Therefore, in my opinion, following are the key areas that will most likely be higher in the pecking order for evolution of commercial operations:
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Sales force structure: Far from ‘rep mirroring’ models, the pharma sales force will now increasingly move to 1 rep per sales territory structure. This will mostly be driven, at least in the short term, by increased expectation for ‘social distancing’. However, this will not necessarily translate into downsizing of the sales force. To the contrary, the sales force organizations will be re-structured to expand the universe of “targets”.
There will now be a renewed focus to include Integrated Delivery Networks (IDNs) and Pharmacy Benefit Managers (PBMs) into “traditional” call plans. So far, these stakeholders were reached by specialized sales teams, causing gaps in understanding and mapping the total pharma value chain at local /regional levels.
Analyzing the online news and posts over the last couple of weeks – using WNS’ Social listening and monitoring platform Socioseer® - we have observed that 25 to 30 percent of all online and social activity (related to pharma) has been about ‘Pricing and Affordability’ and ‘Availability and Access’ of medicines. Unfortunately, the analysis also indicates that >80 percent of this ‘Voice of customer’ has negative sentiment and, subsequently, reflects poorly on the pharma companies and the entire value chain.
Source:McKinsey
Therefore, it is now imperative for pharma companies to leverage their existing sales organization to talk not just about ‘efficacy’ of drugs with prescribers, but also focus on ‘availability’ and ‘affordability’ while building stronger partnerships with IDNs, PBMs and so on.
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Multi-channel adoption: It is now a foregone conclusion that pharma companies will need to scale up multi-channel marketing to reach their target accounts. As things stand, in-person contact by sales reps constitute between 80 percent – 90 percent of all engagements. These in-person interactions are not just the details / calls conducted during rep visits, but also include local events and conferences. Considering that non-personal and digital channels constitute a small proportion of the current outreach programs, the biggest challenge for pharma companies is not about setting up the systems or technology required but to facilitate this behavioral change.
Like nearly every industry, pharma sales reps also rely on building and nurturing relationships with their customers – physicians, nurses, front-desk executives and clinical staff. Therefore, expecting them to adopt and move to ‘digital’ interfaces is a big ask, which needs extensive re-training and re-tooling. Even from the perspective of a physician, s/he are used to sales reps filling the cabinets with samples, dropping educational collateral at the front desk, sending invites for conferences and so on. Therefore, it is not any easier for physicians to adopt ‘pull’ models for information access or for ordering samples.
Every dollar spent towards enabling and scaling digital presence will need to be met with a comparable investment towards facilitating the adoption. In fact, pharma companies will need to get as close as possible to ‘omni-channel’ strategy where each channel is viewed not as a disparate program / engagement, but as organic extensions of each other. So, the corporate Website, e-sampling platform, e-detailing platform and even printed collateral need to “converge” to one theme and one experience. And, this will be the key to achieve value across both analog and digital worlds.
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Performance Measurement: Even though this trend started a few years ago when some pharma companies decided to move completely to Management by Objective for Incentive Compensation, most of the pharma companies still use Territory Sales to measure their sales force performance. While we do not expect companies to drop ‘Sales’ as a metric completely, it is now imperative for them to include and, perhaps, focus on other KPIs too while evaluating their sales force. This is especially important given the first two factors – re-structuring of sales force to focus beyond prescribers and encouraging multi-channel adoption.
We, at WNS, have been encouraging our clients to consider ‘Quality of Effort’ as an equally significant performance indicator as the ‘Outcome of effort’. While Territory sales is usually a good proxy for ‘Outcome of effort’, there are many metrics that need to be included to understand ‘Quality of Effort’ – the intent is to ensure we acknowledge and appreciate the key behavioral aspects that lead to sustained long-term impact and not just immediate monthly / quarterly sales. For example, one such KPI we recommend is Cadence of activity – looking at not just average reach or frequency, but at the discipline too. For one of our clients, we used statistical measures to prove that maintaining a well-scheduled cadence of calls yields better result than sporadic visits even though the total number of visits over a period of time might be the same. For example, a rep calling on a physician once every month will have better long-term relationship than another rep calling physicians twice every other month, even though both of them would have called on the physician ~ 12 times in a year.
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Automation and Artificial Intelligence: Commercial teams that have so far largely refrained from adopting automation and artificial intelligence systems by generally labelling them as ‘retail industry constructs’ will now have a new-found appreciation for these solutions. It is now critical for them to evaluate and deploy solutions, including ‘Next Best Action’ and ‘Nurture Marketing’ to ensure that physician (and patient) engagements continue to the extent possible. The need to develop rich content repositories and ability to serve relevant content will be important.
For example, based on physician specialty or her patient mix (by leveraging patient level data (APLD) or basic demographic data in / around physician’s postal code or even her social media interests as visible through tweets or ‘following’), pharma companies can push and recommend relevant and personalized collateral for physician education. This could include invites to conferences that are specifically relevant to the physician – so, it is possible that a conference on “Acute Respiratory Disorders” might actually be very relevant for an endocrinologist based on her patient-mix.
While there have been investments in AI and Automation by pharma companies over last few years, they have so far been limited and, perhaps, concentrated on chronic disease management in the areas of oncology and diabetes. Therefore, this is still an enormous opportunity to leverage AI in improving the patients’ and physicians’ ability to prevent and manage diseases.
As we observe from the survey conducted by McKinsey in late 2018, pharma companies have generally lagged behind other industries in adopting AI and automation to support their commercial operations.1
Irrespective of how things evolve in the future, we have to acknowledge that while most of us ‘stayed home’ to prevent the spread of the disease, the medical community has been fighting at the front lines to treat and cure. So, even when things return back to normal, it is important for pharma commercial organizations to realize that medical professionals are more than just ‘prescribers’, influencers and KOLs. Therefore, even though there will be a need to meet ‘pent-up’ sales numbers, it is important to remember that the medical community will need time to rest, relax and rejuvenate… before they can reflect on the learnings from the crisis, and life in general, and move on…