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The traditional commercial sales model in biopharma of deploying teams of reps to call on physicians is broken. Here, Stephen J. Donnelly outlines a new approach.
The traditional commercial sales model in biopharma of deploying teams of reps to call on physicians is broken. This is a dramatic pronouncement, but consider the following statistics: According to research from ZS's AccessMonitor in early 2015, only 47% of prescribers now permit in-person visits from sales reps. Simply stated, more than half of writers have simply shut the door on the rep. Additionally, consider that as recently as 2009, the percentage significantly restricting rep access was only 22%. Even traditionally rep-friendly specialties have significantly changed their policy towards sales reps. Access to dermatology and gastroenterology offices has plummeted in just the last two years. And in oncology, where 75% of oncologists were considered ‘accessible’ in 2010, now, just 5 years later, only 25% will see reps. Commercial organizations have a significant challenge: reaching the unreachables.
What is the reason for this change? First, there is provider consolidation and an increasing number of younger physicians joining health networks that have ever more stringent institutional policies barring reps from the premises. There are also greater demands on physician time. On top of that, younger physicians have grown up and been trained in an environment where resources were readily available digitally. For them, there has never been an expectation (or recognition of the value) of a rep relationship.
Yet surveys of what physicians want and need repeatedly point to the utility of educational and scientific resources that only brands can deliver. The present (and future) of biopharma sales strategy will not be calculated based on how many detail calls can be made to high decile writers by a territorially-aligned sales organization. Instead, it needs to be revamped into an agile approach, coordinating integrated sales and marketing. The new commercial organization needs to deliver a consistent and coordinated message across an array of multiple alternative communication channels, engaging physicians using their preferred method of communication. I term this a “modern sales and marketing approach.”
A new approach
The modern sales and marketing approach has evolved to allow agile commercial organizations to orchestrate delivery of on-demand resources to once unreachable physicians. Although on-premise access has contracted, physicians are increasingly supportive of customer service representatives. The CSR is a virtual face to the brand, making themselves present through a multichannel approach of phone, on demand chat, and other channels. The CSR provides access to samples, brand educational resources and patient education. Their role is not limited to serving up resources and pointing HCPs to condition and brand-specific physician websites, but also includes scheduling high-value details with scientifically skilled reps through virtual channels. Repeated surveys are unequivocal: physicians both need and value scientifically trained representatives who are adept at having evidence-based conversations. Even digital natives want to speak with brand representatives if they are articulate about the disease state, can expand on the clinical literature and can help physicians sort through therapeutic options. It goes with out saying that making efficient use of these highly trained scientific resources is a challenge. Scheduling and deploying high-value virtual reps requires an orchestrated marketing approach, beginning by setting expectations with HCPs and ensuring that the detail is focusing on the issues and questions that matter most.
Another brand-delivered virtual resource that is highly valued, particularly in oncology and conditions with considerable patient and caregiver disease burden, is the clinical health educator. Details with these nontraditional reps delves into patient education, product support and adherence and retention. The modern sales and marketing approach can optimize and orchestrate these resources as well.
The needed paradigm shift
The modern sales and marketing approach is a paradigm shift from the non-personal promotion that brands have been doing for the past decade. Non-personal is based on the notion of a “filler tactic,” intended as a supplement, subordinate to the role of the rep, and deemed appropriate for those pockets of physicians who were beyond the sales rep’s reach. Even with agency support, brand managers scramble to assemble wave-based email campaigns. They are time consuming to create, often uncoordinated with other brand marketing activities and moreover their effect on prescription writing is almost impossible to tease out. After a few months and a short series of waves, the campaigns grow old and there is little to show for the effort.
By contrast, the modern sales and marketing approach is designed to be evergreen, that is, continually relevant. Instead of leaning on email to push an outbound message, this multichannel approach uses a coordinated cast of digital components, (targeted web, personalized email, HCP-brand microsites, e-sampling) as well as highly targeted direct mail. While the non-personal approach is all message “push,” the modern sales and marketing approach balances message delivery with building a virtual presence to support the on-demand needs of HCPs. Finally, while the effect of single channel non-personal promotion is often disappointing with email open and clickthrough rates in the single digits, the integrated multichannel approach of modern sales and marketing is synergistic: the coordinated channels of targeted digital advertising, microsites, email, direct mail and customer service tele-detailing reinforce one another producing a sustained and significant result on brand writing.
It has often been said that individual physicians differ in how they want pharmaceutical companies to communicate with them. In the absence of the field rep, the need for preference-based communication becomes even more important. If we want to reach unreachable physicians, we need to not only coordinate our approach but also ensure that we are weighting our communication to the channels that each physician prefers.
Unlike non-personal tactics where measurement may be limited to open rates and website visits, the modern sales and marketing approach is built on the same sales metrics that the commercial organization uses with sales reps. The approach is closed loop, using sales data to both adjust the marketing investment as well as providing timely sales outcomes. By utilizing control group methodology, the approach is designed to withstand the scrutiny of data scientists inside the organization.
The fundamental difference between non-personal promotion and the modern sales and marketing approach is that the new approach crosses the chasm between the traditional roles of sales and marketing. Non-personal promotion is, and always will be, a marketing tactic. It comes out of a marketing budget, is often designed by a marketing agency, and is typically of only passing interest to the sales organization. The modern sales and marketing approach is designed to finally draw the world of sales and marketing together. It may be funded out of a marketing budget, but the success metrics are the ones that the sales organization cares about deeply: the maintenance and growth of prescription writing
Bridging the chasm between sales and marketing requires an organizational shift. Historically, much of the marketing-related effort of brand managers has revolved around developing the messaging, position, and tactical materials needed by the sales organization. It is no small job to do this; the point is that brand managers have always considered their role as marketing – not sales. By contrast, it has been the sole job of the sales organization to drive the sales number by working the call plan. Sales and marketing have always existed in two connected but separate silos. Reaching the increasingly large percentage of unreachable physicians will demand that the roles of sales and marketing be melded into a cohesive whole.
Ambitious goals made manageable
Telling a brand manager that what is needed is a coordinated, systematic approach to delivering communication through multiple channels, based on physician preference (all measured by a bulletproof methodology to measurement), seems far more ambitious than what a typical brand might be able to support. Won’t it require significant brand time and extensive legal, medical and regulatory review? Not necessarily. There are out-of-the-box approaches that can speed a brand to market, covering part or all of their most valuable writers who are lost to the rep.
This same approach can also be expanded to reach growing physicians who were never targeted by the sales call plan in the first place (but can be identified through growth-model targeting and have significant future potential to the brand.) The modern sales and marketing approach is investment based, not dissimilar to the way that the sales organization determines their call plan. But the model is more flexible, guided by an objective of meeting the needs of physicians who need practice resources and high-value education (instead of an objective of delivering a defined number of sales details or completing a series of high-priced sample drops.)
Modern Sales and marketing services can be delivered through specialized vendors or inside sales team carve-outs. No matter the approach, the resource must be a data integration partner, who can both execute and seamlessly pass customer data to the enterprise data warehouse. This not only allows reps in the field to access and utilize assets in their SFA systems but allows full and immediate data transparency across the organization.
There is no doubt that the number and percentage of unreachable physicians will continue to grow. As new healthcare professionals enter the profession, they are continually less likely to want to (or be allowed to) see a sales rep inside their facility. Yet with an agile approach to marketing, brands can continue to be relevant to support practitioners’ needs. There is no substitute for a highly trained rep who can speak to the clinical science and help healthcare professionals enhance their practice skills. However, deploying these resources with the inefficient approaches we have used in the past is no longer sustainable. Only a modern sales and marketing approach can cost-effectively reach the unreachables and ensure that brands are deemed a valued presence.