Reimagining the Pharma Sales Rep Model

During the last decade, the pharmaceutical industry has continually experienced changes in the external environment that have forced the industry to shift from managing diseases to managing patients’ health, from payment for drugs to payment for outcomes, from one-drug-fits-all to personalized precision medicine. Every move has forced the sector to transform and evolve to a more patient-centric model. COVID-19 is yet another development that offers the potential for pharma companies to disrupt the current marketing and sales business model and aim at achieving functional excellence.

Specifically the pandemic has wreaked havoc across the healthcare industry, driving vast changes in what healthcare providers need and value from pharma companies. As a result, the industry is being forced to develop new ways to engage with physicians. As measures like lockdowns and social distancing continue to be enforced by governments amid the public health crisis, pharma needs to figure out what that means for their traditional rep-centric model. 

Healthcare providers' focus has been shifted, leaving them with less time and fewer resources to care for patients living with other chronic conditions. In many cases, new patients with noncritical needs have been turned away, and existing patients have delayed routine checkups or refuse care for other conditions to avoid potential exposure. All these factors, characterized as the “new normal,” affect how healthcare providers (HCPs) are interacting and will interact with other stakeholders in the healthcare ecosystem for the foreseeable future. Moreover, when it comes to the role of the pharma sales rep, there's certainly no real precedent to learn from on how to proceed during times like these, but it will be critical to carefully navigate their relationships with physicians and help them put patients first.

Until 2020, pharma had lagged other industries in its investment in digital marketing and sales. As a result of the pandemic, spending on digital projects in the industry accelerated and is starting to catch up with levels in other industries. Pharma companies were able to make a swift and effective transition to video calls and virtual detailing, which was accompanied by immediate education, training, and learning resources. Virtual engagement with HCPs and key stakeholders is here to stay, requiring sales teams and customer-facing roles to create new ways of making meaningful connections. 

Let’s look at the data. As per a ZS poll, by the beginning of 2021, 70 percent of reps were back working and their activity is about 50 percent of what it used to be in terms of the number of calls. Currently, two-thirds of sales rep activity are virtual calls and only one-third are being conducted face-to-face (F2F), down at least 90 percent.

According to Accenture and other market research firms, an estimated 83-87 percent of HCPs say they will want either all virtual or a mix of virtual and in-person meetings even after the pandemic ends as a result of what they have experienced in the last 12 months. If we look at Mexico specifically, Smart Scale’s research in December 2020 shows that 71.5 percent of physicians have adopted and embraced the digital/virtual approach and 52 percent of physicians anticipate a hybrid (F2F/virtual) pharma activity in their offices post-pandemic. 

If anyone had doubts about the power of virtual engagement, telemedicine, and digital health, COVID-19 has laid them to rest.

Reimagining a new model:

 There is now a unique opportunity to develop a new model — a more customer-centric, effective, and efficient model — that leverages multiple channels, better integrates medical, access and commercial functions to meet the diverse needs and expectations of HCPs, decision-makers and key stakeholders, while truly adding value to patients.

What I foresee is a shift from full F2F to a mix of F2F-virtual-digital and from quantity to quality; rather than having short interactions many times a month or many times a year with a physician, interactions will tend to be longer, but much less frequent. Reaching physicians in the future will not move to all virtual and digital; in-person contact will remain an important tool in the sales rep toolbox, particularly in relation to product information and drug samples. It will just not be used as often. However, sales reps may be hesitant to engage with physicians through virtual visits, or they may just prefer to do F2F, as that is the skill they know and master.

Reps will need to re-position themselves as a trusted partner and an adviser, rather than as a sales or commercial rep. This will require a significant effort and emphasis on training, upskilling and empowering sales teams to better deploy technologies and acquire new skills.

The best approach to address the current and future environment changes, would be striking the right mix of the three modes: in-person, virtual, and digital, i.e., emails and apps, tailored to the preferences of the physician and/or key stakeholder. Using advanced omnichannel technology to look at each physician holistically, understand each interaction with digital media, measure each impression, and assess each stimulus, is the way to develop strong engaging relationships. The greatest change will not be in which channels become more predominant, but rather how we use them, how we mine the data that comes from them, and what we expect our teams to accomplish.

During the transition, companies will need to ensure reps stay engaged with their customers, while truly adding value during these times of changing needs and constraints. Ramping up digital deliverables while upskilling the sales force could help significantly in this endeavor. Likewise, companies need to be careful not to add to the noise, so ensuring that online engagement helps rather than overburdens physicians will be critical. Overall, the customer experience should be a performance indicator that must not be overlooked.

Furthermore, other customer-facing roles like medical science liaisons (MSLs) and key account managers (KAMs) (both provider-centric and payer-centric) will be under pressure, too.  So, considering them as part of the new model and contemplating them for different technology training and upskilling initiatives will be a must, especially as they work more effectively under a team approach, addressing multi-stakeholder needs and concerns.  A multi-stakeholder call, for example, creates greater opportunities for engagement and follow-up, as it often becomes a string of interactions, which will entail virtual, in-person, email or app touchpoints and it sets up a dialogue over time with multiple people. Physicians can now have a team solving their questions or concerns as opposed to one person trying to do everything. This enhances the customer experience by creating value to the medical community and their patients.

Evolving Field Force:

As the industry faces challenges such as a decreased accessibility of HCPs while they increasingly obtain information online, coupled with a decreased willingness to receive in-person visits, the role of the field force needs to evolve to provide more than just information but create value and a memorable experience. Despite the challenges this new environment poses, I truly believe there has never been a better, or more appropriate, moment to reimagine and evolve their role within the pharma industry.

How can companies evolve to deal with these challenges and become future-fit for the “new post COVID-19 era?”

Companies will need to focus on differentiating while adding true value beyond the attributes of their brand or service while transitioning to a new sales model. They can start by ensuring they build on:

1)   Enhanced technology that really helps – Relying on smart devices that help and simplify staying in touch with the medical community stakeholders, covering and tracking a broader territory, breaking down communication barriers to office visits, enhancing professional consultations and supplementing product orders. The key is to remember that the technology needs to respond to human needs to make the interaction more enjoyable. Creating a total experience is vital.

2)    Upskilling and training – Upskilling the field force and customer-facing roles to operate in a hybrid in-person/virtual role will be paramount, as a return to a pre-pandemic full F2F model is unlikely. Virtual engagement will play a bigger role in a post-COVID world; hence, the rep’s purpose needs to evolve beyond an efficient way to achieve personal communications. Reps should become an orchestrator for the healthcare professional (HCP), leveraging available resources (including their team support roles) to help them navigate the difficult landscape. Bottom line, we should think of the rep as a service; and as such, offering the right tools and training becomes imperative.   

Focusing on upgrading virtual engagement capabilities, being prepared to change enablement models in response to variable needs, and developing the leadership, skills and behaviors required to thrive during change should become steppingstones in the new model. A key success factor will be to coordinate the touchpoints to ensure that the customer experience is continuous and engaging across multiple points of contact.

Companies will need to bring together human and technology skills to enhance the capabilities of both and guarantee a robust service design approach. In this new context, customer-facing roles will need to understand the science, genuinely be interested in patients, capable of having a meaningful discussion with the HCP on a patient case, and not try to push a marketing message; rather, uncover often hidden needs that the customer has. Counting on individuals who can create an effective team approach and interact to find the right treatment for the right patient and give advice on how to use the product properly will make a difference.

Bottom-line, there will need to be an evolution in the service provided, moving from delivering information to offering insights instead; and insight interpretation requires upskilling. Reps will need to have personalized information at the right time to satisfy changing HCP requirements. The pandemic has driven dramatic geographic and specialties variability and change. Most importantly, these qualitative differences could be significant enough to drive different customer engagement models and messaging. 

This is a good time for companies to upskill the field force to play a role in value-based communications, while meeting compliance and legal requirements. Delivering insights and recommendations based on a physician’s real-time and real-world patient data, such as adherence approaches or providing patient support activities in a compliant matter, will now become a competitive edge that will render differentiated value. . The first company to nail this – generating memorable and valuable experiences – will not have long to benefit exclusively before everyone else cottons on.

Just a word of caution regarding patient data as many questions remain unanswered around ownership and security; following compliance guidance is recommended.

3)    Effective virtual relationships – An engaging customer-facing force that effectively builds virtual relationships will be critical to succeed. Keep in mind that physicians are now in the driver’s seat. Sending reps to the physician’s office on a fixed reach and frequency goal, with a predefined number of visits a day and measuring their performance against this, will not be useful or meaningful any longer. Physicians still welcome the contact, but interactions will need to be at their pace.

Alternative channels, messaging, email, and other options will be required. Most of the communication today is being done via “push” methods. The need for “pull” options will increase, and this is where AI, machine learning, advanced analytics, and other technologies will be very helpful.

But most importantly, all customer-facing roles will have to focus their efforts on helping physicians get access to and provide value for the patient to build meaningful relationships with HCPs. Discussing the whole patient treatment journey rather than features of a brand or brand choice should be the new approach if you want to differentiate and truly engage.

4)    Tracking and Measuring what matters  – Simply replacing reps with a virtual version is fraught with issues. Being clear on what you are trying to achieve is critical to ensure you are tracking the right indicators. For example, over promising the power of technology or the efficacy of a product by showing they are better than the HCP’s knowledge or experience or current incumbents will not only cause conflict, but it will miss the point. It should be about demonstrating how combining your product or service with the HCP’s experience could improve patient outcomes. That is what finally should matter to all key stakeholders: the patient. Every customer-facing role needs to embrace this new approach and be very clear on what outcomes matter and what is being measured, to ensure they align their actions toward meeting them. Adjusting KPIs and aligning incentive plans to relevant indicators will be necessary.

Every customer-facing role needs to embrace this new approach and be very clear on what outcomes matter and what is being measured, to ensure they align their actions toward meeting them.

The changes COVID-19 has brought to the industry will be continuous, fast, and uncertain. These pandemic-induced patterns are likely to become permanent. The dramatic increase in digital adoption presents a pivotal opportunity for pharma companies to challenge and evolve their current sales model. The role of the sales force will have to change as lockdowns persist, information is easily available and willingness to see in-person reps decreases. The companies that succeed will deliberately develop their ability to thrive and adapt through this change.

In short, the shift to a hybrid virtual/F2F model can help sales organizations potentially lower their cost per visit, extend their reach, and significantly improve sales effectiveness, while meeting the needs of customers who are demanding these new ways of interacting and who are likely to work closely with firms that do it well. But while the opportunity is significant, so is the pressure to capitalize on it. Companies that commit to further upskilling their people in a cross-functional way, truly add value to the patient/HCP journey, and digitalizing their go-to-market models should derive a competitive advantage in the form of more – and more loyal – customers than their slower-moving peers.

According to The Economist, a wise incumbent tries lots of new, small ideas constantly to see what works, thus creating an iterative process where it can learn from . That is the goal, and this should be the beginning of the next evolutionary journey for the pharma industry.