“Only a crisis, actual or perceived, produces real change.” We are now in the situation Nobel Prize-winning economist Milton Friedman once described, in which necessity and urgency can make the once unthinkable become possible. The urgency brought on by COVID-19 has also introduced an opportunity for the pharma commercial operations model: Pharmaceutical companies know it’s imperative to change their commercial model to adapt to the trauma of the healthcare landscape, but are also finally in position to implement long-delayed reforms to their operations and technology.


COVID-19 brought significant disruptions to the healthcare field that reinforce the long-felt need to make operations more local, flexible and nimble. In an uncertain and changing crisis environment, pharma organizations have had to continuously monitor local ecosystems affected differently by the virus and readjust their deployment and planned activities. Field reps, working from home, have had to find new ways to connect with physicians or administrators, and continuously 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, realize the importance of strategically preparing for success. 


No one can predict with certainty how the crisis will evolve market-by-market, or whether it will return in waves, but it’s likely many changes to the healthcare system, and by extension, to the pharma model, are here to stay. So how does pharma move forward during a time of uncertainty? There are three core capabilities in which organizations should invest to succeed in supporting these evolutions in the commercial model: move from national cycles to localized planning; evolve the field organization’s value proposition and mix of roles to better respond to new or changing marketplace needs; and help field representatives become more adaptive. 

Even before the pandemic, many commercial operations leaders, responding to the speed of payer and provider network consolidations, concluded that uniform national cycles no longer cut it. The emergence of local health markets with unique power relations and dynamics made it necessary to work smarter—to consider deployment in a local mindset, structuring local teams to best respond to individual market nuances. The pandemic has only accelerated this trend, with states’ healthcare systems impacted differently, and therefore closing and re-opening at different paces.


Moving forward, it’s critical for organizations to be more precise and nimble. Commercial operations teams need to build an infrastructure that can monitor ecosystem evolutions and enable local teams to respond rapidly. Field leaders should be able to rapidly grasp the power structure and latest influences in their marketplace, adjust the team size, change the mix of roles and make the refinements needed for a coordinated deployment. But traditional sales performance management systems are organized by business unit models for products or therapeutic areas and hierarchies, making it difficult to enable such local, coordinated changes. To accomplish the ideal, pharma must demand more of its technology.


As the industry transitions from one-off planning to a more agile and always-on commercial workforce, it requires the power of microservices and cloud-based, big-data ecosystems to support the needs of a more connected and data-driven business. 

A second key change, long needed but recently made more pressing, is for field organizations to provide a new value mix to the marketplace.


Field forces have been traditionally structured to provide a set of services adapted to the needs of key healthcare stakeholders: traditional reps provide basic information-sharing on products to physicians; reimbursement specialists work with administrative personnel in provider offices to remove financial obstacles to therapy adoption; and account executives or key account managers (KAMs) partner with providers to understand and help enable key strategic objectives. Since these role combinations provide value to the marketplace, they must also adjust to the changing needs brought on by the pandemic—requiring field organizations to regularly evolve their value mix.


The first adjustment that organizations are likely to see is the increase in patient-management needs. The increase in remote care—at the height of the crisis, approximately 60% of patient visits were remote, compared with 4% throughout 2019—is likely to subside even after re-entry, and will lead to unmet patient needs. Pharma has an opportunity to fill this gap by increasing the prevalence of patient support and management roles in field organizations.


Similarly, healthcare systems are seeking strategic partnerships with manufacturers and the industry has seen an increase in integrated delivery networks (IDN), as individual practitioners find it increasingly difficult to practice without the resources and capabilities of larger organizations. The corresponding shift in the power structure makes it necessary for pharma to de-emphasize traditional roles focused on individual decision-makers and increase the focus on healthcare systems. This puts a premium on protocols that offer the latest available information. A recent roundtable discussion led by ZS principals Namita Powers and Mike Moorman with 17 industry leaders confirmed that pharma’s customers look to organizations to provide solutions that help them through this period. As a result, key account management and partnership strategies will take on more prominent roles in the future.


As the field’s value mix needs evolve to a multi-role, shared-allocation ecosystem of patients, nurse specialists, KAMs, reimbursement specialists, and more, the complexity of the network increases manifold. To keep pace with these evolving market needs, commercial operations require more robust platforms—that use concepts like graph analytics, influence networks and node-based optimization techniques to optimize network representation—to meet these new challenges. 

The third imperative for commercial operations is to enable field representatives to be more adaptive. The pandemic shutdown restricted face-to-face visits and required reps to interact differently: with targeted emails, scheduled calls or Zoom meetings and remote sample management. Representatives and managers on the front line have improvised to respond to new situations. Going forward, pharma organizations need to equip their field reps with tools and resources to react quickly to these changing needs with appropriate actions. The healthcare crisis has highlighted the pre-existing need to adopt remote web technologies, and to go beyond the personal channels into a more omnichannel ecosystem that supports emails, social media, web conferences and more. Humanizing and personalizing these experiences are important considerations for wider adoption across the user community.


The key is to establish the right balance between reactivity to market events and consistency with the organization’s overall strategy. This, too, has tech implications, as the new infrastructure needs to be integrated, intelligent and insight-driven. The platform of the future should be capable of drawing contextual and actionable insights to help maximize rep impact. Agile, integrated, promotion planning; assessing the responsiveness of available channels; and reflecting individual channel preferences will allow operations to inform their field roles of the most likely path to success. 


Given the magnitude of shock to the healthcare landscape, pharma can introduce greater change to its commercial model in the next two to three years than it has seen in the past two decades. But organizations shouldn’t stop there. Alongside changes to the sales model, it’s imperative to implement the needed operational and technology changes in support of this new model. As Alex Gorsky, CEO of Johnson & Johnson, famously said; “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, technology is a vital ingredient for success in the digital world, particularly when harnessed to address changing industry needs. The need of the hour is to choose a platform that can bring together the ideal blend of codified domain knowledge and modern technology to create rapid business transformation and adoption. 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, reflective of recent insights and events.