Tag Archives: Representatives

This New Engagement Model Garners Significant Rewards For Pharma

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Last year, on July 26, 2021, I wrote in this blog on gaining a competitive edge with Omnichannel pharma marketing Omnichannel pharma marketing. However, from several recent studies, it appears, it’s still remains in a nascent stage. Most players in the industry haven’t been able to get there, just yet.

This is evident from a paper, published in the Reuters Events on November 08, 2022. It underscored, ‘But few, perhaps none, can say they have yet mastered omnichannel. A 360-degree view of the customer remains a work in progress. The seamless customer experience that physicians have come to expect in their private lives as customers in retail, finance, or hospitality, remains an aspiration.’

That said, the good news is – today – with rapidly declining Covid-19 onslaught, many drug companies have realized that their earlier assumption of ‘we know what our customers want,’ is invalid in the emerging perspective. Thus, it is foolhardy for their marketing strategy planners to believe that have a 360-degree view of their customers. This realization has prompted several companies to find out, based on the data, what the key customers’ needs are and engage with them accordingly.

In this article, I shall, therefore, reemphasize for the consideration of the young marketers that Omnichannel customer engagement, including patients and doctors, would help fetch significant and sustained financial rewards for drug companies.

However, another visualization of 6 years ago seems to have come true:

About 6 years ago, on December 26, 2016, I visualized in this blog: ‘a majority of the doctors’ choices in India would, possibly, involve MRs, while a good number of other important doctors’ choices may probably be independent of them. Nevertheless, from this emerging trend, it’s clear now that multi-channel engagement would be a new normal in pharma sales and marketing, sooner than later.’

This visualization seems to have come true by a great extent, as vindicated by the above study of the Reuters Events. It confirms, currently, most companies are stuck in multi-channel content delivery and, in fact, are still a long way of enjoying the benefits of truly aligned – Omnichannel engagement. This brings us to the question: ‘What’s the difference between Multi-Channel and Omnichannel content delivery strategy for customer engagement?’

Difference between Multi-Channel and Omnichannel content delivery strategy:

The article published in the Pharmaceutical Executive, on June 30, 2021, indicated: ‘An integrated strategy based on Omnichannel marketing is now increasingly replacing multichannel marketing.’

Nonetheless, in my article of July 26, 2021, I highlighted, although both omnichannel and multichannel engagement will be able to deliver targeted contents to patients through several interactive digital platforms, these two aren’t the same. Omnichannel approach connects these channels, including smartphone-based Apps, specially formatted websites, social media, community, and the likes – bridging technology-communication gaps that may exist in multichannel solutions.

Notably, any change from the fragmented and siloed multichannel approach to Omnichannel marketing would entail simultaneous orchestration of channels across personal, non-personal, and media. Besides orchestration of channels, the message of course, needs to be unified, interrelated – without being repetitive. From this perspective: ‘Bringing the channels and stakeholders together in a truly integrated manner is the pivotal shift required to break through today’s noisy and crowded pharmaceutical marketplace,’ as the above Pharmaceutical Executive article concluded.

More and more people are charting the digital space:

Fast increasing penetration into the cyberspace by a large section of the population, especially in the healthcare space – triggered by Covid related lockdowns, is now all pervasive. An increasing number of people now want to know more and more about various disease states, their treatment and prevention options, in the digital space. Patients and healthcare providers’ key requirements include, where to get the right information from, and how.

Information-needs expanding beyond disease or drug efficacy and safety:

A discussion, arranged by the Fingerpaint Group and published in the Fierce Pharma on November 14, 2022, covered some interesting points in this area. It acknowledged that in the digital space: “You’ve got the efficacy, the safety information, all that.” The discussion then pointed out: “But for a consumer, it’s a different type of journey. It’s, how do I learn more about the disease I’m dealing with? What is it I want to know, not only either for me, or if I’m a caregiver for somebody in my family, even, how do I help support them?”

Thus, it comes out clearly that patients’ or care givers’ quest for information isn’t just about the disease, it’s also about the quality of information that will help the person, as a whole. The drug companies, I reckon, should now accept it as one of their responsibilities. As one of the participants in this discussion said, ‘finding ways to reach everybody in the whole continuum so that they’re educated and informed, so that they can make better decisions for themselves,’ are imperatives for the marketers.

Personal detailing or other personal engagements don’t become irrelevant: 

Omnichannel approach doesn’t make traditional in-person detailing or other personal engagements irrelevant or obsolete. However, those alone, will no longer help a pharma player to achieve performance excellence. The new challenge is how does a company get to the right audience, get the right product to the right patient, or caregivers, amongst this vast ocean of digital noise.

Moreover, the ongoing digital push – beyond several essential personal outreach, will only accelerate in different ways. Omnichannel customer engagement, based on their own terms of engagement, including time, speed, and quality of information, will be the name of the new the game for success.

Many pharma companies aren’t sure where to start, But…

McKinsey & Company in a paper, published on January 05, 2022, also said so. It observed: ‘An analytics-enabled omnichannel commercial model can elevate HCP engagement, but many pharma companies are not sure where to start.’ However, it reiterated: ‘An analytics-enabled omnichannel commercial model can create value; Companies should start now.’

Thus, many pharma marketers may require hand-holding by domain experts, at least, to begin with. However, selection of experts being the key, should go through a structured validation process, including their previous success record in this initiative. As I articulated above, the challenge remains, how does a company use Omnichannel platform to engage the right customers with the right products and associated details, navigating through the noisy cyberspace.

That said, it won’t be unfair to acknowledge that many pharma companies are moving in the right direction.

But many pharma companies are moving in the right direction:

As I mentioned in my article of May 31, 2021: COVID-19 is driving lasting changes in what HCPs need and value,’ found the Accenture Healthcare Provider Survey May 2020, named – ‘Reinventing Relevance.’ Several physicians from the US, Europe and Asia were found to have experienced a significant change taking place in many pharma companies’ communication with them – going much beyond just product information.

Accenture’s follow-up study in August 2020 also reiterated, ‘pharma companies have improved how they engage with healthcare providers during Covid-19.’ It, therefore, appears that the new value expectations of many physicians are being met with a newer value delivery model, significantly deviating from pre-Covid practices.

However, in the above article, I discussed about value delivery through content – not about the channels used.

Conclusion:

The paper by McKinsey & Company, as mentioned above, also indicates another important point. While channels to engage HCPs and other customers are proliferating, the line between online and offline engagement is rapidly blurring. It further adds, managing this imperative has become more and more overwhelming for sales reps. The reason being, they “have traditionally relied on their ‘instincts’ to build relationships with HCPs.

It is now becoming challenging even for many experienced reps to tailor and optimize today’s complex mix of channels, content, and frequency of interactions for individual HCPs, the paper underscores. Which is why, today, transforming the existing commercial model is considered both inevitable and urgent, and:

“Pioneers that have adopted analytics and omnichannel approaches as part of their commercial model have garnered significant rewards.” the paper concluded.

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.

 

Shape of Future Pharma Operations – Emerging A Pragmatic Outlook?

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Just as newer reports come almost every day on safety, efficacy, dosage interval or span of immunity of Covid vaccines, similar reports are also reaching us about the possible future shape of pharma sales and marketing operations. Some hardcore optimists, apparently more from India, still believe that current changes in pharma customer behavior are mostly transient. All business processes will eventually fall in their traditional grooves, as the Covid menace disappears from our lives soon.

No doubt, several studies are also bringing out a number of respondent doctors’ preferences on reverting to F2F engagements, programs and events. Nonetheless, most other experts, including several large global pharma majors, believe that the future shape of business operations won’t be quite the same as the past. There are better ways to be more effective, leveraging the changing environment. Accordingly, they have initiated actions, reimagining the pathway of new operational frontiers. In this article, I shall explore the evolving pragmatic outlook in just two of these action areas:

  • The new and unique role of medical representatives
  • Digital health care solutions as a new growth opportunity

New role of medical representatives:

A recent survey published by Reuters Events Pharma on December 18, 2020, revealed that 30% of the respondents still expect that Medical Reps’ (MR) face-to-face access to HCPs would return to the status quo ante of Covid pandemic restrictions. However, a majority of 70% felt that the old normal is unlikely return as such. The study also brought out that the size and disposition of sales teams are under review by many of pharma players and smaller field forces look likely, as the industry moves on.

My personal experience with the Indian Pharma Industry sources suggests, when a Covid pandemic wave starts finding its peak, the feeling of the above 70% prevails. However, when the same wave climbs down from its peak to a transient trough, a large number of Indian companies and experts tend to feel somewhat akin to what the above 30% expressed in the Reuters Events Pharma survey. The process gets repeated with the emergence of the next wave.

Alongside, as the above survey also finds out, most physicians are no longer expecting – brand-driven high sales pitches, during any MR-Doctor interaction or the engagement process. Instead, they are increasingly looking for insights – in an integrated, personalized and value-driven interactions with the Reps.

Considering this as a trend of over last one year or so, it is likely that MR-doctor interactions will now need to be on digital and omnichannel platforms to deliver a personalized and value driven an experience to the customers. In this environment, the field force may be smaller in size than what it used to be in early 2020 but will have a unique new role to play. This process will come with a new challenge, especially to those inbred companies, who are still undecided about the road ahead for business excellence, in the new normal.

Three new pharma leadership challenges:

Apparently, a large number of domestic drug companies, irrespective of size and scale of operations still feel comfortable to be in the old comfort zone that had propelled the business in a growth trajectory. Most pharma sales and marketing staff members, at several levels, have grown within the industry, consistently delivering high performance.

This situation by itself, as the above research paper revealed, poses three fresh challenges for many companies to make their field-staff ready to play a unique and fresh role in e-marketing. Thus, the three new knots to untie in the virtual world, are the following:

  • Currently, most MRs are not proficient in selling in virtually,
  • They are being led by people who have also never sold virtually,
  • They are being trained by people who also have never sold virtually.

MRs will continue to have a role to play even in the digital world:

To overcome the above challenges, today’s reality prompts new L&D needs of pharma’s new e-environment. And from this perspective, I think, they would need professional domain experts’ hand-holding, at least, in the transition phase of digital marketing. Some companies have initiated this process for greater sales force effectiveness, since 2019. A recent example in this area may be quoted from a report on October 01, 2019.

The article highlights, ‘AstraZeneca sales reps have some new help in the coaching department, resulting improved interactions and better development of sales reps’ strengths. While leaders still manage reps, artificial intelligence—in the form of data generated from thousands of field-coaching forms—now adds machine-learned analysis and advice.’

Thus, it is worth noting that MRs will continue to play an important role, alongside remote digital marketing using omnichannel or multi-channel engagement platforms. The same also came out clearly in the latest study from healthcare consultancy ZoomRx, reported on April 08, 2021, where its findings raised an important question - ‘Did pharma overshoot digital sales rep calls?’ This dilemma was prompted by the study charts reflecting a decline in its effectiveness, during this specific survey period.

Thus, in my opinion, a hybrid business model for better performance will be more effective in the new normal. However, ascertaining the right mix of digital and MR’s in-person interactions, may pose a challenge for many pharma marketers.

Entry into digital health solutions – an opportunity for growth: 

Before Covid pandemic, digital therapeutics or digital health solutions were not an unknown area for several pharma companies, as a growth booster in the modern world. But, it wasn’t explored so intensively as it is being discussed today, for the same. A recent paper titled, ‘Digital health during COVID-19: lessons from operationalizing new models of care in ophthalmology,’ published in The Lancet on February 01, 2021, vindicates this point.

The paper emphasized, due to Covid pandemic ‘the traditional face-to-face patient–physician care model has had to be re-examined in many countries, with digital technology and new models of care being rapidly deployed to meet the various challenges of the pandemic.’ It further highlighted, these new models incorporate digital health solutions such as telehealth, AI based decision support for triaging, besides clinical care, and home monitoring.

Global pharma majors, such as Novartis, have publicly acknowledged on January 21, 202 that ‘digital innovation looks set to dominate the 2021 healthcare agenda.’ The statement said, COVID-19 was a catalyst for change in healthcare during 2020 and an accelerator for digital health. Similarly, 2021 looks set to continue the revolution – exploiting ‘an explosion of interest, traction and scale’ in the potential for digital solutions. These would not only support remote working, but also keep the very fabric of business, healthcare, education, and essential services in operation.

Other important and recent examples of digital health care solutions: 

Witnessing the COVID-19 pandemic pushing more people toward virtual doctor visits over the last one year, AstraZeneca, as reported on April 06, 2021, is preparing for it in the new normal, through a novel project with Massachusetts General Hospital. The Company is now in the process of establishing and validating its ‘recently launched digital health platform, designed to help patients with chronic illnesses manage their conditions without stepping foot into the academic medical center’s clinic.’

Similarly, several other companies, are also investing to be early entrants with user friendly state of the art technology in this space. Interestingly, many of these ventures were reported during March and April 2021.

Conclusion:

Arthur Miller’s play ‘Death of a Salesman,’ broadly addressed the loss of identity and a man’s inability to accept change within himself and society. Although, the book depicts a larger philosophical perspective of life – many pointed out similar issues in the drug industry perspective, as well.

Nonetheless, many studies have established, pharma MRs have been effectively delivering, since long, the endpoint deliverables, as expected of them – sales. However, the question that still haunts many – can this core process be re-imagined for greater efficiency and effectiveness at a lesser cost, harnessing modern technology. An article, published in the Pharmaphorum on March 11, 2011, has also suggested – ‘in the wake of the COVID-19 pandemic, there is an even greater need to re-examine the rep’s role. How can a field force evolve to deal with current challenges and be future-fit for the way we will be working in the post-pandemic world?’ 

There is no confusion today that MRs’ will have a key role to play in pharma’s digital endeavor. However, the key purpose of having them has evolved during the pandemic. Such as, from being an efficient way to achieve personal communication objectives – to be an orchestrator for physicians to navigate the difficult landscape, providing them a differentiated service. For this purpose, I reckon, a hybrid business model for better performance, will be more effective in the new normal, while quickly adapting to digital transformation. However, arriving at the right mix of digital and MR’s in-person interactions, may pose a challenge for many pharma marketers, as it will be a company-specific need.

Similarly, the criticality of leveraging opportunities to provide remote delivery of digital health care solutions to patients, has also come onto the radar of many pharma players, during this difficult time. Several players have already added this area as a lucrative business expansion platform – many more are expected to follow. Thus, in my view, the fast-evolving data-based trends are now giving a pragmatic shape to future pharma operations – especially on the new and unique role of medical representatives and the relevance of digital health care solutions, as a growth opportunity.

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.

Creating A Unique Patient Experience By Listening To Patients Voice – An Imperative In The New Normal

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Acquiring deeper insight on the patient journey through a disease treatment process to create and enhance end-to-end patient experience, never assumed such critical importance, ever in the past. Without this realization, I reckon, even digitalization of any scale in the pharmaceutical industry, is unlikely to yield desired results. The term ‘Patient experience’ is generally considered as ‘the summation of interactions that influence patient perceptions across the continuum of care, until now,’ as defined in an article, published by Aranca on February 28, 2020.

This isn’t a new concept. This subject was well-deliberated even before the pandemic crisis. For example, an article, published in the Pharma Voice on April 2014, had also highlighted this point. It wrote: “Too many companies continue to view the world as a physician-centric, and do not recognize the growing influence of the patient in treatment decisions. The evolution toward a fully integrated commercialization approach centering on the patient experience will continue to crystallize over the next five to 10 years. Within a few years the industry will universally have one goal that supports the patient experience, as there is a tremendous amount of attention being put on the patient today.”

Even thereafter, another paper, published in the Reuters Event Pharma, on August 17, 2017, also reiterated: ‘A greater understanding of the patient journey is rapidly becoming an essential tool for market access.’ It further elaborated that the use of patient journey data stands to benefit everyone:

  • Patients: through empowerment programs,
  • Pharma marketers and more widely, the Company: by targeting the right patient segment and the company more widely.

The paper concluded: ‘Given the potential benefits, pharmaceutical companies should develop a robust mechanism to design effective patient journeys, which could prove instrumental when it comes to bridging treatment gaps and improving quality of life for countless patients around the world.’

From this perspective, Covid-19 pandemic seems to have hastened the process with changing customer behavior and expectations in the new normal, thorough understanding of customer needs emerged as a key success requirement for pharma marketers. That said, customer experience has to be measured both qualitatively and quantitively through credible market research initiatives, capturing the patients’ views. Guessing the same, as was generally the common practice in the old normal, would no longer suffice. This article will dwell in this area.

The pandemic played a catalytic role:

That Covid-19 pandemic played a catalytic role to hasten the process of providing a unique patient experience during a patient’s journey through a disease treatment process in the digital world. This was vindicated by a ZS study, published on July 05, 2020. The analysis found – over the last three months several companies started looking at new ways to engage with patients. These include:

  • Forming patient panels – to continually check and monitor the quality of patient experience that the company is providing,
  • Connecting with patient advocacy groups – to get a pulse on critical needs
  • Leveraging the field force – to hear from physicians where their patients need the most help.

These are laudable initiatives for dovetailing patients’ views in the drug marketing strategy to provide a unique experience to patients during their end-end-to journey through a disease treatment process.

Measuring patient-experience – an integral part of digital sales and marketing:

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 PharmaEasy, or even for availing a service through Urban Company.

The November 15, 2020 research report of DT Consulting has also reiterated this need. It found, patients seeking and receiving care, depend on a complex system of health providers—an environment in which pharmaceutical companies play an important role. ‘When seeking care, patients gravitate to experiences that other patients rated well; when receiving care, they prefer experiences that consistently meet or exceed their expectations,’ it underscored.

Why then all pharma digital initiatives for its customers aren’t in sync with such practices? It’s about time that pharma players also follow a similar path, to continually improve company offerings, based on what the customers expect from a company’s brand and services – regardless of whether they are doctors, patients or any other key stakeholder.

I re-emphasize, this initiative has to cover end-to-end of a customer journey starting from clinical development, brand launch and expansion of market access. In each of these stages, loose knots, if any, require to be tightened, after thorough deliberations, to delight the customers – and consequently rewarded by them, appropriately. While some progress can be seen in this area, pan industry progress in this space, still falls much short of other industries. A pharma company may continue to ignore its importance, even in the new normal, at its own peril.

The way forward won’t be a bed of roses, expect thorns to overcome:

The above ZS study also brought out some interesting facts, as follows:

  • 43% of participants cited difficulty identifying quantitative, measurable KPIs that fit within the organizational structure and practices,
  • 29% indicated a lack of tools and resources to help communicate tangible outcomes and the case for change
  • 22% cited organizational silos as the true barriers.

The good news is, as the study highlights, Covid-19 has proven that it’s quite possible to actually be more patient centric to create an exclusive brand experience for patients. But, many ‘organizations still have work to do, in getting there.’

Sermonizing what patients’ need, without involving them, may be counterproductive:

Things were quite different in predominantly a physician-centric world for patients, in the old normal. At that time, sermonizing the treatment needs of patients, blended with a heavy dose of respective company’s self-serving interest, sans patient involvement in the treatment decision making processes – worked. The same approach may not yield desired cost-effective outcomes, when the customer behavior, triggered by the pandemic, is fast changing, for various reasons.

‘Patients want more services before they are treated’ for a disease: 

Many patients have been asking for more services, especially from the pharmaceutical companies, even before they undertake the journey of getting a disease well treated by medical professionals, regardless of disease types. Till Covid-pandemic, this remained mostly an unmet need for many patients, as this is an arduous for most pharma players. Which is why, most drug companies did not want to jettison the traditional approach, in favor of being ‘patient-centric.’ Thus, the entire decision-making process for any disease treatment continued to remain ‘doctor-centric.’

This wasn’t an unknown need for most patients, either, as it was well documented through several research studies. For example, an Accenture survey of 10,000 patients had examined their unmet needs in seven different therapeutic areas across the entire patient journey. Its findings concluded, ‘patients want more services before they are treated for a disease, regardless of disease type.’ Interestingly, even when such services were available in some places, the vast majority of patients still are not aware of the availability of these patient services, the paper added.

The situation is different today:

Overall, the situation is different today, mostly because, during a long Covid-19 lockdown period, many patients started visiting the cyberspace to manage their health, in increasing numbers. With the experience thus gained, a large population, even in India, now consider digital as a primary channel to initiate the journey for their disease treatment, such as telehealth.

As judicious assimilation of knowledge has always been a source of wisdom, patients have now become wiser to demand more services from a drug company that will help them to get cured of diseases and maintain good health – the way they want. More importantly, patients have also realized that in most cases treatment alternatives to choose from, are plenty.

Thus, the above study of Accenture raised the following question for the pharma companies to ponder that is more relevant today than ever before: ‘Are pharmaceutical companies missing a significant opportunity to provide services at the earliest possible point in the patient journey – before they are even being treated for a disease?’ That’s why, ‘patients deserve as much focus, if not more, in pharma market research as ‘physicians.’

‘Patients’ deserve as much focus on market research as ‘physicians’:

In the old normal, medical reps, in general, used to expect their target physicians to educate the patients about the disease while prescribing their respective company’s brands. With many patients getting more and more informed in the digital world, pharma companies need to strategize a comprehensive patient engagement and educational campaigns, enabling patients to actively participate in their treatment decision making process, exactly the way they want, to improve quality of life.

From this perspective, collecting first-hand data on patient-experience, straight from the voice of patients, isn’t too common a practice for the drug companies, even today. It will rather be a new venture for many, to gain meaningful insights on the impact of their operational endeavor – from the patients’ perspective. This will, in turn, help organizations strategize more productive engagements with them, reaping a rich harvest.

The process starts with ferreting out patients’ needs from a variety of credible sources – after cross-checking and getting it vetted by focus groups of patients, in due course. Some pharma majors, reportedly, invite patients to narrate their experience in the disease treatment process, directly to medical reps at their sales meeting on virtual platforms. A few others have started patient-groups in the selected therapy areas, for the same purpose.

Nonetheless, pharma marketers to please ensure that their organizations need to genuinely care about the patients, making this onerous task deliver a win-win outcome for both. The key point to take note of is that its real purpose, in no way, should be achieving any company’s self-serving objectives, under this creative façade.

Conclusion:

Creating and enhancing the unique customer experience has been recognized as one of the key success factors in any industry, pharma business is no exception. Curiously, it could not draw as much focus as it should have been, until Covid-pandemic struck, triggering disruptive changes in the customer behavior and the overall commercial environment. The good news is, in tandem with their digital transformation process, several drug majors are now mulling about patient experience-driven marketing strategies.

For this purpose, the pre-requirement is to put in place a comprehensive patient experience measurement framework, to accurately understand the end-to-end journey of the patients in their disease treat processes. This would include, capturing their key unmet needs from various sources, including focus group studies of real patients, in various formats.

Prudent use of connected health applications and AI platforms may be of great help – supported by state-of-the-art analytics, to gain meaningful access to patients’ behavioral and attitudinal data for strategic use, in various digital platforms. This has the potential to deliver a quantum leap in business outcomes. From this perspective, I reckon, for creating a unique patient experience, listening to patient voice, is an imperative in the new normal.

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.

How Pharma To Stay Relevant To Customers In The New Digital World

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Covid-19 vaccination has commenced in India on January 16, 2021, as in several other countries of the world. A few million Indians, across the country have already received their first shot, according to media reports. But, this isn’t the endgame of pandemic by any measure. Covid-19 will get over – only when it gets over.

Interestingly, on March 07, 2021, the Union Health Minister claimed, ‘the country is in the end game of the COVID-19 pandemic. Curiously, the very next day – the Indian Medical Association IMA termed it as: ‘Unauthorized political statements on Covid-19 pandemic invokes a false sense of security.’ Moreover, vindicating the IMA statement, the Coronavirus trend report, updated as on March 05, 2021 clearly demonstrated that ‘The pandemic is far from over.’

As a fallout of this pandemic, alongside many other nations of the world, most industries in India are going through a recovery process of disruptive changes in the business processes, after a harrowing time. Pharma industry is no exception in this area. Recreating contemporary operational processes to excel in the new normal, would call for not only jettisoning many practices from the old normal by the new ones, but also the creative deployment of the precious resources, by each pharma players.

Accordingly, the need for avant-garde digital-based customer engagement services, is gathering winds on the sails of the ships of pharma marketers, signaling a ‘never before’ urgency to move in this direction. It’s a new business imperative to survive, perform, and excel in pharma. At the same time, the industry also should examine other critical changes required in its primary interfaces with customers, in today’s fast evolving scenario.

This process would involve redefining the new roles of some critical positions in the organization. Today’s article will explore how pharma will stay relevant to its customers, increasingly getting more and more involved in the new digital practices.

Some key challenges in pharma digital strategy:

One of the key challenges for a productive ‘company – physician engagement’, in the new normal, is to be available at any preferred time of customers’ choice and the way they want. This may include, both virtual and in-person F2F engagements, along with customized contents for the same. This need is universal and, by and large, remains the same for key stakeholders of all drug companies.

This point was further reinforced, in the February 22, 2021 article on capacity building in the digital space, published in Reuters Events, Pharma. It focused on demands in new era of ‘digital-first customer engagement’, where content creation and omnichannel engagement also play equally vital roles.

Besides, the paper emphasized, today’s need is investing in the type of contents that add clinical value, as opposed to overtly commercial marketing type material. The primary task for marketers is now, therefore, to use updated, high-quality, neutral content on customer engagement platforms that will offer value – the customers are looking for – and not just values from a company’s self-serving perspective. From this angle, the new content model prompts greater customer involvement for meaningful outcomes.

In tandem, company staff members – including medical representatives, need to acquire multi-tasking expertise, being equipped with – required digital knowledge, skills on using digital platforms and ascertaining individual key customers’ engagement needs. Whereas a company’s digital strategist will work on “digital initiatives, solutions, products and how those will be integrated locally.” Thus, this is not about making everyone a digital expert, as the article underscores.

Need to redefine work processes and realigning the staff members:

As the above article from Reuters Events reconfirms, the digital approach that several pharma players were taking even a year or two ago is redundant in the new normal. Amid rapid transformation in the drug business, ‘pharmaceutical industry can no longer act like ostriches. Digital is no longer a fancy add-on, it’s an integral part of everything we do,’ the study highlighted.

Thus, to move in this direction effectively, pharma companies would require redefining many work processes and realign the staff members in sync with their new roles, accordingly. Further elaborating this point, the Accenture study – ‘A digital booster dose for health care,’ identified a few such roles that will undergo a metamorphosis to meet with post Covid challenges. Following are some, where urgent transformations required are, as follows:

 A.   ‘Intelligent representatives’ – not just ‘medical representatives’: 

In the current scenario, rep’s engagement process with the medical profession calls for leveraging specific intelligence based on behavioral preferences. This is fast emerging as a key requirement. Thus, the paper underscores: “Armed with a closed-looped CRM, representatives can effectively use data insights to plan, deliver and report calls.” I also indicated earlier – to succeed in this effort, individual skill sets, such as digital awareness and analytics will be of great use. The core objective is, looking through physicians’ eyes to understand their needs and solve problems by ‘serving customers as individuals, not as numbers in a call roster,’ the study emphasized.

B.  ‘Customer experience managers’ – not just ‘brand managers’: 

While using omnichannel digital platforms, doctor-patient interactions become more content dependent. Accordingly, brand managers’ role will be pivotal to facilitate a uniform interaction experience across all channels.

Therefore, for targeted communication, better understanding of doctors and patients and how they want to be engaged, is a key requirement. Which is why, brand managers will have to acquire skills, such as content management for continuous engagement across multiple channels. This is now absolutely necessary for effective branding in fostering a new genre of ‘customer-brand relationship’ model, across the company.

C. ‘Helping doctors manage their practice and patients better’ – not just ‘brand marketing’: 

‘Think beyond the patients’ – suggests the Accenture survey. This is because, virtualization of healthcare is all about doctors making further customizations into how they operate, both clinically (teleconsultation) and commercially (payments). This is, another important area where pharma companies can further differentiate themselves, by helping doctors manage their practice and patients better. The process entails acquiring critical skills in disease awareness, identifying key gaps that impact patient experience and clinical outcomes, alongside various digital engagement tools to perform these functions.

Conclusion:

The current year is expected to witness flooring of the gas pedal, as it were, in pharma’s digital transformation process, while navigating through humongous challenges on the way. The process includes, redefining work processes and realigning the staff members to establish a new customer-brand relationship’, based on Covid triggered changes in the customer behavior.

A quantum improvement in the usage of digital tools and platforms, alongside targeted content creation will be pivotal in pharma’s customer relationship management to excel in the changing business environment. Many doctors and patients have already signaled their acceptance for digital or virtual interactions, besides some well identified F2F engagements with relevant and personalized data-driven content as they expected from each drug company.

This need arises when one considers the findings of another Accenture Survey. It reported, while 39% of doctors want all medical representative meetings to be virtual, even post pandemic, ‘around 10% of key doctors still want to go back to pre-COVID-19 norms for in-person meetings.’ Thus, the point to ponder in this area is how to structure these F2F meetings for highly productive outcomes.

However, it’s also a reality that during Covid days, doctors wanted to interact with the Medical Reps more than what they used to do in the past. This offers a huge opportunity to drug companies in leveraging pharma rep’s interaction to accurately understand their customer-insight. Consequently, the new approach will help pharma companies, not only in staying relevant to its customers in the digital world, but also, to keep themselves prepared to face similar challenges in the future, proactively.

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.

 

Changing Doctors’ Practice Dynamics With Covid-19 And Beyond

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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   

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.

Pharma Sales Post Covid-19 Lockdown

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Disruptions from Covid-19 pandemic have caused limited access to physicians for Pfizer’s marketing and sales teams have had. If ‘the novel Coronavirus pandemic hamstringing the company’s sales team,’ there could be a slowdown in new prescriptions and a sales hit in the second quarter, said the global CEO of Pfizer, on April 28, 2020. He further said, ‘new prescriptions for a range of its products will decline as patients continue avoiding in-office physician visits.’

Pfizer is not only the company facing such situation. In fact, the entire pharma industry is encountering a tough headwind for the same reason. However, being very specific on the quantum of sales hit – on the same day, ‘Merck, with a heavy presence in physician-administered drugs’, predicted an adverse impact of US$ 2.1Billion on sales, from COVID-19.

Physical absence of, virtually the entire pharma field force in the field for strict compliance of social distancing during the lockdown period, causing a crippling effect on the new prescription demand generation activity. This possibility was hardly imagined by anyone in the industry. Which is why, the current situation is too challenging for pharma sales and marketing leadership teams to respond, with a sustainable strategic approach. Moreover, most of them don’t yet seem to be accustomed with charting any pivotal demand generation activity, sans field force.

Further, the meaning of ‘Patient-Centricity’ in the post lockdown period – still maintaining ‘social distancing’ norms, is expected to undergo considerable changes. This may include development of newer health care practices for many customers, which they started practicing during the lockdown period. However, no one can exactly predict, as on date, whether such changes will continue for a long term, as we move on. In this article, I shall deliberate on a likely scenario in the pharma selling space post Covid-19 outbreak, based on research studies. This is primarily because Covid-19 could be with us for a long time.

Covid-19 could be with us for a long time:

As reported, on the day 35 into the world’s largest lockdown, India, reportedly, was failing to see an easing of new cases similar to what hot spots such as Spain and Italy have recently experienced with more intensive Covid-19 outbreaks. Even today, the scale and duration of the pandemic are very uncertain, so will be the necessity of maintaining social or physical distancing guidelines. This possibility gets vindicated by what the Director General of the World Organization said on April 22, 2020: ‘Make no mistake: we have a long way to go. This virus will be with us for a long time.’ Thus, shutdowns in different forms, is expected to continue for some time in India.

‘Covid-19 pandemic to last for minimum two years’ with its consequent fallout also on the pharma industry:I

Interestingly, ‘India began its containment measures on March 25, when its outbreak showed only 564 cases.’ As on May 03, 2020, the recorded Coronavirus cases in India have sharply climbed to 39,980 and 1,323 deaths. India is now expected to prepare exiting the 54-day lockdown in phases from May 17, 2020, with a few limited relaxations even before that date. However, as the BBC news of April 9, 2020 also points out, the country may not afford to lift the lockdown totally – everywhere, for everyone and for all the time, anytime soon, for obvious reasons.

The April 30, 2020 report from the Center for Infectious Disease Research and Policy at the University of Minnesota, confirms this situation. It says: ‘The Coronavirus pandemic is likely to last as long as two years and won’t be controlled until about two-thirds of the world’s population is immune.’ This is because of the ability to spread from asymptomatic people, which is harder to control than influenza, the cause of most pandemics in recent history. Thus, the Coronavirus pandemic is likely to continue in waves that could last beyond 2022, the authors said.

Many countries around the world are already facing similar issues for exiting Covid-19 lockdown. It has been observed that easing the lockdown is a tricky policy choice, as it triggers a fresh wave of infection, as recently happened in advanced countries, such as, Singapore and several other nations.

It is, therefore, clear now that shutdowns need to continue in different forms in India as different waves of Covid-19 infections strike, in tandem with scaling up of requisite testing and health infrastructure to manage those outbreaks, effectively.  Consequently, its impact on the pharma industry is likely to continue with its unforeseen fallout, prompting the same old question, yet again, why the oldest commercial model remains pivotal in the pharma industry.

The oldest commercial model remains pivotal in the pharma industry:

About a couple of years ago from now, an interesting article of IQVIA, titled, ‘Channel Preference Versus Promotional Reality,’ highlighted an important fact. It said, one of the oldest commercial models of using medical or sales representatives to generate product demand through personal communication with each doctor, and other key stakeholders, is still practiced in the pharma industry, both as a primary medium and also to communicate the message.

The same model continues in the pharma industry, regardless of several fundamental challenges in the business environment. Curiously, erosion of similar models in many other industries, such as financial and other services, in favor of various highly effective contemporary platforms, is clearly visible. Some of these fundamental challenges involve an increasing number of both, the healthcare professionals and also patients they treat, moving online.

This has been happening since some time – long before Covid-19 outbreak. Today, many patients want contemporary information on the disease-treatment process, available alternatives and the cost involved with each. These patients also want to communicate with their peers on the disease for the same reasons, before they take a final decision on what exactly they would like to follow. A similar trend is visible, at a much larger scale, with medical professionals, including top drug prescribers.

Healthcare customers’ increasing digital preference was captured well before the Covid-19 outbreak:

The rise of digital communication as a global phenomenon, was deliberated in the June 04, 2019 ‘Whitepaper’ of IQVIA, titled ‘The Power of Remote Personal Interactions.’ It captured an increasing digital preference of healthcare customers much before Covid-19 outbreak. For example, according to IQVIA Channel Dynamics data1, there was a 26 percent decline in total contact minutes for face-to-face detailing in Europe, since 2011.

Another 2018 IQVIA survey reported, 65 percent to 85 percent of representatives were saying that access to physicians is becoming harder. The paper also indicated that the rise of digital and multichannel communication with healthcare professionals has been far from uniform across countries, with Japan leading the world, followed by the United States.

India is an emerging power in the digital space, today. Thus, I reckon, it has immense opportunity to leverage digital platforms in healthcare, especially to effectively address the current void in the demand generation activity of drug companies. The key question that needs to be answered: Are pharma customers developing new habits during, at least, the 54-day national lockdown period?

‘It takes about 18 days to 254 days for people to form a new habit’:

According to a study, titled ‘How are habits formed: Modelling habit formation in the real world,’ published on July 16, 2009, in the European Journal of Social Psychology, it takes anywhere from 18 days to 254 days for people to form a new habit. Thus, changing preferences of many healthcare consumers, including doctors and patients, at least, in the 40-day period of national lockdown in India, may trigger a change in habits of many patients. This change may further evolve over a period a time.

Such changes would demand a new and comprehensive ‘Patient-Centric’ approach from pharma players, as well, having a clear insight on the dynamics of the changes. Gaining data-based insight on the same, pharma sales and marketing leadership would need to develop a grand strategy to deliver ‘patient-group’ specific desired outcomes. One of these approaches could be, triggering non-personal sales promotion on digital platforms.

Triggering non-personal sales promotion on digital platforms:

Dealing with future uncertainty calls for non-conventional and innovative strategies, such as, generating brand prescription effectively even without personal promotion. Thus, to tide over the current crisis, triggering non-personal sales promotion on digital platforms, appears to be the name of the game. In a 2018 IQVIA survey, looking at the multi-channel landscape in life sciences, 54 percent of the 250 respondents from pharma and biotech were found already using virtual interactions, such as e-Detailing, or were planning to assess the approach.

What is required now is to rejuvenate the initiative, with a sense of great urgency. Covid-19 pandemic has the possibility and potential to expedite a strong pull in this direction, responding to a new ‘customer-centric’ approach, as prompted by the evolving scenario, triggered during the 54-day long stringent lockdown period. This is especially considering the fact that it takes about 18 days to 254 days for people to form a new habit.

Further, as Bloomberg reported on May 02, 2020, “coming up with a vaccine to halt Covid-19, in a matter of months isn’t the only colossal challenge. The next big test: getting billions of doses to every corner of the world at a time when countries increasingly are putting their own interests first,” which may take quite time.

Conclusion:

One thing for sure, the sudden outbreak of Covid-19 pandemic has made all ongoing and robust strategic business plans somewhat topsy-turvy. Most pharma companies were compelled to floor the break-pedal of several business operations, including prescription demand generation activity of field sales forces, during the lockdown period.

At this time, many healthcare consumers, including patients, tried various remote access digital platforms to continue with their treatment or for a new treatment of common ailments, besides procurement of medicines. Two primary drivers, in combination with each other, prompted those individuals to try out the digital mode. One, of course, the stringent lockdown norms, and the other being the fear of contracting Covid-19 infection, if the prescribed personal distancing standards are breached – just in case.

This position may lead to two possibilities – one, involving the patients and the doctors and the other, involving field staff/doctors/hospitals/retailers, etc. During, at least, the 54-day long lockdown period, if not even beyond May 17, 2020 – those patients may develop a sense of convenience with the digital platforms. This may lead to a new habit forming, which has the potential to create a snowballing effect on others – through word-of-mouth communication. The process may signal a shift on what ‘Patient-Centricity’ currently means to the pharma players.

The other one, I reckon, involves with the continuation of strict social or physical distancing norms for an indefinite period. This could seriously limit field-staff movement and meeting with the doctors, hospitals/retailers, besides many others, and more importantly would lead to a significant escalation of cost per call. The question, therefore, is: Will pharma selling remain as before, post Covid-19 lockdown? Most probably not. If so, a new task is cut out, especially for the Indian pharma leadership team, to chart a new ‘Patient-Centric’ digital pathway, in pursuit of sustainable business 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.

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

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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     

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.

Multichannel Marketing: Two Important Pharma Trends

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On September 6, 2018, Reuters reported the announcement of GlaxoSmithKline (GSK) that it would cut about 650 positions in the United States related to a global restructuring program. This includes 450 Medical (sales) Representatives (MR). Similar announcements on job cuts for MRs by other pharma companies are being made since the last several years. Last week’s GSK announcement was the continuation of the same process. This prompts me to use the aforementioned global news while focusing on two important emerging trends in the pharma industry, as we witness today.

In the rapidly digitalized world, several broader questions are often raised today. These include whether or not e-detailing in the pharma industry will eliminate the role of MRs, or for that matter will digital marketing replace the pharma print media? As the concept of ‘multichannel marketing’ (MCM) gains momentum, finding right answers to these questions or at least the right trends are assuming as much importance for business success. As I don’t have any specific answers to these queries, in this article, let me discuss just two of these emerging trends, as appears to me.

Importance of multichannel marketing in pharma:

Many pharma companies are fast realizing that their customers, such as doctors, patients and others, are showing increasing interest in getting the requisite product or treatment related information from multiple readily available channels or sources. These are accessible both in digital and print platforms, which are often of independent origin. Such behavioral preferences of pharma customers are contrary to what was mostly happening in the past, globally. However, in the pharma world of contemporary India the same old traditional path of product information flow, from drug companies through Medical Representatives to doctors, continues, by and large.

Looking ahead, ‘multichannel marketing’ for pharmaceutical and biologic products is being generally considered as the recipe for commercial success of brands. Thus, pharma players are trying to engage their customers more through multiple channels, both directly or indirectly. This is happening in many countries of the world. It is a matter of time, I reckon, that majority of large to medium Indian drug manufacturers will also follow suit.

Two interesting trends:  

As multichannel marketing in pharma catches up, I find some interesting developments. These are outcomes of different channels getting balanced, based on customer preferences. Let me underscore, these are customers’ perceptions in the real world and not what the drug companies and their associates usually think, hence are worth considering. The two emerging trends, in my view, are as follows:

1. Although, the role of Medical Representatives is still important, but not as indispensable as was in the past.

2. Despite high decibel discussion over digital media, print media is still very relevant.

1. Impact on the role of Medical Representatives (MR): 

“There is an ongoing debate about the effectiveness and impact of the traditional sales representative, with some arguing to discontinue the role while others sense an opportunity to improve both rep productivity and efficiency.” This was articulated in a McKinsey & McKinsey paper titled, “Death of a sales model or not.” The same article also says, even those who champion the role, point out that using richer analytics, better leadership and aligned incentives to deliver stellar results in many geographies.

To comprehend what is really happening in this area, I would quote below from two important global survey reports, with a sincere wish that similar surveys are carried out in India too. Although, these two surveys are different in nature, but address the same basic issue.

A. ZS’s Access Monitor 2014 survey:

According to this survey, “Representatives access to physicians continues to decline, particularly in certain specialties and areas of the country. Overall, close to half of all doctors in the United States are now considered “access restricted” to varying degrees.” It further says: “Since the initial ‘Access Monitor’survey in 2008, access has steadily fallen, with 77 percent of physicians considered “accessible” that year, compared with 65 percent in 2012, 55 percent in 2013 and 51 percent in 2014.

In another important finding the same study captured that “the pharmaceutical and biotech industry wastes approximately USD 1.4 billion in infeasible calls. (A call is considered infeasible if a best-in-class sales rep can’t deliver it.) The cost of infeasible calls appears to have plateaued, as companies have largely squeezed out sales force inefficiencies— making alternative channels the best path to improving access and customer engagement.”

B. CMI/Compas Media Vitals research 2018:

Despite such debate, doctors still value face to face interaction with MR, across the world. However, the digital tools and platforms of various types are increasingly used as the source of both new and existing product information, including updates.

According to CMI/Compas Media Vitals research 2018, as shown in the Table I below, doctors’ dependence on MR for information on new and existing products now stands at 51 percent and 46 percent, respectively. Similarly, for product updates their dependence stands at just 39 percent. The above McKinsey & McKinsey paper also predicts that the number of MR will gradually decline as the multichannel marketing initiatives pick up.

That said, in Table I – dinner meeting ranks seven and peer to peer information comes in the third place. Digital sources when put together now occupy a significant part of the doctors’ preferences for obtaining product information.This is also clear from the Table I that the doctors have started showing interest e-detailing, as well.

Table I:  How do you want to receive information from pharma companies, for:

In % New Products Existing Products Product Update
E-detailing

15

16

13
EHR

16

16

26
Reps’ Email

21

7

27
Medical Journal

22

19

12
MSL

24

23

14
Pharma Brand E-Mail

24

21

28
Direct Mail

32

29

29
Peer-to-peer

47

40

21
Dinner Meetings

49

45

24
Representatives

51

46

39

(Source CMI/Compass Media Vitals 2018)

Dinner Meetings:

As I said before, “Dinner Meetings” were rated as the second most preferred choice of the doctors for getting new and existing product information, in the above Table I. This is interesting, especially when one reads it along with the findings of the research paper, published in the August 2016 issue of JAMA Internal Medicine. The study concluded with: “The receipt of industry-sponsored meals was associated with an increased rate of prescribing the promoted brand-name medication relative to alternatives within the drug class.” The paper also clarified that “the findings represent an association, not a cause-and-effect relationship.”

2. Print media remains relevant despite digital push:

The research by CMI/Compass Media Vitals 2018 has also shown that despite the abundant availability of online versions of various medical publications, many doctors still prefer to read the print format of the same Journal, as shown below in the Table II:

Table II. How do doctors read medical Journals? 

Online/Digital format (%)

Print format (%)

47

53

(Source CMI/Compass Media Vitals 2018)

Although, the professional portals are the most used to get the requisite information by the doctors, print journals still rank number three, after peer-to-peer information.

That print media is still relevant for the doctors to know about drugs, was confirmed by another study, as shown in Table III:

Table III. Print media is still relevant:

Professional Portal Colleagues Print Journals CME Meetings Online Journals Drug Ref. App In Person Speaker program
72% 67% 66% 66% 53% 53% 53% 53%

(Source :Kantar Sources & Interactions report from September 2017)

It is noteworthy that ‘online journals’ rank number 5, after ‘CME meeting’.

Conclusion:

Despite Millennials in India mostly prefer reading news online through digital media, print media has still remained relevant and growing too. So are the television channels, regardless of easy availability of anytime streaming of all types of news, videos, TV serials and even movies.

Moreover, with increasing preference of digital media by an increasing number of populations, reliance of many industries such as Fast-Moving Consumer Goods (FMCG) haven’t totally shifted from magazine and newspaper advertisements, alongside targeting their customers through digital platforms. The same is expected to happen with various print formats in multichannel pharma marketing, where the physical presence of MRs still play an important role. Thus, to create a greater impact on doctors, patients and other stakeholders, pharma marketers are expected to leverage the best of both print and digital world in the form of comprehensive MCM initiatives. It could well be more on digital platforms and less with print materials, as we move on.

The new role of MRs was epitomized in an interview of the Sales Director, Roche, UK, published in the eyeforpharma on January 26, 2018. In the words of the sales director: “For us, in our market, the traditional showing a visual aid and some messages with the HCP is dead… But the face to face meeting is certainly not. Its role, however, will be more about adding value, about finding the right patients for the right drug.” He further highlighted, “the clear challenge that stands before the pharmaceutical industry’s sales organizations; a world where access to physicians is diminishing, trust in the information the industry provides is dwindling, and having a costly sales force is increasingly hard to defend.”

Against this backdrop, regardless of MCM, the role of those MRs who will be in sync with the requisite applications of technology in their focus areas of work, will continue to remain relevant, though they will be lesser in number. A few of them will also stand out and shoulder higher and higher professional responsibilities in the industry.  Be that as it may, in my view, these two emerging trends are expected to gather a strong tailwind, at least in the medium to long term, heralding the dawn of a new era in the Indian pharma industry.

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.