If there’s one thing the past two years have taught us, it’s that the life sciences industry is capable of accomplishing things well beyond what was once thought possible. The industry initiated agile experimentation, operating smoothly through unexpected changes, and cloud technology played a part in that. Challenging the status quo and taking the right risks showed the potential for how much more we can do to improve drug development and commercialization in the years to come.

 in this publication five years ago has not happened, but it is now closer than ever. The upheaval of the pandemic created focus and a new adaptability to change. We are more comfortable experimenting, and we have a greater appreciation for taking a long-term mindset.

Digital disruption radically alters how an industry operates, like we saw in travel and transportation with the emergence of new digital models from Uber and Airbnb. For life sciences, digital will fundamentally change how we work collaboratively across the industry to serve patients, health care providers, payers, and governments. It’s not going to happen all at once, but the changes over the next five years will be significant.

Two major opportunities exist in the introduction of fully digital trials and a new modern data foundation for precision targeting of more specialized products.

The fragmented nature of studies results in a lot of wasted time and money. Patients need a better experience. Sites need simplicity. Sponsors need instant access to data.

The digital trial model goes beyond a decentralized one, making it easier for all major stakeholders to participate by connecting sites, sponsors, and patients with a standard paperless workflow. With this ambitious approach, the industry could significantly cut trial times and costs to deliver new medicines and treatments to patients more quickly.

To get there, we need a relentless focus on the patient and site experience. Companies may need to appoint and empower a chief patient officer or a chief customer officer to drive this change. However you approach it, dedicated teams should have accountability for a more consumer-like patient experience.

Like clinical trials, the industry’s approach to data is going to change. In this new era of precision medicine, relevant data connections will deliver more precise insights for effective patient segmentation and targeting. Investments in hundreds of disconnected data sources have attempted to solve the problem, only to create unnecessary complexity, inefficiency, and patient privacy concerns.

The way forward isn’t just having more data; it’s about focusing on the right data. That means real-time, patient-first data derived from diverse sources rather than the historic prescription-centric approach. A deeper, more complete view of the patient journey will deliver greater precision in both finding and treating specific people.

Getting digitally fit for the changes ahead

As science continues to advance at a rapid pace, how the industry executes will need to evolve. New operating models and more robust data foundations will allow for even greater speed, focus, and collaboration over the next five years.

Now is the time to get digitally fit with an integrated cloud and data strategy that is suited to new specialty medicines and a truly patient-centric approach. There’s a lot to accomplish, but as COVID-19 taught us, there are no limits when we’re all working together toward the same goal.

, Founder, CEO, Veeva Systems. You can find more of his perspectives on business at 

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Digital disruption is poised to usher in a new era of customer-centricity and efficiency, starting with trials and precision targeting.

As Change Continues, Are You Digitally Fit For the Future?

convened a diverse group of pharma executives from large and smaller biopharma—both commercial and clinical stage—as well as the industry’s leading policy organizations BIO and PhRMA, to get a holistic view of trends surfacing today that will impact the industry in the next few years. Suffice to say, the past two years were hard to predict, but the panel sought to forecast the enduring trends throughout 2022.

The event was moderated by Michael J. Hennessy Jr., president and CEO of MJH Life Sciences, 

Following are highlights of the conversation (answers have been edited for length and clarity). 

View video excerpts from this roundtable on 

Heading into 2022, we’ve seen everything from supply chain issues, inflation, emerging variants, the latest and greatest Great Resignation, and growing concerns around the FDA. Let’s start with the Great Resignation and the topic of talent.

Sanjay S. Shukla, MD, MS, President and CEO, Atyr Pharma:

 This is a high-growth year for us, and retaining talent and recruiting new talent is top of mind. There is a lot of nuance involved, given what’s happened with COVID. We are going to have to handle talent much more differently than we have in the past. We’re going to have to be more creative, with more hand-to-hand negotiations in any role we think about.

Timothy Whitten, CEO AND President, Taiho Oncology: 

We’ve hired more than 125 people since the pandemic began. Many are new positions because we are growing, and some are a result of turnover, which has increased. But we’ve been able to find people reasonably well.

Anne McDonald Pritchett, PHD, Senior Vice President of Policy and Research, PhRMA: 

Speaking for the industry overall, we continue to have a huge gap in terms of STEM workers. We’re very focused on growing that pipeline, particularly as we see proposals from Congress and administration to enhance biopharmaceutical manufacturing in the US and we know we need to grow the workforce and fill new positions.

Also, how do we increase the diversity in our workforce? PhRMA recently partnered with UNCF and the Center for Healthcare Innovation to hold our first Graduate Summit where we had 600 virtual attendees. It focused on getting people excited about biomedical careers and helping them make connections to potential jobs for a more diverse workforce.

The area of focus for ’22 is talent and the recognition that talent is global. While we’ve known it’s global, it will probably stay that way. Having the ability to be flexible, recognizing that not everyone needs to move to a corporate office to do their job, is one way of addressing the global talent needs. Then retaining that talent and giving them a reason to believe there is still great opportunity to grow with the company they are at.

In our case, we were fortunate over the last year to go from roughly 50 to 300 employees, so we are definitely successful
in sourcing talent and bringing them onboard. Now it’s about building
that culture.

Cartier Esham, PHD, Chief Scientific Officer, BIO: 

BIO, in particular, has a large number of the smaller emerging biotech companies that don’t quite have a product on the market. We launched a LinkedIn group that creates a community of professionals to improve their ability to find and onboard professionals…specifically those from diverse backgrounds or maybe currently underrepresented at large across the industry.

 On the talent side, I would add specificity, depending on what stage your company is in. Our company is also in a high-growth stage, with our first product approval earlier this year, as well as initiating six clinical trials. We are located in Research Triangle Park, N.C., which has one of the highest concentrations of PhDs, but with the aperture broadening and moving from local/regional to national/international talent, it really requires attracting folks who are inspired by your innovation. Then we, as leaders, are creating the healthiest culture possible and willing to go soup to nuts engaging the employee base even more than we did pre-pandemic.

I’m most encouraged by the very honest discussions we have with candidates about the alignment in values and expectations, which the environment is calling for—ensuring that alignment between those potential candidates and the company. And that enables us to carry out our missions that much better.

There also is the competitiveness issue of everyone competing for the same qualified candidates. So work flexibility and being devoted to the mission are going to be important distinguishing factors as we move forward.

Steve Lo, President and CEO, Zosano Pharma: 

When we think about talent, we need to acknowledge that even our contract manufacturers have challenges with keeping staff on board. There may be rising costs in their labor, etc. We’ve been tracking that trend as well, because we all have tight timelines and having to revisit those based on labor challenges is necessary.

As several of you hit upon the people aspect, in a conversation I had recently with another CEO not joining us today, was the newest generation in the workforce—the Gen Zs. They are much more forthright in terms of their expectations. How are you accommodating all of the generations while not leaving some out?

Maria Maccecchini, PHD, Founder, President, CEO AND Executive Board Member, Annovis Bio:

 I think that’s an excellent question because I’m probably on the older side and now our company has many more younger people. I like the fact that we get novel input; I’ve been shepherding these drugs now for 10 years, and it’s wonderful to get different input. It takes time to see a different way of looking at things, to step back and say, “Well it’s not my idea, but it’s great.” I really believe that adding young people has helped us a lot.

To Maria’s point, we’ve also tried to listen to the more tech-savvy folks who suggest interesting tools for collaboration. If we agree, we train everyone on that. That’s certainly been an area of opportunity for us to continue to find a way to balance the work flexibility and building company culture with both in-house and remote employees.

The newer generation is different but energizing. They clearly want transparency and authenticity. Development is also high on their radar because there is a propensity for them to have many more professional chapters in their career than many of us, or at least what I had. And engaging them for their input is also a great opportunity for their growth.

 COVID also gave us an opportunity to practice a different level of corporate empathy and an opportunity to experiment. And it’s not just the “younger generation.” I’ve had more conversations with folks who’ve been at this for decades, and I use the example, even for myself, having to take care of or visit older parents.

It’s no longer work/life; it’s life/work balance. I’ve listened closely and have had more conversations to challenge employees, in a way, to say if they need to work in the UK for a month to take care of family or work from the East Coast, or whatever opportunity that works for them, it’s OK. It’s a chance to do things differently. We’ve turned the conversation upside down and it has highlighted what really is important to people.

Let’s take this a step further and talk about what changes COVID brought to the company or what that flexibility means to your company.

 With the hybrid model, we found that it’s important to take time and think about the calendar. For example, for certain days of the week where you expect everybody to be in the office, how is that time being utilized most productively versus what might be able to happen on flex days where more Zoom calls might be more productive?

 Another issue is contingency planning. There is one plan for face to face, another plan for virtual, because at Taiho we have found that some things are more effectively done face to face than virtually. For example, having strategic discussions with our parent company in Japan has been more difficult over Teams or Zoom.

We also went through our job descriptions and identified positions which could be based remotely all the time and which positions needed to be in the office some of the time on a hybrid model. This translated into 30% of our positions being fully remote and 70% being hybrid. In July, we started having people come back two days a week and there were a lot of hugs, people missing that social connection. We will continue hybrid. There’s no perfect answer.

 Flexibility is the keyword that we learned over the past two years. We’ve learned that there’s the ability to leverage technology to get work done. With that being said, I still am a huge believer that human interaction is so important to building the culture. As Tim said, we reopened our office in California July 6. It was like people returning from summer break in high school seeing friends again for the first time in a year and people were just so happy to be back together. And that fosters the culture and fosters the trust that’s necessary for the long term.

 We started two Phase IIs exactly when the pandemic started, and we pretty much had to improvise because there were no good rules or no good understanding. And we learned to do a lot of things virtually. Auditing PIs, auditing sites, auditing everything, and some problems with supplies.

Now going into two Phase IIIs, I feel a lot more confident. We have learned how to maneuver, be much more flexible, and figure out what we do virtually and what we do in person. I agree that strategic thinking is not done very well on a computer screen. So really, my biggest issue is to recruit patients and make them feel comfortable enough, because at least one visit has to be at the hospital. The rest we can do virtually.

Has there been any shift in a direction for sourcing of materials, considering the global supply chain challenges?

 We were very assertive in leveraging our balance sheet to ensure that we were able to source raw materials for our API for drug substance. The lead times have extended out. There is a scarcity of certain raw materials, as well as a scarcity of equipment available.

We were very cognizant that we just couldn’t source for the next year to two years. We were thoughtful in terms of how far out we could source, and we secured supply to ensure that we had adequate drug substance for our products so that patients would have access to our medicine.

It required a lot of work, but based on that, we’ll be in very, very good shape for the next several years.

 Just like James, we did think early about the fact we would need novel API material; and I think we are set. It may have taken a little longer to source it, but overall we haven’t seen too much of a problem, so we are lucky.

I would add that it’s important to have a backup. Having a sole source for an API or a sole source for your manufacturing facility probably wasn’t a good idea before, and it’s certainly not a good idea now. And having that backup in a different geography than your primary manufacturer reduces your risk.

 BIO and PhRMA have been very focused on educating policymakers on the value of globally resilient supply chains, the negatives of having everything in one particular country for a myriad of reasons. We’ve seen a dramatic shift over the past year from government and lawmakers on how to enhance resiliency in supply chains. The fact that we didn’t see major disruptions in the supply of innovative medicines thus far during the pandemic is a testament to the value of those globally resilient supply chains.

There have been many executive orders from the administration focused on supply chain resiliency, more than $19 billion has been approved by Congress, so we need to be proactively shaping how that’s allocated.

 When the Defense Protection Act went into effect for smooth manufacturing of vaccines and antivirals, we needed to make sure that wasn’t implemented in a way that unduly disrupted the supply chain for the smaller mid-sized companies that have regular standing orders.

Moving forward, we need to pay very close attention to ensure ideas around strengthening the domestic capacity here in the US through incentives or utilization of advanced manufacturing technologies is done in a way that strengthens and not harms the global supply chain.

How have the past 18–20 months altered the long-term strategic plan for your organizations—other than flexibility in the workplace?

 It has underscored the importance of this industry. When you look around the globe, who was able to innovate with the speed, the creativity, and ultimately the success? Hopefully, what we’ve learned during the past 18–24 months, whether it be regulatorily or development or other practices, was how do we embed those so the industry is actually healthier going forward in terms of our patient focus, faster speed, and more alignment on delivering innovation to unmet medical need. I hope it doesn’t relapse into some of the legacy positions that this industry has struggled with the past 20 years.

The use of digital tools has accelerated dramatically. Telemedicine is increasing access to healthcare for a lot of populations, and the regulatory flexibilities necessary due to the COVID pandemic have not resulted in any negative impacts on assessments of safety and efficacy. We are looking to embed many of those lessons learned into standard operating procedures as we engage with the FDA and others.

 We have leapfrogged our learnings about how to potentially utilize a different clinical development paradigm that could lessen burdens for patients. Next year presents an opportunity, both in working with the FDA and through the legislative process to solidify those opportunities using real-world digital tools, decentralized trials, all of which will help in diversity representation and the clinical development ecosystem as a whole.

As far as what we are doing strategically, our commercial team has done and continues to have those discussions around how we communicate with our customers and what tools we use in what instances. It’s become very, very individualized.

As a commercial organization, the access to healthcare professionals is vital. We have some accounts and some physicians that refuse to have a virtual discussion, and we have many others who are just the opposite. You really need to know your customer and spend a lot of time, strategically and tactically, figuring out the best way to communicate with them and meet them where they are. Having the ability to do that, that’s going to continue in 2022.

 Life sciences and biotech are going to be a destination. Never have I seen so much innovation from technology. For example, there is so much innovation around using better artificial intelligence to design your clinical trials to be more efficient.

It’s safe to say that many years ago, this industry was viewed a little differently. I am very excited about our industry being a preferred destination for future business school grads, engineers, and others.

 If the pandemic did one good thing, it really focused on meaningful, impactful innovation. With COVID-19 affecting so many, and the world’s eyes watching eagerly for vaccines and treatments to help, what I hope the industry learned is the importance of innovation translating to real patient outcomes. Even in clinical development, prioritizing endpoints, for example, to those that change that patient’s life. I know that’s a difficult topic to have, but it’s something I’m hopeful we get more engaged in as a drug developer.

 is Pharm Exec's Group Editorial Director. She can be reached at 

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Our latest CEO Leadership roundtable focused on the most top-of-mind issues for companies.

Ready for Pharma’s Next Chapter

Healthcare providers (HCPs) have never been easy to reach. But today—between the deluge of communication in digital channels, the increasingly complex landscape of therapies and treatment protocols, and the expectation for highly personalized interactions in all aspects of consumer life—the bar for what merits HCP attention is higher than ever. If brands want to get through to physicians in a meaningful way, commercial teams must ensure everything from the message to timing and channel is clearly tailored to their needs and interests.

A decade ago—prior to artificial intelligence (AI) becoming such a powerful tool for businesses looking to engage customers—life sciences organizations often had to rely upon monolithic, single-vendor solutions instead of a more specialized, best-of-breed ecosystem when integrating technology, AI, and data into a coordinated plan of engagement with customers. The benefits of specialized solutions were also more difficult to measure and realize. But now, with many technologies helping to ease the integration burden of data, strategy, AI, workflow, and analytics, organizations no longer must place all their eggs in one basket with a single vendor—nor should they.

By taking an ecosystem approach, life sciences organizations can enjoy solutions that are ready to perform as soon as they’re implemented with the flexibility to adapt in the future (see graphic on facing page). Here are three tips for designing an omnichannel AI ecosystem that maximizes investments while remaining nimble in today’s dynamic and competitive market.

How do vendors position themselves within the larger ecosystem?

Challenge technology partners to explain their sense of urgency for working well with others to generate value for customers. It can help to break down your needs into six ecosystem categories, where there are a range of platforms, tools, and technologies that may be in various stages of maturity at your organization.

Data companies compile or generate the critical inputs for commercial strategies, analytical models, and more. Data sets can include HCP profiles, markets, social/media, EHR/claims/Rx, research publications, insurance and government, socioeconomic and behavioral, lab/diagnostic, ERP, budgets, personnel/performance, channel engagement metrics, and more.

The platforms or systems for managing and integrating data, applications, and APIs from disparate sources, including both cloud-resident and on-premises endpoints, allow data to be leveraged effectively by other tools and users. These include data warehouses, Extract/Transform/Load (ETL) and integration systems, customer relationship management (CRM) systems, traditional insights/analytics applications, and customer data platforms.

Methodologies and algorithms to rank and classify HCPs into segments for different go-to-market campaigns and programs, which are composed of tactics and rules for specific actions based on a triggering event or series of events. Examples include HCP segmentation, content and creative development, marketing campaigns, and customer journey design.

4. Omnichannel Intelligence and Optimization–

Algorithmic analysis, distillation, and prioritization of all possible actions to determine the next best action within and across channels for both the user and the target customer. For instance, omnichannel optimization, next best action, and predictive insights.

5. Omnichannel Execution and Channel Activation–

Technology that enables marketing, sales, and medical affairs teams to engage with HCPs across multiple in-person and digital channels. These solutions include marketing automation, sales and medical user apps, and third-party publishers.

6. Systems Integration and Professional Services–

 Services vendors and consultants that implement and integrate systems by deploying a team of IT consultants to provide professional services for a specified scope and rate are an important final part of the ecosystem.

There are key players in each of these categories, and while some may fit into several, each category typically has one standout. Therefore, the key to maximizing your success comes from ensuring that the best of each category integrates with the whole ecosystem.

At Aktana, for instance, our primary focus is omnichannel intelligence and optimization. As a result, we’ve invested considerable effort integrating with the upstream data and strategy layers of the ecosystem as well as downstream execution channels. Even with modest upstream data, omnichannel AI can start to generate impactful next best action recommendations and insights, growing smarter and more powerful as organizations layer in richer profiles and data sets.

The downstream systems are an equally important consideration, as the best insights and suggestions have little impact if they’re not acted upon by marketing, field, and medical teams. To make user adoption as frictionless as possible, companies need seamless integration with omnichannel execution and channel activation platforms to reach users when and where they already work.

For sales and medical teams, users need to be able to plan and execute their engagement plans with HCPs with well-curated and timely suggestions and insights about their accounts and KOLs—whether that’s on a desktop, via video conference, or in person with a mobile device. For marketing users, this can mean ensuring suggestions and insights integrate into marketing automation, journey orchestration, and campaign management systems.

How can the right combination of data, strategy, and technology amplify impact?

There is often low-hanging fruit—for example, existing internal data sources—that generates impact while also laying a good foundation to expand in the future. There is a misconception that companies must start with optimized, clean, and fully organized data to see any results from an AI solution. However, companies with even an imperfect data foundation can be very successful if they practice good data hygiene with systems that most organizations already have and use daily, such as a CRM system. However, it often comes back to fundamentals such as clean, curated, and structured data in the CRM, including HCP account data and up-to-date territory alignments between field and medical teams. With these fundamentals, pharmaceutical commercial teams can start leveraging the core competencies of each technology partner to ensure HCP interactions are relevant to their specialty, practice setting, and any expressed preferences and interests.

For example, a company may have rich data on HCP activities in research publications and social media that can finally be used in targeted field rep suggestions to test how well a new campaign strategy is performing. Or a team may be leveraging a new marketing automation platform for better digital communications but need a way to optimize and coordinate which messages are delivered by global marketing campaigns and which are better delivered via in-person visit or virtual rep detail. Each of these capabilities alone can have value. But by integrating them into an ecosystem, companies can supercharge these investments and better measure how each is performing relative to its cost.

“It’s important for organizations to have a digital ecosystem that places the customer at the center and creates a holistic 360-degree view of their needs,” says Andy Fuchs, vice president of commercial strategy at Veeva Systems. “A platform that brings together data, analytics, and content to activate field sales and medical teams is critical in driving informed actions that move the needle with customers.”

Whose roadmaps will activate and accelerate your organizational vision?

While vendors may have areas of focus, the market will continue to evolve in new and unexpected ways that challenge those focus areas. Therefore, it’s important to develop a vision that spans multiple years. In addition, adopt solutions that not only integrate seamlessly but do so in a way that enables a company to measure the impact of each ecosystem component quickly.

For example, you may have recently invested in analytics models to improve HCP segmentation, but it takes an ecosystem to verify whether the new models are working effectively and where they can be improved. Or, you may have an agency developing interesting new content and campaigns for your brand, but with only modest ability to measure the short- and long-term results. By integrating those campaigns and content into an omnichannel ecosystem, you will be able to continuously measure, adapt, and achieve your vision.

When adding a new partner to enhance any part of this ecosystem, ask for its latest roadmaps and consider how it aligns with your short-, medium-, and long-term needs with an emphasis on continuous improvement and impact measurement.

As Bill Gates once said, “Most people overestimate what they can do in one year and underestimate what they can do in 10 years.” Likewise, it’s important to craft both a pragmatic and ambitious vision to drive progress within your ecosystem of vendors—especially when it comes to the complexity of implementing an AI-driven commercial solution.

“The backbone of a successful omnichannel solution relies on driving business initiatives forward with the flexibility to innovate,” concludes Fuchs. “Look beyond partners’ roadmaps to those that fit your long-term vision, offering greater agility and impact as business needs and HCP engagement preferences evolve.”

, Director of Strategic Alliances & Business Development, Aktana

Designing an omnichannel artificial intelligence ecosystem that integrates strategies can boost commercial success for pharma.

The Tech Perspective: Coordinating a Plan of Engagement

Diversity, equity, and inclusion (DE&I) is clearly on the radar of all industries, including pharmaceutical manufacturers and marketing/advertising agencies. While those two sectors operate under generalized categories for US Business and Labor Statistics, as well as the US Census, there are clear calls to action for both to step up the DE&I of all populations within their walls. And while these initiatives happen separately in these companies, where is the specific pharma marketing and their third-party agency partners in this stage of the DE&I evolution?

According to Stephen Frost, CEO and founder of Included, a diversity and inclusion strategy consultancy, pharma is still living in the Diversity 2.0 space of the maturity 

. “But, I would say that many have moved into Inclusion 3.0, which is more mature and about really embedding it in what you do. Examples would be hiring clinical trials diversity directors or a vice president of inclusion…roles that get the ideas embedded into the company’s practices.”

But marketing and advertising itself as an industry appears challenged in recruiting and retaining diverse employees. In 2019, the Association of National Advertisers (ANA) released a report showing that recruiting and retaining racially diverse talent is a problem among marketers due to a fundamental disconnect between the resources being invested in diversity initiatives and a lack of inclusiveness felt by diverse workers. The association developed four key areas to help develop a diverse workforce, as follows:

Rebuilding Reputation with Students: Creating greater awareness and relevancy of the marketing industry with students

Reconnecting with Academia: Building greater and deeper connectivity between academia and the marketing industry

Recruiting and Retaining with Purpose: Leveraging a marketing-driven mindset when recruiting and retaining talent

Reinventing for the Present and Future: Building the right marketing capabilities for growth for our organizations.

This might look strikingly similar to what has preceded the marketing and advertising employers in regard to STEM. And, similarly, it resembles a Diversity 2.0 approach.

With these issues in mind, how do pharma, marketers, and external agencies get to a culturally inclusive and relevant marketing strategy?

Frost says that procurements is one area of business that has embraced DE&I in its contracts. “The US is the most advanced market for supplier diversity,” says Frost. “However, there is a debate whether it’s just a ‘tick-the-box’ approach or whether it’s genuine. But the fact is now in many contracts, there are clauses requiring diversity and—in many cases—requiring an audit of that.”

Christine Sakdalan, vice president of customer engagement strategy and solutions for Otsuka, and CEO of a nonprofit organization called Momentum and Value for People of Color (MVPOC), adds, “In pharma, we say we are here to transform peoples’ lives. However, how that translates into action sometimes is lacking in terms of having the right representation of our patient populations we serve in our communications and marketing materials. We have the best of intentions and best purpose in mind, but we don’t always support that with the right infrastructure or investments or the right partnerships, including our agency partners.”

While on the topic of RFPs and requiring that partnered companies fulfill diversity requirements, as well as NASDAQ’s requirements that public companies disclose board diversity, this speaks to the increase in transparency to this process. And, for some in pharma, that is an opportunity to effect positive change.

 last year, CEOs gathered with Frost to discuss diversity and inclusion on the broader pharma level. Roundtable members favored the external requirements and transparency among all external vendors as a way to ensure commitments to diversity are taken seriously, and as a way to show leadership in the entire pharma ecosystem.

Lydia Cronin, marketing manager for Included, adds, “Outside of an inclusion rider, or a contract clause, there should be a kind of threshold of what your standards are in terms of DE&I of particular organizations that you might be partnering with. Because pharma has the reputational and financial power to make a difference, and revenue potential sometimes is the only thing that speaks to them.”

External contracts and hitting partners in their pocketbooks is not the only way to influence a diverse workforce. Another way is to look internally, and especially in drug commercialization, that means sales.

Frost describes a pharma client who was selling its diabetes product in the southern US, with a salesforce that was entirely Caucasian, and not reflective of the target healthcare professional (HCP) workforce. “It had a commercial impact,” says Frost. “The HCPs are looking much more at who is selling to them. So whether a company partners with Black health associations or NAACP, you may be getting it wrong. If you peel beneath the marketing and the product doesn’t stack up because your entire field force is white, it’s a problem.”

To that end, Frost believes these more practical aspects of examining the marketing and detailing and doing an audit of the marketing, as well as social media, is on the board. He also suggests looking for marketing talent outside of pharma and brining their broader consumer strengths into the mix.

Currently, Frost and Cronin are preparing their next book and have interviewed a number of pharma leaders. Cronin tells 

, “They are turning more to authenticity. It can’t be just putting [a diverse representative photo] on the front and pushing that out and assuming that no one is going to question what comes beneath. It’s needing to have that backed up within an organization.”

Sakdalan agrees: “We need to understand the insights for those cultures and understand how to engage in a more relevant way. In marketing, it’s a deep understanding of who you are trying to reach and engage to enable better decision making and to take action accordingly.”

To that end, Sakdalan suggests a holistic approach to these communities. For example, if the culture includes dancing, music, and food, then that needs to be a part of the campaign. “If you are creating a healthy eating program for people with diabetes, for example, you need to offer healthier options for the foods that a particular culture actually eats,” says Sakdalan. Does that information only come from the internal teams or the external teams that are on the projects? Not necessarily, says Sakdalan, but at least market research and campaign testing to the awareness of these cultural approaches are important.

“Make sure your market research is diverse or representative of that community,” says Sakdalan. Another way marketers can learn new approaches is through cultural immersion. “Ethnographies…use that as part of a cultural immersion for the right community. It will expand your horizon. As long as you have the awareness, knowledge, and desire to do something different and purposeful, the actions will be impacted by that.”

Measuring the effectiveness of culturally relevant marketing and advertising campaigns is not hard, says Sakdalan, because we have “overwhelming amounts of data.” In the end, however, “it’s the same as any campaign—using pre- and post-tests, targeted media buying and optimization geared toward certain populations, and measuring effectiveness of that.”

Cronin also suggests a sentiment analysis tool conducted across press or on social media to see how people are talking about your company or campaign, as well as other tools that come with measuring brand awareness.

As Sakdalan reiterates, “You’re not changing the process, you are changing the way you approach the process.”

Pharma should take an integrated approach to representing cultural elements in materials.

The Importance of Culturally Inclusive and Relevant Marketing

The US has the largest advertising industry in the world by a considerable margin. China, next in line, spends about one-third the amount the US does. According to Zenith Media, the US is expecting to spend a total of $320 billion on advertising in 2022, and of that total spend, about $200 billion will likely be attributed to digital media.

Digital media has more than doubled in terms of spending since 2017 and has accelerated swiftly since the onset of the pandemic in March 2020.

 This isn’t a surprise, as the past couple years of pandemic-induced physical isolation have shifted gazes and attention from the real world to screens and devices, including smartphones, tablets, computers, and streaming TV. It’s said that it takes an average of 66 days for a new behavior to become automatic,

 and everyone—from children to grandparents—have certainly had the time to form new media habits. Advertisers now have a vast audience primed for relevant digital communication. In addition to this captive audience, advertisers have troves of data and insights available to them before, during, and after campaigns.

The pharma industry seems to be following a similar theme. As of 2020, the US owned nearly half (45.9%) of the total pharma advertising market share worldwide, with China (8%) and Japan (6.8%) being the next two highest in terms of share. When looking at these statistics, it’s important to note that the US is one of two nations worldwide (New Zealand being the other) that permits direct-to-consumer (DTC) advertising, which significantly increases spending. The rest of the world focuses on unbranded campaigns to indirectly impact consumers.

While the majority of industries within the US took a large hit during the length of the pandemic, pharma notably increased its ad spend over the past two years. A lot of this can be attributed to the need to reach several stakeholders in new and creative ways, but there’s also an undeniable focus on health that the pandemic has enhanced dramatically.

Opportunity is knocking for pharma, and companies are looking to capitalize. According to Statista, only the retail industry spends more money on advertising than pharma, at 26% and 18.8%, respectively. Historically, pharma has been largely invested in traditional avenues such as linear TV and print. Though digital has always been in its collective mind, the recent deep dive into the medium is now becoming an unavoidable reality.

Healthcare has moved to the center of public consciousness over the past 10 years, firmly establishing itself as a growing influence on nearly all aspects of daily life. There is a huge amount of investment, primarily driven by the exponential growth of biotech and its focus on cancer and autoimmune diseases. Constant innovation and a heavy flow of new products and treatments are being developed, which is crowding the markets.

It is a formidable challenge for manufacturers to raise awareness to all the stakeholders involved, which are aplenty: healthcare professionals (HCPs); patients and caregivers; insurance companies and other payers; patient advocacy groups; hospital systems; influencers; KOLs and digital opinion leaders; etc. The goal is to make all these stakeholders aware of the diseases and treatments available, educate them, help remove any stigma associated with the diseases, and ultimately push for more positive outcomes via accessible treatments. The sheer number of targets is expanding, especially considering how specialized the pharma industry is.

HCPs are overburdened and do not have the time that they used to have. Most HCPs now prefer a hybrid of physical/in-person encounters and digital. In addition, the prevalence of the empowered patient has made pharma take notice. The days of simply accepting what your physician tells you as gospel are over. Patients gather their own intelligence on the internet and make decisions way before they step into an HCP’s office—whether physical or virtual. In fact, Google often leads them to an HCP’s office. In 2020, Google received 1 billion health-related searches per day—and that was pre-pandemic.

 Empowered patients are ultimately better patients because they are ready to have a conversation with their HCPs, they have less hesitance, and they take their medication throughout their entire journey. Better adherence leads to better outcomes, which is better for brands.

As a result, marketers have changed their channel mix during the pandemic, moving to digital channels, including social. While the traditional avenues of linear TV, print, radio, and mail certainly have their place (some more than others), digital advertising is quickly becoming a main focus of the pharma industry.

Linear TV losing share to digital channels

A successful pharma marketing campaign addresses its entire audience. While there is certainly still room for more broad-stroke marketing via linear TV and other traditional HCP-targeted advertising (print, radio, e.g.) created to support pharma’s historically greatest asset, the sales force, things have changed dramatically over the past two years.

Since the dawn of pharma commercials on linear TV in the late 1990s, pharma has invested heavily in the channel, relying on upfronts as well as dayparting—the segmentation of broadcast day by hours that helps define the demographics that are tuned into certain programming. While this approach used to be the gold standard, today there are many more targeted options available and many fewer eyes on linear TV.

Today, people commonly stream directly from the internet or via connected TV, such as Roku. New formats are available in these media channels, and more importantly, longer formats that maximize storytelling, better suiting the ads offered up by pharma, which include a significant amount of fair balance as the ads come to close. In addition, new content suppliers are springing up all the time. HBO Max, Paramount+, Discovery+, and Peacock all launched in 2020–2021. Most importantly, there are more advanced data analytics provided in real time, which allows marketers to make informed decisions about ad spend and react to trends as consumers interact with the content.

 reached out to Amanda Powers Han, chief marketing officer at Greater Than One, to get an expert opinion on the more granular aspects of a pharma brand planning approach as it stands today. Once pharma’s field force got grounded at the onset of the COVID pandemic, non-personal promotions (NPPs) became vital.

“If you think about the past two years, the access that the sales teams have had in terms of personal detailing has been really spotty and, in some cases, non-existent,” says Powers Han. “So there was and is an increased reliance on non-personal programs that could reach that target list of physicians, and then provide that valuable physician-level engagement data back.”

 detailed how frequency of interactions with HCPs was dropping off a cliff—sales teams were barely able to interact with HCPs during the pandemic. A rep might secure one interaction, but the chances of getting another were cut in half, and in half again, etc. When it comes to NPP, HCPs appreciate personalized and relevant content, so it’s imperative that all of the communications are intelligent. The goal is to win another meeting, whether physical or virtual, or a plain old phone call, and have NPP and personal, human interactions feed off one another to establish good relationships.

“The engagement data we get back, based on the physicians who have either opened an email or engaged with a program, or clicked on something very specific in terms of the content we’ve been serving them, is intelligence that is fed back to the broader commercial organization to be used in more creative ways as well,” says Powers Han. Results of an NPP engagement creates data that provides a more targeted way for a salesperson to go back and have a more engaging human-to-human conversation with that physician based on what the marketer knows interests that particular physician. It’s essentially a way to connect the dots and create a hyper-specific and customized content strategy from one physician to the next.

Another avenue that Powers Han utilizes is engaging HCPs at the point of care or prescribing via electronic medical records (EMR) media. Companies can incorporate advertising as the physician is sitting down with the patient and using the EMR system to record specific interactions, and influence that prescription brand choice as the physician and patient dialogue is taking place.

“It’s great, because with far fewer patients going into the office, the more traditional forms of point-of-care advertising were not always a smart option, because the physician and the patient weren’t necessarily sitting down in the same room having the conversation in the more traditional doctor’s office.” This approach is successful because it takes advantage of being in the right place at the right time, as well as being personalized and relevant.

While not as shiny as other paid media forms, search engine marketing (SEM) has always performed well and is successful for a few different reasons. The No. 1 reason is that it provides a solution when the HCP or the patient/caregiver is searching for a specific solution. In other words, it’s always personalized and relevant. “In terms of channel mix, paid search is one of the consistent components in our media planning and buying,” says Powers Han. “When you think about the reliance on awareness-based advertising and building awareness and interest in the brand vs. where we can intercept and perhaps help that physician where they need something specific, search marketing is a workhorse for us.”

As stated earlier, Google received 1 billion health-related searches per day pre-pandemic, about 7% of all Google searches. And according to PranifyRX, when comparing digital channels, more pharma advertisers by far bought Google SEM than any other social, display, or programmatic network in the second half of 2020—and it wouldn’t be too speculative to say that the trend continued throughout 2021 and will continue into 2022. While it’s always great to include some “sizzle” when it comes to exciting opportunities and media programs, impact and results are paramount.

A media buy, in most cases, incorporates a mix of direct and programmatic placements to achieve credibility in terms of environment but provides an efficiency play that comes with programmatic. And while companies can and should target based on demographics, they can get much more precise. Powers Han details a few additional approaches that can hyper-focus a campaign:

 On Medscape, companies can filter by cardiologists, for example.

 Instead of thinking about a specific website such as Medscape, companies can utilize a programmatic or data partner to reach all of the cardiologists who have prescribed a product for hypertension, and then deploy ads across a thousand or more websites—but only to those specific physicians.

Contextual ads allow companies to surround specific content, such as hypertension, with ads that are directly related to a certain condition.

This focuses on the sites that certain HCPs have visited. For example, if they visited a brand site for a certain drug, retargeting that group personalizes a communication, because the interest was there.

While it has always been in the background, Powers Han says social media has grown exponentially recently, especially for healthcare clients. “Companies are finally getting more comfortable with how we can engage patients and caregivers on social in a way that is authentic and not quite as disruptive or jarring, more so on the unbranded vs. branded when it comes to paid social advertising, and more in terms of developing disease-state communities,” she says.

HCPs are on the same page as well—the vast majority are on social media, especially in the past two years. A survey of 4,000 physicians that’s nearly a decade old conducted by QuantiaMD stated 90% of physicians were using social media, 65% professionally. More recently, a 2021 study indicated that 91.1% of HCPs use social media during the workday.

What’s great about paid social is that it’s all about the targeting strategy. The more sophisticated the targeting strategy, the more optimized and impactful the advertising can be, both in terms of what the client is trying to achieve and from the patient/caregiver perspective—they’re viewing ideas, content, and offers that are relevant to them.

To offer an idea of the level of targeting that can take place, Powers Han provides an example: “We successfully targeted caregivers of children who have plaque psoriasis, a very rare condition, by partnering with a third-party data source that has a relationship with Facebook and could identify them. Data will always be a topic of discussion, but when done in a sensitive and thoughtful way, the content that we’re serving the audience is most relevant, and it resonates with them.”

According to Statista, between July and November 2020, the healthcare and pharmaceutical industries in the US spent $198.3 million on Facebook advertising, with Instagram not too far behind at $151.5 million in ad investments. Other platforms are pushing, and they’re all relevant for one reason or another, whether it’s targeting ability, demographics, or length and type of advertising available. Even the most conservative of clients should investigate the channel and platforms within. The audience is there, and it’s looking and listening for information and conversations about conditions, symptoms, stigma, health, illness, etc.

The top three social platforms used for influencer marketing in the US in 2021, according to eMarketer, were Instagram (67.9%); Facebook (52%); and TikTok (42%), which has really accelerated. The prevalence of influencers in health mirrors the greater market. They are big business in health, acting as advocates for a brand or condition, and can have significant impact. That said, the rules are changing as the medium continues
to develop, and pharma marketers should always stay current
and compliant.

Other digital channels experiencing a boom

In addition to social media, there are a number of other digital approaches experiencing an increase in attention by pharma:

 As a result of the pandemic and an explosive turn toward telemedicine, point-of-care advertising in magazines or kiosks in physician offices has experienced a tremendous downturn. Companies like Populus Media now sell ad opportunities within the telemedicine platforms delivering the virtual office experience. The only challenge is that the technology is so new that it hasn’t quite scaled yet.

 There’s also been a surge in video and podcast advertising. Video brings an ad to life and allows for more story development and often more emotional connection. Podcasts have been a great medium to advertise because of the demographic data available to marketers, as well as the ability to choose a program with relevant content.

 Another impactful channel to add to a media mix is OOH advertising, with its place-based media (billboards, kiosks, urban panels, etc.) found on city streets, across transit systems, and in airports, malls, and even doctors’ offices, often in digital forms. This medium reaches valuable, diverse audiences in America’s top cities and provides data-driven solutions for advertisers to reach those audiences. Starting in 2016, OOH exponentially picked up steam for healthcare marketers, largely due to the fact that digital enhancements eased any previous apprehension they harbored about utilizing the channel. And while the entire OOH industry declined in revenue in 2020, the decline in pharma and healthcare wasn’t as steep as other verticals.

According to Ross Krentzman, vice president of sales at Intersection, an experience-driven OOH media and technology company, pharma is increasingly investing in OOH. “Coming off the heels of recent advances in data and technology in OOH—including audience targeting to reach the right audience at the right time, automation for campaign execution, and solutions to measure business outcomes—we’re seeing a huge increase in digital OOH media buying by pharma brands across the board.”

He says OOH now has the ability to hyper-target based on audience demographics and location. Dayparting, days of the week, geo-targeting, and point-of-sale radius targeting are some of these more detailed methods. Brands often like to plan their OOH ad campaigns around medical events or place their ads near hospitals, which is cost-effective and can reach an elusive audience, since OOH cannot be blocked, skipped, or missed. Pharma brands, especially OTC brands, are also looking to be close to points of purchase, such as a Walgreens or CVS.

In addition to advanced targeting and seasonality, there have been massive improvements in measurement and in data. “Pharma companies can measure the effectiveness of their ads in the same way they do in digital,” says Krentzman. “For example, we can measure ‘script lift,’ an attribution study strategy that connects advertising audiences to pharmaceutical outcomes.” Having high-quality data attached to the entire ad journey continues to transform OOH and elevate its perception in the eyes of marketers.

Ad spend opportunities and trends are numerous for pharma marketers, and those mentioned here are just part of the story going forward. There is so much left to flesh out, including the complex worlds of influencer marketing and mobile. The growth and advancement of artificial intelligence for marketer intelligence is another incredibly important innovation, while the traditional channel of email marketing is being enhanced by embracing personalization and relevancy.

What’s certain in this ever-changing area is that with all of the stakeholders involved, with all of the complexity that exists in the industry, and with all of the hesitance to embrace new ways to target diverse audiences, marketers should employ an omnichannel strategy that coordinates brand messaging across online and offline channels. With the pandemic-forced mass migration to devices, digital should be embraced wholeheartedly. An omnichannel strategy is at its best when it provides clear and consistent communication throughout its targets’ journey, and it employs a continuous stream of high-quality data that provides flexibility and the ability to pivot at will. Finally, companies need to remember that their audience is human. Human insight and empathy, as well as authenticity and transparency, should always be essential to the pharma industry.

Pharm Exec's Senior Editor. He can be reached at

https://www.forbes.com/sites/bradadgate/2021/12/08/agencies-agree-2021-was-a-record-year-for-ad-spending-with-more-growth-expected-in-2022/?sh=22df95397bc6

https://www.healthline.com/health/how-long-does-it-take-to-form-a-habit#takeaway

https://www.telegraph.co.uk/technology/2019/03/10/google-sifting-one-billion-health-questions-day/

https://www.cureus.com/articles/61722-a-study-to-see-the-effect-of-social-media-usage-among-healthcare-providers

Industry embraces modern approach to commercialization, but keeps human connection at center.

Messaging Makeover

Nabriva Therapeutics’ CEO Ted Schroeder heads one of the few small commercial-stage biopharma companies engaged in the development of innovative anti-infective agents to treat serious bacterial infections. Nabriva Therapeutics currently markets Xenleta® (lefamulin), its semi-synthetic pleuromutilin designed to inhibit the synthesis of bacterial protein in oral and IV-administered formulations, which FDA approved in August 2019 for community-acquired bacterial pneumonia (CABP). Ed Cox, MD, MPH, director of FDA’s Office of Antimicrobial Products, said in a press release at the time, “For managing this serious disease, it is important for physicians and patients to have treatment options. This approval reinforces our ongoing commitment to address treatment of infectious diseases by facilitating the development of new antibiotics.”

New antibiotics is the key phrase here. Most people may be familiar with the term bacterial resistance or antibiotic resistance. As Schroeder points out, this “resistant” situation has been evolving throughout the entirety of his career, which has been mostly in antibiotic marketing and sales. Schroeder entered the industry with Bristol Laboratories, a division of then Bristol Myers, selling antibiotics to both hospitals and outpatient settings. Schroeder says, “This is when they actually still manufactured antibiotics in Syracuse, N.Y.” But soon after this heyday, there was a dearth of innovation in the antibiotic market, for numerous reasons.

For example, says Schroeder, it may have seemed evident to people in the 1980s and 1990s that the war on bacteria had been won. A large part of the gains in life expectancy achieved over the past 70 years can be attributed to vaccines and antibiotics. And antibiotics is one of the few classes of drugs that “cure” something at the end of five, seven, or 10 days, or other short courses of therapy. “Because of that, the economics of antibiotics are difficult, and that drove a lot of people out of the market,” explains Schroeder.

Apparently, resistance wasn’t factored into the exodus equation. Bacterial resistance had been noted as early as 1947, with the first case of penicillin resistance. Discovered in 1928, penicillin wasn’t mass produced for use in people until the early 1940s. But after penicillin, more antibiotics were developed and used—and overused—in the years since. But, as Schroeder points out, “The organisms antibiotics are trying to eradicate are smart. They evade the product that’s trying to kill them, so they create their own defense mechanisms, and they continue to survive.”

 Microbiology and Molecular Biology Reviews

 painted a grim picture for the overall success of global interventions to limit antibiotics overuse in all settings—agriculture, animal husbandry, pharmaceutical access, and healthcare systems. However, it did point positively to research: “It is vital that there should be absolutely no letup in the search for new antimicrobial agents. Despite the negative attitude of Big Pharma, the microbial parvome is nowhere near being exhausted in the search for new antimicrobials. Likewise, many uninvestigated drug targets exist in bacterial pathogens.”

“Quite honestly, I have grandchildren, and I really feel like they’re going to need effective antibiotics. The way the world was going, I wasn’t convinced they were going to get them,” says Schroeder.

He looks at the innovation dearth as proof that it’s just not easy to find new classes of antimicrobials. “There’s a reason why all the antibiotics tend to be from just a few classes…because they worked when other attempts didn’t work. It wasn’t being lazy, it wasn’t lack of trying for the past 30 years. They are not any easier to discover than say a new immuno-oncology product or a new gene therapy, and they’re not any less expensive to develop,” he explains.

Schroeder saw his chance to make strides in antibiotics when he founded Cadence Pharmaceuticals in 2004. The company started pursuing a topical antimicrobial for central venous catheter-related infections but did not make it past Phase III. The company then acquired IV-acetaminophen from Bristol Myers Squibb for development in the US market. The product, OFIRMEV®, was approved for the management of mild moderate pain, as well as severe pain with adjunctive opioid analgesics, and the reduction of fever. Cadence was acquired by Mallinckrodt for $1.4 billion in March 2014.

Again, Schroeder saw an opportunity to form another company to try and change the narrative and help advance the development of antibiotics. In 2015, he founded Zavante Therapeutics. “I will admit, I might seem a little crazy, but I didn’t do this because I wanted to get beat up every day by investors,” he says. “I did it because I really believe that the world needs what we’re doing and that the rewards will come.”

In 2016, Zavante entered clinical trials for ZTI-01 (fosfomycin for injection), or CONTEPO™, as a first-line treatment for complicated urinary tract infections (cUTI) suspected to be caused by multidrug resistant (MDR) pathogens. It is a first-in-class broad spectrum IV antibiotic to treat MDR strains, with the goal of improving anti-infective options in the hospital setting. In 2018, Nabriva acquired Zavante, thus broadening its portfolio, which included Xenleta. Schroeder became Nabriva CEO and led the FDA submissions for both Xenleta on Dec. 20, 2018, and Contepo on Jan. 4, 2021.

Schroeder, seeing another opportunity to influence the antibiotic narrative, became the chair for the Antimicrobials Working Group (AWG) in May 2021. The AWG was formed in 2012 and works with both government and private stakeholders to implement policies that will sustain the antimicrobial innovation infrastructure to combat the urgent threat of antimicrobial resistance (AMR).

“What is needed most,” says Schroeder, “is for the remaining companies in the antimicrobial space, mostly small companies, to get the ear of policymakers to make the kinds of changes that will ensure that we have an antibiotic infrastructure as we move forward. My day job is running the company but also advocating for the kinds of policies that will facilitate continued development in this area.”

He related a recent discussion he had about a friend whose wife was in the hospital for multiple weeks and her family was afraid she would die. The woman, around 50 years old with no underlying conditions, developed an infection, and the antibiotics she was treated with were two of the oldest and least expensive antibiotics that are used commonly in hospitals. “There are better antibiotics than the two she received. Fortunately, she survived. But not without weeks of being in the hospital with the pain, as well as the emotional suffering that families experience. But, had she been treated with the more advanced antibiotics, her recovery may have been quicker and almost certainly resulted in a shorter hospital stay with a less painful experience—maybe days instead of weeks, for all involved,” says Schroeder.

Because of what he calls perverse incentives, mostly at the hospital reimbursement level, as well as hospital administration bonus plan structures around pharmacy use, the situation won’t change without government intervention. “There is almost no legislator that I’ve met with that doesn’t know that antibiotic resistance is a problem,” says Schroeder. “It’s not just a looming problem, it’s a problem now, but there are so many other priorities on either side of the aisle that not enough are stepping forward.” However, Schroeder believes that serious people with real concerns about AMR are turning it into a national security issue. A recent study published in January 2022, estimated nearly 5 million deaths were associated with bacterial AMR in 2019, including 1.2 million deaths attributable to bacterial AMR. These data are alarming and reinforce the urgency of antibiotic stewardship.

Ted Schroeder, CEO of Nabriva Therapeutics, is passionate in his forward-thinking approach to finding the next generation of anti-infectives, as resistance to least-expensive, tried-and-true therapies continues to grow.

Pharmaceutical Executive-02-01-2022

As Change Continues, Are You Digitally Fit For the Future?

Ready for Pharma’s Next Chapter

The Tech Perspective: Coordinating a Plan of Engagement

The Importance of Culturally Inclusive and Relevant Marketing

Messaging Makeover

Ethics of Antibiotics

What’s Up in Biotech These Days? Not Much, Unfortunately

Planning for Second to Market in Orphan Disease Space

AI and Analytics Appear Ready to Surge in Sales and Marketing

It’s Time for Companies To See Employees as Full-Time People

EU Steps in on Pricing, Offers Member States Aid to Negotiate

Moving Forward With Pharma

Pharmaceutical Executive, February 2022 Issue (PDF)

Global Vaccine Access Challenges FDA, Industry