The COVID-19 pandemic will bring unprecedented burden and disruption to the provision of healthcare. While public health officials (and the headlines) rightly will focus on fighting the virus itself, the pharmaceutical industry must look more broadly to continue realizing its purpose of discovering and delivering treatments to a world in need.

 

Pharma is investing heavily in developing COVID-19 treatments and, ultimately, a vaccine, but the industry must do much more beyond that. The needs are vast, and pharma is well-positioned to adapt its numerous resources and capabilities to meet many of those needs. Now is the time for pharma to proactively look for solutions to problems that lie outside its core business model. The companies that choose to take on this challenge will make a tremendous impact on the lives of patients.

 

Before we discuss potential solutions, we need to get a handle on the set of healthcare needs emerging from COVID-19. Broadly speaking, there are two types of patient situations: Patients who have contracted COVID-19, and those who haven’t but who are being treated for other health conditions. As the number of novel coronavirus cases increases, we’ll begin to see those patient populations merge. Patients who are undergoing treatment for other health conditions will become exposed to and, in some cases, contract the virus.

 

In studying the circumstances of both patients who are infected and those who are actively seeking care for other health conditions, we’ve identified three critical gaps in the care that they’re receiving: continuity of care, capacity and knowledge. What’s noteworthy is that these gaps of care impact the COVID-19 and non-COVID-19 patient populations differently. Let’s take a closer look:

  • Continuity of care gaps: Patients currently being treated for health conditions unrelated to COVID-19 face an array of disruptions to their care. Some patients are having difficulty gaining access to healthcare providers, pharmacies and infusion sites due to reduced availability, while others fear the risk of exposure by going to their appointments. Some patients may lose insurance coverage or have concerns about out-of-pocket affordability due to unemployment and under-employment. Finally, patients undergoing treatments that affect their immune systems likely are concerned about their elevated risk of more severe COVID-19 infections. The negative impact of care interruption will be harder for this large patient pool to bear when our acute care system is singularly focused on fighting COVID-19.
  • Capacity gaps: We know from the experiences in other countries that there will soon be substantial resource gaps for acute care, both for patients who suspect that they have COVID-19 or who have been diagnosed with it, and those treating them. Testing in the community needs to scale dramatically. And as testing ramps up, there will be a commensurate growth in the need to support contact tracing and isolation protocols. While these requirements will grow dramatically, local health officials tasked with conducting this work are already strapped, which only exacerbates the problems. As a result, our healthcare system will face tremendous capacity gaps in meeting those requirements.
  • Knowledge gaps: As the infection rate grows, we also will see a significant overlapping population of those who contract COVID-19 while undergoing treatment for an unrelated health condition. In addition to all of the issues stated above, these patients—and those who treat them—will need to make decisions about how COVID-19 affects preexisting treatment plans. In the absence of clear guidelines for patients being treated with ACE inhibitors, adjuvant chemotherapy or immunosuppressants, individual providers will have limited access to the medical information needed to make informed treatment decisions. In such a rapidly evolving landscape, this will present a significant knowledge gap at the point of treatment decision-making.

The pharmaceutical industry has the resources and know-how to address many of these critical gaps in care. From a commercial standpoint, pharma has a host of resources that aren’t being optimized during the pandemic. The trick is to figure out how to tap these resources and repurpose them to fill the gaps. Beyond the industry’s 65,000 field-based sales reps who are distributed throughout the country roughly in proportion with the U.S. population, companies have access to information-sharing platforms and data sets that reveal local treatment patterns and changing adherence rates by patient type. They also have distributed knowledge about local healthcare ecosystems, connections to local healthcare providers, and robust field management and operations capabilities—all of which can be useful as the novel coronavirus continues to take its toll on our healthcare system.

 

In normal times, a manufacturer’s commercial organization marshals these resources to increase sales of that company’s promoted therapies. There’s typically a heavy focus on driving market share and new patient demand. Now, the commercial organization must retool to meet a new mission. Instead of seeking the next new patient—a difficult ask when many physicians are not physically or emotionally open to promotion—pharma should adapt its commercial organizations either to address local gaps in continuity of care, capacity gaps for those with COVID-19, or both.

 

In addition to these commercial resources, pharma has robust medical organizations that include medical experts with deep disease area understanding and teams of field-based personnel (MSLs, nurse educators and others), many of whom can engage directly with patients and fill knowledge gaps for physicians. They also can leverage their connections to medical societies and leading experts in the academic and treatment communities.

 

These medical organizations can play a vital role in supporting healthcare practitioners who are seeking the best available information about how to treat high-risk patients in the COVID-19 era. This aligns well with the types of questions those treaters will have, too.

 

The pharmaceutical industry has the resources and know-how to address many of these critical gaps in care. From a commercial standpoint, pharma has a host of resources that aren’t being optimized during the pandemic. The trick is to figure out how to tap these resources and repurpose them to fill the gaps. Beyond the industry’s 65,000 field-based sales reps who are distributed throughout the country roughly in proportion with the U.S. population, companies have access to information-sharing platforms and data sets that reveal local treatment patterns and changing adherence rates by patient type. They also have distributed knowledge about local healthcare ecosystems, connections to local healthcare providers, and robust field management and operations capabilities—all of which can be useful as the novel coronavirus continues to take its toll on our healthcare system.

In normal times, a manufacturer’s commercial organization marshals these resources to increase sales of that company’s promoted therapies. There’s typically a heavy focus on driving market share and new patient demand. Now, the commercial organization must retool to meet a new mission. Instead of seeking the next new patient—a difficult ask when many physicians are not physically or emotionally open to promotion—pharma should adapt its commercial organizations either to address local gaps in continuity of care, capacity gaps for those with COVID-19, or both.

In addition to these commercial resources, pharma has robust medical organizations that include medical experts with deep disease area understanding and teams of field-based personnel (MSLs, nurse educators and others), many of whom can engage directly with patients and fill knowledge gaps for physicians. They also can leverage their connections to medical societies and leading experts in the academic and treatment communities.

These medical organizations can play a vital role in supporting healthcare practitioners who are seeking the best available information about how to treat high-risk patients in the COVID-19 era. This aligns well with the types of questions those treaters will have, too.

To succeed in addressing the current environment’s care gaps, pharma leaders will need to take charge of implementing changes to their respective companies’ “normal” operating models. It’s important that leaders set the right tone for their companies—and the industry as a whole—by laying out objectives tied to society’s needs, rather than to prior near-term revenue figures. It’s critical that pharma companies focus on all patients, not just “their” patients. And that means we’ll see pharmaceutical manufacturers temporarily become allies in the same cause, rather than competitors in the same therapeutic space. Payers and pharma can become true partners, together ensuring continuity of care for patients. Finally, leaders must empower their teams to quickly change day-to-day operations. As leaders consider the path forward and begin to make changes, we believe that the following approaches could be pivotal:

  1. Clearly define your company’s new purpose. Once pharma leaders have identified the needs that their organizations will address, the next step is to develop and send clear messages to their teams. Setting up the right communication cascade ensures that everyone in the organization is clear about their role during this temporary new reality. With this approach, all employees will be equipped to perform their new roles without interruption and understand how they’re contributing to the organization’s new, albeit short-term, focus.
  2. Embrace partnerships at the local and national level. Locally, commercial and medical field personnel can partner with health systems, payers and public health officials to help meet many of the community treatment needs; share data about gaps in continuity of care; and provide access to medical knowledge about treating high-risk patients. For example, payers have care management teams that focus on their high-risk populations. Pharma could help those teams by sharing insights that identify where care disruption is taking place and which patients within the plan may need additional support. Nationally, companies should seek alliances with fellow pharma companies around shared public health objectives; technology companies that are scaling solutions like telehealth and remote monitoring; and governments seeking to manage pandemic response.
  3. Get the easy things right. With so much economic disruption, pharma must continue to ensure access to care and address drug affordability issues. Eligibility criteria for free drug programs should be relaxed until the economy recovers. Pharma should use some of its already-purchased consumer advertising capacity to create campaigns that highlight those resources.
  4. Repurpose commercial operations to support new objectives. The core activities of the commercial operations function must adapt to support the new objectives. If field sales personnel will continue to have incentive plans, those should be tied to objectives like maintaining continuity of care in a disease area, rather than hitting previously specified product sales levels. Metrics and reports also should align to those new objectives. For example, instead of highlighting figures like market share trends, reports could identify the providers with the greatest market prescription volume drop-off as an indicator of greater disruption. Targeting also should evolve to prioritize those physicians who, according to claims data, have the most patients in need of support.
  5. Seek regulatory flexibility and communicate proper guardrails. Given the regulatory restrictions around how commercial personnel engage with providers and patients, pharma companies will naturally be skittish about materially changing the nature of these roles in the absence of regulatory confidence. There is, however, strong willingness to loosen restrictions at the federal and state levels for those with ideas for how to help. We are seeing this, for example, with the rapid expansion of telehealth benefits in Medicare or with 10 states re-opening ACA enrollment. Pharma leaders should work closely with compliance organizations and regulators to identify paths that meet the urgent needs of the day and ease the return to “business as usual” when the crisis has passed. Field management should be educated on any guardrails and empowered to work with their teams in the right spirit.
     

This global crisis could become the pharmaceutical industry’s finest hour. To make good on this promise, the industry will make contributions beyond developing treatments and vaccines that put this disease behind us. Pharma also will play an instrumental role in saving countless lives by addressing the disruption that the COVID-19 pandemic is bringing to healthcare. Pharma will embrace this challenge, and quickly. After all, with the disease growing exponentially, every minute counts.