workforce significantly or kept flat. According to this study the changes in the workforce of these 4 companies are as follows:

Workforce	Bristol-Myers Squibb	GlaxoSmithKline	AstraZeneca	Eli Lilly
2007	42,000	103,483	67,400	40,600
2017	23,700	98,462	61,100	40,655

However, even in the year 10, all the four companies - Bristol-Myers Squibb, GlaxoSmithKline, AstraZeneca and Eli Lilly posted not just sales growth, bit all-round performance improvement, as may be seen by clicking on each.

Having deliberated on the impact of downsizing field force, let me now focus on powerful complementary measures for augmented value delivery to customers.

Today’s reality for pharma business in India can’t be wished away:

The EYstudy titled, ‘Reinventing pharma sales and marketing through digital in India,’ captures the current situation quite well. I am quoting below just a few of those:

Today’s tech-savvy physicians are relying far less on reps and more on digital devices for healthcare information. Only 11 percent of healthcare professionals in India prefer in-person visits from a company representative, according to a 2016 study by Health Link Dimensions. Likewise, many patients arming themselves with medical knowledge available online, gradually relying less on only physicians’ decision-making. Thus, the rules of engagement need to be redefined.

With a shift in focus toward more complex or specialty medicines, pharma companies continue to add new layers of MRs to increase geographic coverage. The increasing number of MRs and the number of brands under each of them have drastically reduced the time and quality of sales pitches – from being scientific to mere brand name reminders.

Physicians’ place at the center of the pharma ecosystem as almost the sole-decision makers, is very likely to become a thing of the past with the emergence of a broad array of customers with a new mindset.

New tech-based entrants providing information platforms, analytics, e-consultation services and access to medicine online are challenging pharma’s value creation story.

Enhancing customer experience needs a hybrid business model:

The new market dynamics, demands cutting-edge brand-value augmentation measures, enhancing customer-experience with some tangible benefits. These telltale signs can only be ignored at one’s own peril. Let me also illustrate this point with the findings from another research study.

According to 2015 Oncology Customer Experience Tracker of ZS, “Oncology companies can add USD 50 – USD 75 million in incremental sales for every USD 1 billion in current sales by delivering a better customer experience.”

This vindicates that creating a better customer experience should be the key goal of pharma’s augmented value delivery system – going much beyond the traditional communication of key product features and its clinical benefits. This new concept is fast emerging as the fulcrum – not just for creating a strong brand pull, but also enhancing the public image of the organization. And can be achieved with a right blend of:

‘Must do’ mindset of top management,
Expertise in well-targeted – multi-channel content making,
Expertise on data-science and analytics to churn out the right information from a large pool of data,
Wherewithal for effectively using the right digital platforms, either directly to customers or through a leaner and digitally-skilled sales force having a ‘can do’ attitude, as the situation will demand.

Some companies are testing the water:

Conventional ways to improve Sales Force Effectiveness (SFE), especially with soft skills, besides, of course product knowledge, is not new to the pharma players. What they need to do is change the primary focus of increasing sales through delivering mostly the key intrinsic value of the brand, to increase profitable sales by delivering augmented brand value, leading to enhanced customer satisfaction.

This is a major shift from the traditional paradigm and would surely entail application of digital technology and data science. As I wrote before, many companies have started adopting this approach – mostly with one baby step at a time, right or wrong.

Observation and findings of an India specific study:

Noting that ‘Indian pharma’s journey to a digital world has just begun,’ the same EYstudy, as quoted above, reported the following findings, among a few others:

Lack of a clear digital strategy/value proposition and change management are the two key barriers to embracing digital.

Whatever was being done manually earlier is now being done digitally. But we are not adding additional value. On the other hand, companies globally are now cautiously moving toward being digital practitioners.

Indian pharma majors will need to grow into integrated health care providers – offering both products and services, forging patient-centric partnerships and demonstrating value to a broad array of customer groups.

The good news is, some of the key observations of the study also include the following:

Some are using digital technology to capture untapped and unstructured data, to make their sales and marketing decision making process more agile and robust.

Powerful apps with dynamic, meaningful content and the right value proposition are gaining popularity.

Several players, while staying within the realms of regulatory boundaries, are enabling patients to actively manage their care.

Conclusion:

As we look around, many drug companies, especially in India, continue to remain focused on the age-old transactional sales and marketing models, delivering the intrinsic brand values, irrespective of the changing pharma market dynamics, especially disregarding what today’s customers in the knowledge economy look for. Traditional training and incentivizing a large, and often flabby, sales force on product and rupee value territory-sales against the target, are the general ways to achieve these. The focus on achieving the internal sales targets, regardless of the processes being contentious or not.

Modern time warrants a different conversation altogether – creation of a unique customer experience – with augmented value delivery systems. Achieving this goal would entail astute applications of modern technology, complementing the reach and impact of the right-sized field staff efforts, and leading to improvement in ‘sales per employee ratio.’

Thus, I reckon, higher sales or the need for an expanded market access, may not necessarily entail a larger field force, but a new breed of leaner and especially skilled MR to deliver the needs of the changing healthcare landscape.

By: Tapan J. Ray

PILMAN

A Tapan Ray Website

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