AvantSpeakPharma Innovation

Tip of the Iceberg

The stakes of launch are high—studies show that how successful a brand is at launch almost always determines how it performs over its life cycle. In preparing for launch, most pharma brands spend years developing a go-to-market strategy that includes detailed segmentation and targeting analysis supported by robust data and market research, investment in HCP engagement and education across channels, and cultivating critical relationships with KOLs. They also invest heavily in developing a sales strategy and training plan to ensure sales reps have the information and resources to support their HCP customers, and in turn, patients.

However, while most teams successfully develop a strategy for these critical components, many times brands fail to integrate the strategy and execution between medical education and the sales force. As medical educators and marketers, I feel we should ask: If we see the value in spending the time, effort, and money to understand our customers on a deeper level and develop clinically relevant education content, why wouldn’t we ensure the sales force delivers the most effective educational experience at the right time to the right customer? How can we value them as a true strategic partner and give them more than just a brief 20-minute presentation at a national sales meeting on a valuable tool like segmentation and how it applies to educational engagement? I believe collaborating a little closer with sales reps in pulling through medical education strategy is one way to ensure success at launch. But first, a little history.

Beginning in the mid-90s and peaking in the early-2000s, pharma sales reps were among the most highly regarded professionals in the healthcare industry—and there were lots of them: over 100,000. This was also high time for drugs treating lifestyle diseases like high cholesterol and heart disease. The cardiovascular drugs, or statins, were targeted at tens of millions of patients and although education on the drugs was relatively straightforward, a massive sales force was needed to promote them. After all, the Internet wasn’t nearly as sophisticated in its healthcare content as it is now and smartphones were still years away.

Fast forward nearly two decades and the picture is much different. As the patents on primary care drugs began to expire, pharma needed to find a new business model and they found it in specialty care drugs. Cancer was no longer a single disease with a gigantic patient population, but thousands of diseases under “oncology.” Then came gastrointestinal disorders, atopic dermatitis, psoriasis, rheumatoid arthritis, hemophilia, hepatitis, migraine, IBD, etc. In these niche markets, the sales rep’s role changed from merely serving as a brand ambassador—to convince HCPs to choose one brand over another—to an account manager serving as a liaison between HCPs and critical information provided by the brand and medical teams. They now have an array of responsibilities including demonstrating new modes of administration, explaining reimbursement, and identifying patients who need screened for a rare disease and/or might be eligible for a certain drug.

Additionally, it’s become much harder for sales reps (of which there are now only about 70,000) to access HCPs. According to a recent report by ZS Associates, only around 46% of physicians are rep-accessible, meaning they met with more than 70% of the reps who called on them. This is a significant plunge from 2008, when around 80% of physicians were rep-accessible. Government regulations and efforts by hospitals and physician networks to curb sales rep’s influence over HCPs’ prescribing habits have delivered a hit.

Nevertheless, sales reps are still crucial to launch success. For starters, they’re typically the first to inform HCPs of the brand narrative and educate on new indications beyond what is achieved in non-personal launch communications (emails, banners, etc). As the boots on the ground, sales reps give feedback on how a product is doing with HCPs long before the initial market research comes back—in theory, nobody in the company knows the customer better than the sales rep. They’re also the front line when it comes to patient support programs and advocacy and taking the burden off physician offices to get critical answers to product questions.

Given the increasing challenges, how do brand teams prepare sales reps to provide the right message/education to the right customer at the right time, thus driving understanding of the appropriate patient, clinical efficacy and safety profile, and confidence in the patient trial? They can do this with a three-fold approach:

  1. Plan ahead and brainstorm on aligning customer resource management capabilities to marry segmentation analysis with final customer targeting and tiering data
  2. Prioritize medical education strategy rollout in the launch sales training efforts well in advance—this starts with a strong partnership and alignment with sales leadership on how strategically implementing launch medical education initiatives can help their team meet customer needs and engagement goals
  3. Generate boots-on-the-ground advocacy by creating online and offline forums to gain input and perspective from sales reps on their anticipated customer needs, constraints, and preferences—this can take the form of a sales advisory team

While the number of sales reps and physicians who will see them has dwindled, market realities have made them more important than ever. More than just brand advocates, sales reps are the tip of the medical education iceberg—they’re the first to provide HCPs information on patient screening and new indications, help explain reimbursement, and demonstrate new modes of administration, just to name a few—and they help gauge how a product launch is going long before market research is completed. Given these realities, I believe it’s crucial for brands to collaborate more closely with their sales reps as they launch with medical education.

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