How key account managers can untangle healthcare’s web of missed opportunities

By Sean McCarthy, Director of Commercial Strategy, Veeva Systems

Picture a door. Open it, and five more appear—some are locked, and some are revolving. No, it’s not a carnival fun house, but instead depicts the frustrating process that most key account managers (KAMs) experience in today’s confusing managed care world.

Every day, KAMs are trying to open the right doors amidst rapidly changing healthcare organization structures and ownership, fluctuating physician access guidelines, and dynamically shifting formularies—not to mention the implementation of new corporate policies such as performance or generic use guidelines. This is the tricky healthcare landscape—with all of its twists and locked doors—that KAMs must try to navigate. And, it’s not even close to fun.

Healthcare systems are evolving, too, as they acquire more and more individual and group physician practices resulting in a relatively small but powerful group of health care systems and integrated delivery networks (IDNs). Complicating things further, a more diverse staff has more responsibilities such that they can ultimately influence treatment decisions. Non-script-writers, like physician assistants and nurse practitioners who may have only had a minor impact on decisions in the past, now have much greater influence.

In fact, IDNs have become the predominant form of healthcare delivery in the U.S., and currently own more than 60% of all physician group practices. Practically speaking, this means that a physician whom a life sciences sales rep has been calling on for several years may suddenly be part of an IDN and splits his or her decision-making authority with various other stakeholders like healthcare business professionals associated with the system. As an example, there may be pharmacy buyers who purchase for the whole campus. There may be payers and administrators influencing the treatment decision making. And, of course, there are still primary care physicians. (See figure 1)Pc0590100

FIGURE 1: Early Stages of KAM at Pharma Companies Compared to B2B Companies in General Chart courtesy of ZS, a global sales and marketing firm.

For a limited team of KAMs, it can be extremely time consuming to determine exactly who is in charge and to what degree, yet they are tasked with figuring their way through this managed care maze. Field reps must somehow determine the right healthcare organizations (HCOs) to approach as well as the hierarchy of treatment influencers within so they knock on the right doors and connect with all of the right people. Even once a rep identifies the right HCO to approach, he or she may still struggle to decipher which of the dozens of stakeholders to target inside.

“Account management, with all of the consolidation occurring in the industry, has become a real opportunity for growth but requires new, innovative thinking,” said Christine Marsh, Boehringer Ingelheim’s Vice President, Managed Markets Sales. “There are a large number of influencers to engage and the key is figuring out how to do so in the most efficient and effective manner. At BI, we have evolved our account management team to focus on key influencers and have streamlined collaboration to ensure a coordinated account engagement strategy.” Boehringer Ingelheim, one of the largest biopharmaceutical companies in the world, was named one of the 100 most innovative companies for 2015 in the Thomson Reuters Top Global Innovators Report, showing that even giant enterprises can generate fresh thinking. (See figure 2)Pc0600100

FIGURE 2: Consolidation of small practices makes it an enormous challenge to know how individual stakeholders roll up under a healthcare organization

There’s no doubt that this is a pervasive challenge…without many effective solutions. Most sales reps and account managers have but one support tool—wholesale database lists of hospitals. From these lists, reps must try to untangle which people influence managed care, which contracting department is key, which practitioners are candidates for a given product, which business professionals are most critical, and on and on it goes. Even worse, the lists are often out-of-date very shortly after purchased—forcing reps to spend an exorbitant amount of time and effort on manual research and significantly slowing progress. It’s like opening door after door just to see who is inside and then having to conduct additional research to map each individual stakeholder’s influence.

As an industry, we certainly can’t snap our fingers and expect a sales rep who has been calling upon customers using a reach-and-frequency model for decades to suddenly make a successful shift to managing account relationships. There are many more influencers throughout the chain of care that not only influence the script, but also formulary decisions—especially critical considering the expensive drugs available today. Individual sales reps can’t engage all of these key stakeholders by themselves anymore. Instead, life sciences companies need to consider a strategic move away from the traditional one-on-one sales approach to multidimensional, account-focused selling teams that reflect the way today’s customers are organized. Further, managed markets account teams need to be trained differently and backed by technology solutions that, likewise, mirror the new paradigm.

Sophisticated cloud computing and real-time, accurate data feeds combine to deliver data-driven, business-relevant commercial solutions that enable efficient coordination of account-selling teams across the organization. For example, solutions which capture rich data about all key stakeholders at a given HCO (including their affiliations, communications preferences, and relationship networks) can be integrated with sales systems more easily in the cloud. In addition, the confluence of hierarchy information with activity data in a commercial cloud environment enables advanced influence maps which are critical to navigating the complex healthcare ecosystem. It’s a game changer. By being able to identify how all key stakeholders connect, account managers can then expertly target and coordinate their outreach. And, thanks to the cloud, the data stays up to date with continuous field feedback loops that are checked and verified.

Despite the added complexity today, there is good news. It seems that physicians may finally be opening their doors wider and more often to commercial teams—according to new research from CMS/Compas, 39% of physicians are willing to see life sciences reps without restrictions, up from 36% last year and in striking contrast to the trend towards restricting reps from physicians’ offices. The reversal reflects a growing interest in new types of complex products that have the potential to change patient care, according to the research firm.

Personalized medicines, for example, are on the rise but require a great deal of collaboration and knowledge. Personalized medicines represent nearly half (42%) of drugs in the pipeline today, according to a survey by the Tufts Center for the Study for Drug Development, making well-prepared key account managers, specialty sales reps, and medical teams an even more vital part of therapy decision making. For this reason, only 13% of physicians plan to decrease their interactions with the industry compared with 27% in 2014 and 24% of oncologists report plans to increase their interactions with industry, up from 11% last year.

Combined, certainly these indicators paint a brighter picture ahead for key account managers—but only if they are armed with proper training and the right technologies that will allow them to take full advantage of the abundance of data available today. Many existing data models remain flawed—powered by vast swaths of data but without the analytic capabilities to accurately characterize each stakeholder based on their hierarchy in the overall healthcare organization and in relationship to other influencers. These data products, too, are still modeled as a “service,” which means that data is sent to life sciences companies by the batch twice a year, or at best monthly, despite the fact that the market is changing constantly.

To fully leverage the tremendous treasure-trove of data, the life sciences industry needs a new model where data across all key stakeholders is consolidated into one system and updated in real time. The next step is placing data-driven insights about customers—whether defined as an individual physician, healthcare system, payer, or any other influencer—directly into the hands of those who use it most.

Sean McCarthy Director of Commercial Strategy Veeva Systems Sean brings more than 20 years of business process and IT product development experience to Veeva customers. Sean began his career in product engineering and consulting before landing at Boehringer-Ingelheim as a sales operations manager in 2004. During his tenure at BI, McCarthy rose through the ranks in various roles including commercial operations, business analytics, and enterprise IT strategy. Today, he is leading Veeva’s commercial strategy team to help life sciences customers establish new, modern account management strategies and cloud-based solutions into their global commercial operations.  


Veeva Systems Inc. is a leader in cloud-based software for the global life sciences industry. Committed to innovation, product excellence, and customer success, Veeva has more than 375 customers, ranging from the world’s largest pharmaceutical companies to emerging biotechs. Veeva is headquartered in the San Francisco Bay Area, with offices in Europe, Asia, and Latin America. For more information, visit


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