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It wasn’t long before sales reps realized they needed a new strategy to keep prospect pools flowing—18 months later, a mix of in-person and virtual meetings with healthcare professionals is emerging as the preferred approach moving forward.
In March 2020, the onset of the COVID lockdown (initially known as “two weeks to flatten the curve”) took on a molasses-like character. Life felt like it was happening very slowly. Perhaps it was because of the two-week expectation that was set, but it was almost as if we were collectively counting down the days to a new magical holiday that would restore our freedom, way of life, and how we do business.
Nevertheless, it quickly became apparent that something to the contrary was in store for us—we weren’t going to have normal workdays or interactions for a long time, and we were going to have to pivot immediately. For pharma companies and their sales reps, that meant their lifeblood, in-person visits to healthcare professionals (HCPs), would no longer be available. Events, conferences, dinners, and all forms of in-person engagement were going to morph into phone calls, emails, Zoom and Teams calls, webinars, and online events and experiences. It simply had to. Real life became digitized, and everything that had an inherent capability to turn to virtual and digital, did so. The big questions asked at the time, and those that have remained on pharma’s mind for the past 19 months are: Will in-person meetings disappear forever? If they do, how will this affect the way sales reps interact with HCPs, and what exactly are we going to do about it?
When the dust had settled a bit in the summer of 2020, Accenture released an August survey that stated: “87% of HCPs want either all virtual or a mix of virtual and in-person meetings even after the pandemic ends.”1 This statistic, while seemingly indicating a heavy preference toward virtual, also made it clear there would be a mix or hybrid, leaving the rest open to interpretation and explanation.
Fast forward to October 2021. Pharm Exec reached out to Pratap Khedkar, CEO of ZS Associates, a global professional services firm that leverages healthcare expertise, analytics, technology, and strategy, to talk about the firm’s findings over the past 18 months. During the course of the pandemic, ZS polled HCPs every two months, asking how they would like to interact with pharma reps in the future. Most recently, doctors’ responses indicated 50% scheduled in-person visits and 41% scheduled virtual visits.
“What doctors say, and what they do are different matters,” said Khedkar. “Face-to-face in-person meetings are definitely coming back—reps are being pushed to have these high-quality interactions. Compared to a pre-pandemic base of 100%, we’re now seeing about 65% of that number, supplemented by about 10% to 15% remote meetings.”
According to ZS’s findings, it’s apparent that reach—being able to contact the right person at least once—is slowly making its way back to pre-pandemic levels. However, when you consider frequency, or the amount of times you can have a quality interaction with an HCP, reps are not faring well.
“Frequency is dropping off a cliff once you get past the first couple of calls—even when you look at the data over several months,” said Khedkar. “It appears that sales reps aren’t going to get anywhere near the levels of interaction they had pre-pandemic. Sure, 93% of the time you can reach a physician once within a year. Twice, and that percentage drops down to around 50%, four times is 25%.”
Once meetings turned virtual, the quality of the interactions dropped, as did the effectiveness normally achieved with in-person meetings. And some systems used administrative assistants to schedule calls, inhibiting the quantity of meetings and potential touchpoints.
There are benefits and drawbacks to both, of course. InCrowd, a firm providing real-time pharma intelligence, micro-surveyed their audience of HCPs and found similar results regarding preference, with hybrid taking the majority vote of 51%. It found that 43% of HCPs felt that in-person meetings helped build trust, connection, a point-of-contact relationship, and communication that was more personalized and engaging. In addition, they could get samples and have better access to supporting material. On the contrary, 40% of HCPs didn’t like the longer time commitment, physical risk, and inflexible nature.
When it came to virtual, those polled lauded flexibility, safety, and efficiency. Drawbacks were headlined by the difficulty that comes with building a relationship virtually, followed by less effective communication and flow, generic pitches, and the fact that no samples are provided.
What’s apparent is the approach and characteristics of pharma reps have to change in order for them to be successful. “We’re going to need reps that do everything well: physical, virtual, and digital. We’re calling it phygital,” said Khedkar.
Phygital is a term coined and initially copyrighted by the Australian experiential agency Momentum a few years back, which has found new life communicating the workplace realities of the pandemic. A phygital rep calls for a more creative and adaptable person and can focus on all three inroads to HCPs, whether it’s the persuasive extroversion associated with an in-person visit, a well-presented virtual call, or an effectively communicated, audience-appropriate email.
Pharma reps used to be product specialists focused on a set call plan that they followed religiously. Now they have to be customer specialists, as well as adapters, networkers, and be able to perform very well across all three phygital channels. When ZS profiled a group of sales reps to determine potential areas of improvement, it found that there was an apparent skill gap among 60% of reps. There is a need for improvement on many of the individual dimensions that today’s new rep will require.
Pharma leadership plays the starring role in determining how to restructure and add capabilities to encourage the sales rep/HCP relationship to thrive, and that will require a significant metamorphosis. It might seem easy in theory, but change is hard, especially when a mega-industry’s entire tradition of selling is based on reaching its audience in person. Taking the leap is only the first step, and it is encountering significant resistance.
According to Khedkar, “The main story is the skill shift—many reps won’t be able to make the transition. And the industry’s response isn’t as robust as you might predict. Only 50% of pharma companies are investing in retraining the reps. Letting go and undoing the legacy is the hardest part.”
The industry will have to respond to HCPs’ preferences and actions, which clearly indicate a hybrid approach. Time is of the essence. Either the sales force is retrained and taught a new skillset, or a new adaptable force will have to be hired. It seems like many companies are mired in the strategy stage, or betting heavily on pre-pandemic scale return to in-person.
In addition to the 50% of companies focusing on retraining their sales force, the vanguard of the industry, about 15%, is spotlighting content personalization. With frequency dying, pharma must catch up with other industries by providing timely, unique, and relevant information that is customized for each of its targets. The days of sending a one-size-fits-all email are long gone. This was evident even pre-pandemic. Accenture’s Pulse Check survey from 2018 reported, “Despite expectations outpacing efforts to create personal experiences, nearly all consumers (91%) are still more likely to shop with brands who recognize, remember, and provide them with relevant offers and recommendations.”
This goes for physicians, too; they’re a part of the “nearly all.” Nearly all people are consummate professionals when it comes to determining whether content pertains to them or is useless noise. Emails should be tailored based on data about an HCP’s behavior, e.g., does this doctor like the latest articles on efficacy? Or are they more focused on managed care and affordability? Which subject lines are most effective? Companies must collect insights for reps and auto-generate personalized emails that can be sent in the most effective manner, at the most effective time.
Time is extremely important—how can pharma companies best maximize an HCP’s time? Some creative solutions that are being implemented are physician self-portals and 24/7 customer service lines. If a physician only has a few minutes at 1:30 a.m. to dive deep on a topic, they should be able to do so. And doing so can provide invaluable data to sales reps, so they can provide even more personalization. Virtual events organized by customer-centric sales reps not only save the time and energy of traveling, but flexibility also allows HCPs to attend the events that directly pertain to their specialties. And, because they’re virtual, KOLs and experts from all over the world can be recruited to join from their homes to provide invaluable information.
There is much to be done, but it’s all about the audience. It’s clear that the audience, the HCPs, will benefit from a hybrid approach that optimizes every touchpoint through personalization. Frequency has fallen precipitously, so every phygital interaction matters. To be successful, the sales rep of tomorrow (and today) will have to wear many hats. And wear them well.
Fran Pollaro is a Senior Editor for Pharm Exec. He can be reached at