Nearly three years since COVID-19 abruptly forced pharmaceutical commercialization teams to adopt fully digital engagement models, the industry has adjusted to a more complex and diverse mix of engagement modalities.
Pharma is adapting to this hybrid engagement model along with a host of other changes to engagement strategies by rethinking the makeup of commercialization teams and the skills that they prioritize.
In many ways the rep’s role has become more complex. There is a growing requirement for them to connect the right decision-makers at the provider with the right subject matter experts in pharma. In addition, flexible engagement strategies modeled after the two-week “sprints” of agile software development are replacing the static outreach schedules and content calendars that remain in place for months at a time.
“Things have changed so much,” says Jennifer Muszik, Head of Global Commercial Learning at Biogen and a member of the Board of Directors for the Life Sciences Trainers & Educators Network. “You need to know the office, the local market, and the disease state – and on top of that, you need to provide product knowledge and access to the cross-functional team.”
Shorter conversations, more engagements
The use of tools such as Microsoft Teams has changed the nature of one-to-one engagements for field team members. “They were used to walking to the office, stopping, and saying hello. Now, they’re getting HCPs in the flow of their day,” Muszik says. “We’ve had to change the way we engage to drive a more impactful discussion. There’s less small talk.”
Individual conversations may be shorter, but the sudden shift to digital outreach also allowed for more frequent engagement than had been possible with in-person meetings. Instead of waiting weeks for the next meeting, a rep may reach out within a few days with a follow-up email that includes a link to a webinar or white paper, or an introduction to another member of the commercialization team.
Here, the circumstances favor organizations that had been investing in digital pre-pandemic, says Pallavi Garg, Head of Global Oncology Products and 
Pipeline Strategy, Takeda. Micro-segmentation, for example, helps organizations better understand the unique needs of providers, which lends itself to more personalized engagement and more targeted outreach.
This has required commercial teams to step up their investments in analytics expertise. This means improving their ability to gather and analyze provider data from previously disparate silos within the company – such as sales, marketing, events, and the call center – and offer next-best action recommendations for digital engagement.
Muszik says this expertise ideally also involves assisting providers. “How can we help them leverage the data in their electronic health record systems and make more population health decisions?” she says. “How can they identify patients at risk, or patients who are non-compliant?”
Greater focus on relationships
Micro-segmentation and analytics are part of a broader focus on building and managing relationships with key provider accounts, as opposed to primarily pushing information to them. According to Muszik, four key trends have driven this new approach.
One, of course, is the pandemic. The second is an increased need for product differentiation with more generics on the market. The third is a shift in who makes purchasing decisions at a provider amid increased market consolidation. Fourth is a decrease in physician autonomy at the point of care due to increased adoption of clinical decision support tools.
In traditional scenarios, a provider’s first point of contact would be the field-focused sales rep, according to Frank Armenante, Director, Commercial Execution South Area, Novo Nordisk. Now, the focus is less on a single sales transaction and more on facilitating a “true peer-to-peer conversation” with representatives from, say, market access.
Other organizations have started to develop more specialized account management roles in areas such as patient education, reimbursement, relationships with self-insured employers, or supporting smaller physician practices. “These organizations have more of a clinical mindset, and they’re focusing on making real partnerships,” Armenante says.
This is especially the case in oncology, where it’s increasingly clear that a one-size-fits-all approach to commercial engagement won’t do the job.
One reason is the level of collaboration between providers and pharma that’s required to enroll patients. With certain types of cancer (along with other rare conditions), radiology imaging or other diagnostic tests may be necessary to help determine whether a patient is eligible for a particular treatment. That requires intimate knowledge of what the patient’s journey through a particular health system looks like, Muszik says.
Payment models also pose a challenge, especially in the United States. For example, if a treatment transitions from being covered as a pharmacy benefit to being covered as a medical benefit, then a different approval process is necessary. “The salesperson isn’t having that conversation,” Muszik says – legally, sales personnel cannot access data on individual patients – “but they can identify the problem and then get patient access and reimbursement on the phone. That minimizes the patient impact due to delays.”
The ideal commercialization team and strategy
The unique challenges of oncology and rare diseases point to a need for commercialization teams that have the ability and willingness to be agile, Garg says.
“We need to embrace continuous trial and error, to have a constant feedback loop of what we’re doing and how it’s resonating, and adjust the approach based on what we learn,” she says. “We’re often working in disease areas and settings where patients have very little time left, so there’s an urgency that underscores everything we do. We remind ourselves that patients are waiting – and then we ask, from a systems and process perspective, ‘How can we add agility to everything we do?’”
Agility should also be applied to individual engagements. Though Armenante estimates that as many as 90 percent of providers are willing to schedule in-person meetings again, they do also still opt for virtual meetings as well. Some may take an early-morning call at the office before patient appointments. Others may take a call on a day when they’re working at home and seeing patients via telemedicine. Others may sympathize with a sales representative making a three-hour drive and agree to have most meetings occur virtually.
Managing the mix of in-person and virtual visits remains complex to manage. As Muszik puts it, “You may drive past a doctor’s office that doesn’t want to see you, but the office next door wants all meetings to be in person.”
It’s not enough to simply capture this information in a customer relation management system, she adds. Commercialization teams need to incorporate it into their larger engagement strategies. After all, while providers may strongly prefer in-person meetings, they still represent a significant financial and opportunity cost for the pharma organization. Teams have to look long and hard at their desired mix of virtual and in-person engagements and what that means for the make-up of their teams and how resources are allocated to them.
As organizations consider what that mix should be, Armenante offers two areas of caution. One is digital assets. Marketing teams focused significantly on creating websites, white papers, and webinars to foster communication during the pandemic, but these assets are less useful to reps making in-person visits, he says. Multimedia can still have a role, though, as reps could share pre-prepared slide decks or videos during a visit instead of relying solely on printed collateral.
Another is using less-mature analytics tools to offer next-best action recommendations for digital engagement. Armenante likens this to shopping websites that provide irrelevant product recommendations.
To be more effective, these tools need to be able to account for nuance. That nuance could be a single anecdote about a physician’s poor experience with another pharma company’s rep, or it could be broader perspective about supply chain delays for a given therapy. “I’m not sure how effective next-best action is,” he says. “We’re still in the learning state. Are we sure that it’s making us do business in a dramatically different way?”
Leadership as commercialization’s biggest asset
With every pharma company looking to evolve the skills and capabilities of it commercialization teams – from research and development to digital marketing to analytics – effective leadership of them is arguably the biggest asset to invest in.
Muszik says today’s leaders benefit from two core skills: Asking the right questions and managing teams with more and more interdisciplinary skills. Armenante points to a third: Knowing when it’s most appropriate to layer in digital marketing, especially as it can seem more distant than an actual person getting in front of a physician.
Garg admits there’s competition in the industry for subject matter experts on commercial teams. But she says the hardest talent to find is leaders who can break down the longstanding silos within pharma.
“We need visionary leaders who are able to connect the dots between science and commercial and technology,” she says. “It’s only when you connect the dots that you’re able to unleash innovation.”
Related Content: Breaking out of data silos in commercial
Primary Event: Pharma USA 2023Précis: The transformation in the way pharma and HCPs interact is leading pharma companies to reorganize and rethink the makeup and approach of its commercialization teams Premium`: Freemium`: Channels: CommercialChannelimage: 
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