Our panel of experts:
You could get whiplash from trying to follow and respond to the changes in the healthcare sales landscape these days. More expertise is required, from more sources, leading to more pressure on training, plus the focus on more platforms where communication is happening, and the tweaking of messaging across those platforms. How do long-term sales professionals adapt, and what are companies looking for in bringing on new hires for their sales forces? We called on people with experience in this end of the industry to share their insights. If you have additional wisdom to offer, we’re always eager to hear from our readers.
What are the major challenges to sales organizations in pharma, bio and device these days?
ERIC DALTON: The biggest challenge we’re seeing is access to HCP offices, but the most addressable challenge is what to do once a rep is inside of that office, other than fulfilling sample requests. The other major challenge is how to connect NPP marketing efforts with the sales force in order to achieve leveraged success from the combined effort.
CHRIS GISH: First, in today’s environment the pharma sales organization needs to make sense of a growing body of data that is being created as the companies interact with customers in more ways. With digital interactions, telehealth, customer service reps, MSLs, and traditional face-to-face encounters, everything is part of a mix of activity and preferences that are unique to each customer. The challenge to the sales organization is to merge all this valuable customer data into a single view or data base that can be used to make the conversation efficient and effective.
Second key challenge is operational efficiency. Younger employees have less patience for systems that don’t work, numbers that don’t make sense, and old school command and control.
Third is that the “customer” is changing. Physicians are still important but more and more there is a need for key account managers to coordinate a single large account or customer after a contract for access is signed.
SHALINI SHARAD: The changing healthcare needs to require companies to redirect their efforts, budgets and focus on disease management rather than their drugs/devices ONLY. The healthcare market is asking for a treatment package as a “pharma/device product” instead of the traditional product that has been selling over years. This is a result of the constant price pressures, bundle payment models, healthcare cost savings and the need of increased patient life-expectancy/quality of life. Additionally, this change has led to more professional procurement practices in the healthcare ecosystem. Sales organizations in pharma and device companies have to meet the needs of diverse purchasing groups like hospital, IDN, procurement department, HCP and indirectly the patient & payers.
JOE MANSFIELD: The biggest challenge for all organizations is to be relevant and provide value to all members of the respective treatment team. Healthcare professionals have incredible demands on their time and often sales professionals are seen as a distraction and not part of the solution that can bring value.
How are companies addressing these challenges?
JOE MANSFIELD: Top organizations provide their teams with the training and resources to be of value to HCP’s. The sales professionals need to have information that is crucial to treatment decisions and facilitate access to treatment, where the burden created by the insurers can be daunting.
ERIC DALTON: The companies that are tackling these challenges successfully are accessing truly unique data sets that are more behavioral and less Rx specific to help drive customization at the individual HCP level. It’s one thing to know that an HCP wrote a new script, but it’s a completely different challenge to know why. This is especially true with claims data that can take months to process. We’ve found success in going to the source (i.e. the HCP directly) to find out how each of them would prefer to interact with sales reps.
CHRIS GISH: Companies are making strides to integrate all of their customer data into a single place and draw insights from that. Some new approaches using machine learning systems can harvest amazing insights from the data once it is integrated. Artificial intelligence can uncover customers more likely to respond and act, as well as ones that are less likely. This can then be operationalized by the sales force.
To boost operational efficiency, companies in pharma are beginning to streamline activity data and focus only on very high value actions. Also, front line reps are being enabled to make more independent plans focused on results versus activity, and this makes efficiency easier to achieve. Companies are using less user-driven, customizable views for sales data and creating more efficient dashboards and views with the items people most view. This also creates efficiency.
Finally, companies are moving to more hybrid models for field deployment and moving beyond the traditional sales/managed markets/ field-based medical separate teams of the past. Key account managers are becoming more common and enabling better focus on customer need and value versus internal silos competing to talk to that customer.
SHALINI SHARAD: These companies are transforming sales into high quality interactions through digitally transformed channels and effective content based on “product package.” Companies are training sales organizations on solutions to complex reimbursement models along with the drug prescription. This is one significant problem to solve to boost sales. Sales organizations is also changing the sales model to a digital sales and marketing model. This kind of hybrid approach that encompasses both traditional face to face sales interactions and digital interactions is increasing the reach and face time with HCPs, who are themselves on digital/social media.
How has the demand for increased expertise changed the sales staff makeup?
CHRIS GISH: Companies have begun to adjust job descriptions and begin to require more experience in coordination, B2B selling, and negotiation. Local customer-facing members of the sales team and their leaders must be more flexible, able to act in ambiguity, and make rapid decisions. Some awareness of marketing science as well is more and more needed in order to integrate all promotional channels and give feedback to HQ.
ERIC DALTON: The current rep is much more experienced and specialized, with their knowledge of a specific drug class being closer to that of a Medical Science Liaison (MSL). Niche reps within a key area that focus on selling with clinical conviction have a better chance of changing an HCP’s habits than reps focused only on relationships. HCPs demand specific knowledge and expect new updates versus regurgitating the same information shared during previous meetings.
SHALINI SHARAD: Sales staff are becoming more clinical educators who can focus on specialties like Alzheimer’s or oncology reimbursement, treatment that includes biologics/biosimilar. There is a need to have in-depth knowledge of various disease types and treatments possible for financial access. Sales reps should be able to have high quality interactions with the right messages per stakeholder like procurement organizations, HCPs, purchasing organizations, mostly through multi-channels like social and digital media, video interactions etc. It is a package of strengths that include reimbursement understanding, account management, clinical education & treatment options in the market.
What resources are necessary to address the questions posed by a value analysis committee?
ERIC DALTON: Detailed data on cost versus benefit to patients. You have to address why the treatment is needed, the true costs, what the treatment replaces within the current regime, and how it will help the committee prove improved outcomes. Recent deals showcase that “risk shares” based on proving outcomes can lead to more effective deal structures for both sides.
CHRIS GISH: Companies will need to begin to design studies and collect data that reflects real-world use cases. Too often patients in trials are not “real” patients. A second area that requires attention is data collection. In many cases customers are unprepared to collect and report the data needed for value-based contracting. Companies will need to find a way to “meet customers where they are” technically, versus insisting on a complicated need for data. This is what will drive new thinking in the value-based contracting space.
What kinds of supports are helping reps conduct more effective conversations on disease states, practice problems and other issues that are not brand-related?
ERIC DALTON: From my experience, personal research outside of pharma helps sales reps the most with these conversations. Discussing the key therapeutic area and specific patient challenges with family/friends/colleagues/other physicians, along with independent research, is the most valuable, as it provides a similar context to that of an HCP versus what pharma might otherwise produce within training sessions.
CHRIS GISH: The best way to deliver information, whether that is product-related or disease state only, is with effective technology in the hands of the person with the customer. Of course, this means and iPad or tablet, but also means augmented video experiences via VR goggles and headsets. Content also has to be not just digitized but changed to make it more relevant for the technology. This can be done by including gamification and interactive touchpoint.
JOE MANSFIELD: I’m a huge proponent of training the sales professionals as if they are in an MSL role, with the added development of being experts in access. This way they can provide value from beginning to end. Not all sales professionals have these skills nor the aptitude to develop them.
How important is it that reps assist in the doctor/patient conversation, given the limited time HCPs have with patients? What tools are available to help with that?
SHALINI SHARAD: The doctorpatient conversation is the real place where a sale is made. This fact-based conversation between these stakeholders should be most effective in order for the patient to start and stay on the treatment. It needs to include issues like reimbursement, access, side effect management, expected complications, lifestyle etc. Hence, a sales rep should be enabled to offer the “treatment package” that a doctor can prescribe along with the core drug/device. This includes customized care plan for a patient using digital tools, counseling services, financial access & quick onboarding applications for the patient.
CHRIS GISH: Reps can make all the difference in some cases, and in others very little. This is driven by customer preference. Knowing which customer is which is key and enables efficiency. Tools such as ZS’s Access Monitor have become very good crowd source tools to make sure we send reps to doctors looking for F2F contact versus ones that see no reps. Likewise, we do the same for MSLs, etc.
The best tool for short situations is effective training. This has to start with educating on what is vital in the customer’s eyes, and what is interesting to the rep, which aren’t always the same things. Also, the pressure for quick details is also helped again by good technology platforms that engage and work smoothly.
JOE MANSFIELD: This is an everincreasing issue where you need to understand the HCPs dialogue with their patients on treatment options and access. Companies need to provide resources for the HCPs that they can provide to the patients for additional support. For ultra-rare diseases we have extensive patient service support allowing engagement with patients.
ERIC DALTON: It’s crucial in my opinion and is one of the key ways that reps can provide true value to the HCP and their office. An independent study from earlier this year showcased that the top two reasons HCPs meet with reps are for samples and new product information. However, the number one way in which HCPs believe that sales reps can improve is by providing more patient education and information. In the new age of specialized medicine, providing handouts, customized websites and follow-up services for patients are paramount for an improved doctor/ patient conversation, especially for more complex treatments.
How can reps best prepare prior to a call with respect to the patient makeup of a practice, the territory, or the competition?
JOE MANSFIELD: Successful sales professionals in today’s world need to be expert in all things related to the therapeutic area they work: treatment options, nuances of the practice/institution/department they engage with, payor position on their product and competitors, if one exists. The time an HCP spends with a sales professional needs to be of value and not a one-sided conversation focused on the benefits of their product.
ERIC DALTON: From our perspective, proprietary data sets that focus on insights into specific HCP behaviors and interests are key to having a better discussion with an HCP. The relationship has to get back to neutral where the rep provides a real value to the HCP versus simply promoting a message from pharma during that call. Simply asking “How can I help you and your patients today?” is a good start.
SHALINI SHARAD: It’s is critical to understand unmet patient needs and the diseases that they are suffering from. Factors like state laws, social determinants, county benefits, health plans and others impact a patient’s life and have a direct impact on their buying behavior. Sales reps should be enabled with behavior-science based personalized packages per patient segment that further help them in managing their diseases. HCPs want to prescribe these patient-centric packages that keep patients on treatment, help them with behavior-based services and ultimately reduce healthcare costs and improve outcomes.
CHRIS GISH: Veeva is the king of data presentation and the most effective at enabling views on actionable data. When combined with a search engine tool such as Aktana, they become even more effective. These types of tools scan the larger data base looking for activity and trends that have been pre-identified as requiring action or serving as potential change points for a customer. Things like writing a competitor or searching the company website for information.
Where do you see the sales strat-egy landscape headed in the next few years?
ERIC DALTON: I think sales will operate more like that of a white glove/exclusive/ concierge type service, where reps cater to as many needs as med/ legal will allow regarding a specific drug based on the unique insights that are becoming more readily available. I think sample fulfillment will become more automated, which will force sales to think about how to collaborate with an HCP based on different factors, including syncing up with NPP efforts for the brand.
JOE MANSFIELD: The demands on HCP’s will continue to grow, payors will increase their focus on cost containment thru restrictions on access, patients will have increasing levels of frustration accessing specific meds and expanded out of pocket costs. All of which will be the foundation to what core areas the sales professional’s prep needs to be focused.
CHRIS GISH: Sales strategy will be evolving from a traditional marketing/sales dynamic to one more aptly described as marketing & promotion. Promotion will encompass all the ways we can convey the sales message—integrated digital campaigns, telereps, customer service reps, and traditional detail teams. Sales leadership will need to become more fully expert in all ways a product can be promoted and how these levers are best used, as well as when you’re just throwing money away on expensive tactics. Tomorrow’s sales leader will develop key strategies in concert with marketing and then design a multi-channel campaign to promote that strategy.
SHALINI SHARAD: We are already witnessing commercial launch and clinical trial strategies changing in a patient-centric direction. The sales strategy landscape in the future would require a combination of digital medicine, digital health, digital marketing, behavioral science and real world data-based sales strategies. It can be a brilliant combination of market access, digital innovation, brand/ franchise units and marketing coming together. The access to markets and patients, patients’ health outcomes, and healthcare costs will be positively impacted by an organization that no more sells only a drug/device, but a service oriented product working towards improved quality of life.
MEET OUR PANEL OF EXPERTS
Executive Vice President MDcentRx
Erik has helped spearhead the evolution of the business for over 10 years, driving market growth and product innovation for the company.
MDCENTRX’s core expertise is maximizing NPP and sales rep marketing efforts by leveraging our expansive physician community along with proprietary data and analytics.
Former VP US Sales Sunovion
Chris has 27 years’ experience in the biopharmaceutical industry in sales and commercial leadership roles. At Sunovion, he grew their marquee asset, Latuda, into a blockbuster billion-dollar brand. Chris also worked at Pfizer for 21 years with roles in sales, marketing, and training, culminating in his role leading all promotion assets (digital and personal) for Established Products US Brands Group.
VP, US Sales and Market Development PTC Therapeutics
Joe has held leadership roles with several companies in a plethora of therapeutic areas. At PTC he leads the build-out of support functions and hires the U.S. sales team for the launch of novel treatments for Duchenne Muscular Dystrophy. Prior to PTC, Joe held key roles at AstraZeneca as a sales professional, eventually progressing to Regional Oncology Business Director. He subsequently moved to MedImmune as the Northeast Oncology Sales Director, served at UCB as the Eastern Director for Sales, and was National Director of Sales for NPS Pharmaceuticals.
PTC THERAPEUTICS is committed to finding treatment options for patients living with lifethreatening diseases. It has two commercially approved products for the treatment of Duchenne Muscular Dystrophy. Its mission is to build an integrated biopharmaceutical company based on expertise in RNA biology. Its lead product candidate is ataluren for the treatment of patients with genetic disorders due to a nonsense mutation.
Partner, Commercial Launch Excellence & Patient Centricity Wipro
Shalini is a thought leader, author & speaker on patient centricity. Changing healthcare has motivated her to focus on newer ways to engage patients and drive better outcomes. She holds IPs on patient engagement solutions to help in innovative commercialization of drugs from Phase II to launch excellence, enhancing patient adherence, driving better patient-doctor relationships, and improving health outcomes/QOL/QALY solution sets in valuebased care/FDA digital health regulations. She has worked with many pharmaceutical organizations across clinical and commercial programs: CVM, oncology, CNS, respiratory, and specialty/rare disease.
WIPRO LIMITED is a leading global information technology, consulting and business process services company that harnesses the power of cognitive computing, hyper-automation, robotics, cloud, analytics and emerging technologies to help clients adapt to the digital world. Wipro is recognized globally for its comprehensive portfolio of services and strong commitment to sustainability and good corporate citizenship. It has over 160,000 dedicated employees serving clients across six continents. It offers IT, platforms & consulting solutions to the healthcare and life sciences industries.