“Only a crisis, actual or perceived, produces real change.” More than a year after the onset of the pandemic, we are still in the situation Nobel Prize-winning economist Milton Friedman once described—one in which necessity and urgency make what was once unthinkable possible. Pharmaceutical companies know that to adapt to the trauma of the healthcare landscape, they have to change their commercial model. And as waves of disruption continue to elevate the need for local, flexible and nimble operations and technology, pharma companies are finally in a position to implement long-delayed reforms.
But how does pharma move forward during a time of increasing uncertainty? Over the last year, pharma organizations have continuously monitored the impact of the pandemic on local ecosystems and readjusted their deployment and planned activities in response. Field reps working from home have found new ways to connect with physicians or administrators, and they continue to adapt their messaging to better address key concerns and new problems. Organizations have often made the right calls on the fly, but now, more than ever, they need to set the course for substantial, strategic change in the face of disruption and uncertainty.
No one can predict how the crisis will evolve market-by-market or whether it will return in waves, but one thing is certain: Many of today's changes to the healthcare ecosystem—and, by extension, to the pharma model— are here to stay. To keep pace and successfully support the evolution of the commercial model, there are three core capabilities in which organizations should invest: moving from national cycles to localized planning; evolving the field organization’s value proposition and mix of roles to better respond to new or changing marketplace needs; and helping field representatives become more adaptive.
The trend toward localized planning is not new, but it picked up steam during the pandemic. For years, many commercial operations leaders have responded to the speed of payer and provider network consolidations and concluded that uniform national cycles no longer cut it. When local health markets emerged with unique power relations and dynamics, the industry had to work smarter. They began to consider deployment in a local mindset, and they structured localized teams to respond to individual market nuances. Today, as each state's healthcare system flexes with the impact of the pandemic, local markets are closing and re-opening at different paces.
Moving forward, organizations must become more precise and more nimble. Commercial operations teams need to build an infrastructure that can monitor ecosystem evolutions and enable local teams to respond rapidly. Field force leaders need to grasp the power structure and latest influences in their marketplace swiftly so they make the right adjustments—like calibrating the team size, changing the mix of roles and making critical refinements to achieve a coordinated deployment. But traditional sales performance management systems are not built to support localized planning. They are often organized by business unit models for products or therapeutic areas and hierarchies, making it difficult for field force leaders to enable local, coordinated changes. To remain agile and strategic in a dynamic healthcare ecosystem, pharma must demand more of its technology.
As the industry transitions from one-off planning practices to a more agile and always-on commercial workforce model, it requires technology that is integrated and insight-rich. Digital platforms that wield microservices and cloud-based, big-data ecosystems have the power to support the evolving needs of a more connected and data-driven business.
Another long-standing need that is growing increasingly urgent is for field organizations to provide a new value mix to the marketplace.
Traditionally, field forces have been structured to adapt a set of services to meet the needs of key healthcare stakeholders. This approach targets a few key players: traditional reps who share basic product information with physicians; reimbursement specialists who work with administrative personnel in provider offices to remove financial obstacles to therapy adoption; and account executives or key account managers (KAMs) who partner with providers to understand and help enable key strategic objectives. These role combinations provide value to the marketplace, but their needs are changing as they adjust to the pandemic and its aftermath. To address the shifting needs of these key players in the healthcare ecosystem, field organizations will need to evolve their value mix regularly.
As organizations respond to this trend, the first adjustment they are likely to see is an increase in patient-management needs. At the height of the crisis, remote care increased substantially—with approximately 60% of patient visits made remotely, compared with 4% throughout 2019. But that spike is likely to continue to subside even after re-entry, leading to unmet patient needs. Here, pharma has an opportunity to fill the gap by increasing the prevalence of patient support and management roles in field organizations.
Similarly, healthcare systems are seeking strategic partnerships with manufacturers, driving an increase in integrated delivery networks (IDN). Because individual practitioners find it increasingly difficult to practice without the resources and capabilities of larger organizations, the upward trend in IDNs is causing a corresponding shift in the power structure. In response, pharma organizations have to recalibrate their role structures—by de-emphasizing traditional roles focused on individual decision-makers and increasing the focus on healthcare systems. This puts a premium on protocols that offer the latest available information. During a roundtable discussion led by ZS principals Namita Powers and Mike Moorman, 17 industry leaders confirmed that pharma’s customers look to organizations for solutions that can help them through this period. As a result, key account management and partnership strategies are likely to take on more prominent roles in the future.
As the field’s value mix changes and structures evolve to accommodate the needs of a multi-role, shared-allocation nexus of patients, nurse specialists, KAMs, reimbursement specialists, and more, the healthcare ecosystem is growing increasingly complex. To keep pace, commercial operations will require more robust digital platforms and advanced analytics. With tools that can optimize network representation with concepts like graph analytics, influence networks and node-based optimization techniques, organizations will have the technology and the insights they need to meet today's challenges and evolve with the shifting needs of the market.
The third imperative for commercial operations is to empower field representatives to become more adaptive. When shutdowns restricted face-to-face visits during the pandemic, reps began to interact differently. They used targeted emails, scheduled calls or Zoom meetings and enabled remote sample management to connect. Representatives and managers on the front line have improvised to respond to new situations. Going forward, pharma organizations should equip their field reps with the tools and resources they need to react quickly and appropriately when needs change. The healthcare crisis has only elevated the need for field force representatives to adopt remote web technologies and go beyond personal channels. By embracing an omnichannel ecosystem that supports emails, social media, web conferences and more, pharma can humanize and personalize experiences—elements that merit wider adoption across the user community.
When becoming more adaptive, balance is key. Commercial operations must establish the right balance between reactivity to market events and consistency with the organization’s overall strategy. This, too, has technology implications. The new infrastructure will need to be integrated, intelligent and insight-driven—and capable of drawing contextual and actionable insights to help maximize rep impact. The platform of the future should support agile and integrated promotion planning, assess the responsiveness of available channels, and reflect individual channel preferences. This will allow operations to inform their field roles of the most likely path to success.
The more shock and disruption the healthcare ecosystem experiences, the greater its capacity for change. That's why pharma is likely to introduce more change to its commercial model in the next two to three years than it has over the last two decades. But organizations shouldn’t stop there. As pharma leaders adjust their sales models, it’s imperative that they also implement the necessary operational and technology changes to support the new model. Without a platform that can bring together codified domain knowledge and modern technology to create rapid business transformation and adoption, sustainable operational change is not possible.
Pharma operations leaders should not waste this opportunity to finally become more nimble, allow their sales organizations to better adapt to local situations and provide more dynamic guidance that reflects recent insights and events. As Alex Gorsky, CEO of Johnson & Johnson, famously put it, “Going forward, we won’t be classifying ourselves as just a healthcare or biopharmaceutical industry, but we’ll be a healthcare biopharmaceutical technology industry.” More than ever, pharma leaders are embracing technology as a vital ingredient for success in the digital world, particularly when harnessed to address changing industry needs.