The Long-Term Impact of Covid-19 on Commercial Engagement Models


ANDREW J. MOORE, M.D. Southeast Cancer Center
DAVIDEK HERRON Head of Digital Platforms & Operations Teva Pharmaceuticals
SVP, Sales and Commercial Operations Biohaven Pharmaceuticals
STACY SINGER STONE Director, Commercial Business Partner, Information Systems Astellas US LLC


DAN RIZZO VP, Global Business Consulting Veeva

In our ongoing attempt to assess the effect of the Covid era, we’re glad to present this panel on how the virus has affected commercial engagement. This was conducted at The Veeva Commercial & Medical Summit, the largest commercial and medical affairs event in the life sciences industry, connecting over 4,500 professionals. This year it was conducted virtually, and featured over 70 sessions, five specialized tracks, and 49 speakers from 34 companies. The event included this media roundtable on how commercial operations are changing, conducted by Dan Rizzo, Veeva’s VP of Global Business Consulting. We’re grateful to Veeva for the opportunity to feature highlights from the roundtable in this article.

Over the past decade, the industry has been making the shift towards digital. Covid hit and accelerated the shift to leverage digital technology and engage customers – what almost felt like overnight but really occurred over a few months. Companies are relying on their field force to run with digital as a way to manage positive relationships with customers. In terms of adoption, what have been some of the important tactics and strategies you’ve taken to ensure that reps are using new digital channels to engage customers?

Davidek Herron: Covid hit us all like a storm. At Teva, we already had a digital strategy in place. Covid just accelerated it. We built our strategy with our field teams, marketing teams, and customers. We had reps sitting at home globally not able to call customers. We had to figure out what technology they could leverage to get in front of customers. It starts with the people. We had to make sure we had the proper training and proper vision for our sales teams, as well as key account managers, medical teams – anyone that’s customer facing. We had to inspire and get them to believe, This is what we need to do to help physicians and pharmacists and get medicines on their shelves so they can support their patients. It’s really about the people and the strategy we had behind it, accelerated by Covid. The technology was the cherry on top.

Stacy Stone: I was going to echo similar thoughts. I’m on the technology/IT side and have a very strong partnership with our business colleagues globally. We have also used Veeva CRM Engage Meeting and Veeva CRM Approved Email, and content has been a topic of conversation for a long time. What Covid did is helped to accelerate a lot of digital efforts because there was no other choice. In addition to not being able to have remote engagements, for example, globally, we also, in some markets didn’t even have the ability to send an approved email from a rep. Which became really critical in the last couple of months. It was a team effort. If we didn’t have the business engagement, IT support globally, and compliance and legal colleagues willing to maybe push the envelope a little faster than what they were planning to do, we couldn’t have moved as fast as we did to digital engagement. That’s what it took to get this rolled out.

Chris, you’re leading a sales force of roughly 700 people and in the process of planning a new launch. How are you launching in the midst of Covid? Talk through some of the quick shifts your organization had to make to be really innovative and nimble just at the crux of the launch.

Chris Deluzio: For us, we had a little bit of a different story than what Stacy and Davidek referenced in terms of just expediting the capability. We were preparing for launch with no intent of doing virtual, remote rep engagement. We launched on March 9th and were locked down a week later. We quickly flexed to get our virtual capabilities up and running and have those live in about a week. The simplicity of just leveraging a Veeva CRM Engage Meeting for our calls is great right now. We’re continuing to evolve our offerings as it relates to Veeva CRM Approved Email, but overall it did really require us to flex very quickly.

I guess that’s the advantage of being in a smaller organization. We did not have to go through multiple layers of approval. We shared the vision. We implemented the training, got the systems up and running. Fortunately, the commercial operations team that is part of my group and everyone else was bought in. We implemented things very quickly and we’ve seen a pretty significant impact in terms of our launch uptake. All in all, it’s been a really good experience and it has helped to prepare us for the future.

Dr. Moore, you’ve been in practice, treating patients, and dealing with this disruption that’s occurred. You’ve been engaging with pharma through digital. What are some of the benefits you have experienced?

Andrew Moore: I will tell you first and foremost, I’m kind of a creature of habit. If the first rep that reached out to me hadn’t been someone that I had a relationship with professionally and leaned on for patient assistance for a while, I probably wouldn’t have agreed to a digital engagement. I was pretty shocked at the ease and how efficient that interaction was.

Right now, from a provider standpoint, I will tell you that the biggest impact that Covid has had on my clinic is efficiency. Our numbers really didn’t go down because we’re treating active cancers mainly, but just the whole process of screening people through the door increased time for communication to talk to family members because of traffic in our clinic. The use of telemedicine is great.

What I was impressed with most with digital engagement was a 10-minute short, sweet, nuts and bolts discussion – boom, I got what I needed. My staff was more appreciative. Our day was not nearly as interrupted. I was bought into digital engagement with pharma almost immediately after that.

I have been a rep in the field and I know how valuable time is with the customer. Time with the customer in the field, during most interactions, is handful of minutes at best. With digital communication, it’s roughly three, four times longer, sometimes five times longer than that. Dr. Moore, why is that? Why is the discussion lasting longer when it’s through a digital channel?

Andrew Moore: I think there’s more flexibility for me. I’m engaging when it’s a better time for me. A lot of times over a lunch meeting, the rep gets to the office at noon. If I have an overbook that I’ve got to see at lunch or if things are running behind, I could be 30, 45 minutes late. The first thing that’s going to get cut is that encounter with the rep. I think the flexibility of the time is probably the biggest thing. Then, honestly, there’s no small talk. If someone’s in your office, in your break room and physically there providing your staff lunch, you chitchat, and there’s all these people coming at you as well. Signing scripts or they’ve got questions about critical laboratory results. There was much more interruption. It wasn’t just a flow of direct one-to-one contact for four to five minutes. I think the burden is more on the healthcare providers’ time.

This channel is new to many users, and now reps are getting extended time with providers. It tends to facilitate a 20 to 30-minute meeting. It is very different than planning for a meeting that could last two, three minutes in an office center. Davidek, how has Teva gone through the exercise, really making sure that the field was ready for the extended time and the preparation that is required for that?

Davidek Herron: First and foremost, we had to make the technology available. We didn’t launch Veeva CRM Engage Meeting until January 2020. A pilot in Russia with 30 reps and then fast forward two months later, 93% of all our Veeva markets with thousands of reps now are on the program.

I think Dr. Moore hit the nail on the head — he will have that conversation if there is some type of value-add being provided. That’s something that we’re seeing globally now with our sales teams and marketing teams. If we don’t have something of value or service to provide to the Dr. Moore’s of the world, maybe we shouldn’t be engaging with them. I’ve seen this throughout the industry, where certain brands that are not able to get these 20-minute, 15-minute call times because they really don’t have the right content or value of service to provide to the customers. It’s actually a big awakening, I think for our industry. And I think once this dust settles, we really need to look closer at exactly what value are we adding outside of just delivering messages.

At Teva, we’re heavily on the generic side. We are having a lot of B2B conversations. But on the physician side, our marketing teams are working diligently at night, trying to find out really what is the value of service for our customers. How can we serve customers like Dr. Moore to really get them what they need at the time they need it?

Chris, to do that it requires some training of the field to ensure that not only are you ready from a technical perspective, but also that you have the soft skills, content, business acumen, and planning. How is Biohaven making sure that the field is fully equipped in that capability?

Chris Deluzio: We took the approach of applying as many of the basics as we could as just a piece of our broader commercial learning and development, as well as sales operations offerings and platforms. Our gap was always just the data that we were getting, not only from the markets and from our customers, but also from our team. As we continue to gather more data, we are finding some consistent themes. Those that we feel we can increase their skills, like Dr. Moore said, in terms of what that engagement looks like and how it feels. Which can be challenging, because this is not how these reps were brought up. This is not what they were hired to do. We’ve focused on that.

We’ve also focused on the business acumen associated with digital engagements to understand truly what a physician wants. Recognizing we have a product to sell and there are specific physicians we want to go to and focus on like neurologists, headache clinics, things like that. They may not be open to a live engagement right now. How do we better prepare the team to have an impact on them in that virtual environment? And then what’s the next best move as it relates to the business? We planned to have it in our general framework of what we’ve done from a training standpoint. We just really had to focus on some very specific things to accommodate the virtual impact.

Stacy, if you think about digital engagement, soft skills, business acumen, and balancing out your value proposition are important. But a key tool is the reps’ role in educating practitioners on the profile of the medication – the treatment option. Content helps to communicate that and is a key enabler. So what approach is your organization taking, ensuring that content which was previously primarily designed through a face-to-face engagement is right for this digital format?

Stacy Stone: I think it’s a journey. We’re all evolving. With content, you just don’t want to take a piece that was meant for a face-to-face engagement and make it digital. It doesn’t always work. I think we’re all on the same journey towards more personalized communication with doctors like Dr. Moore, to be able to communicate to them with a message that resonates based on all the data that Chris was talking about in the channel that they prefer. And to your point, Dr. Moore, at the time that’s most convenient for you. It seems to all fit that engagement.

We’re looking at content again. We’re really looking at what we currently have. Is it ready for digital? Is the content we currently have even in the right place? With modularized content, do we have the right pieces in place? And do we have the right process to get digital content out there in an agile way?

For us the process of reviewing content, which is so critical in our industry, wasn’t really ready for this sort of really huge push on digital. We were getting there. But this accelerated the look at what type of content we have, what format it’s in, and then how do we get it out to our customers as quickly as possible to answer questions, especially when we’re looking at our oncology space, for example. You can’t just stop communicating with your customers.

Alex Keown, Biospace: When things open back up into something of a new normal, what will that look like as a preference for you, Dr. Moore? Will you prefer to go back to more of the way things were or to stick to this more streamlined program?

Andrew Moore: I will tell you, I am hopeful that it will stay with this digital platform. It’s more on my terms as far as when it’s convenient for me. And, honestly, my office staff, they have commented to me that the couple of meetings or digital encounters that I’ve had where lunch gets sent to them and I have a nice 10-minute talk with the rep online is a lot better for them as well. Because the world in our clinic, and I think all healthcare clinics, is less efficient right now in the post-Covid world. Not having a rep face to face in the office, I think makes things much more efficient and honestly, a win-win on both sides from my standpoint.

Stacy Stone: I think it’s a great question. And I do think what we’re seeing is that it’s going to be this hybrid approach moving forward. I think it’s going to depend a lot on the therapeutic area. I think we’re well aware that oncologists seem to engage with digital a little bit more than others. I’ve even seen by country, nuances, preferences in digital versus non-digital. I think that’s where you get down to the individual sort of personalized touch that we’ve all been trying to attain. And there will be that because access will remain so limited. It’s going back in China, even as we speak, to some degree. It will vary based on region. But I agree, I think a lot of people are going to really appreciate this sort of digital connection, on my time and what works for me.

It will be this blend of a hybrid approach of face-to-face and digital, and based on Dr. Moore’s preference or Dr. Smith’s preference. You need to be measuring that and understanding how you meet them on their terms. What we’ve done as an industry is we have opened up the potential and the possibility to exponentially meet the customers on their terms. As face-to-face meetings slowly return, that’s going to present a whole bag of new challenges and balancing that out. What are some of the challenges you’re anticipating? And how are you planning in response to them?

Davidek Herron: We ran these exercises with pretty much all of our general managers throughout the world. To Stacy’s point, it depends on the market. It depends on the current model that we use. One thing we do see is the fact that the new reality is not going to be like it was before.

Digital is here to stay. I think it’s really going to come down to people and strategy. And the companies that have the best people and strategy to really drive this overall digitalization of our customer relationships will succeed. And you’ll see ones that won’t. At the end of day, I think we have to really focus on the fact that – and this is why I love working in life sciences – everything we do affects patients. We’re here to get medicines to the patients that need them. And I think the more we can focus on that outcome, everything else will just fall in line.

Chris Deluzio: For me, it changes a bit. The data will be better in that we’ll have an ongoing capture of what physicians like Dr. Moore are telling us and what they want. The hard part for us to determine is how long we will do this and how do we prepare for that? It will change the profile of the rep, in terms of you now have to find a rep who most likely would have to balance this hybrid approach. Are there some cost efficiencies, but still impact? If not the same impact, maybe greater impact for those reps that could potentially come in-house and take this virtual approach with customers. And our training and our profile is really going to change as well. That’s what we’re in the process of evaluating right now. And, regardless of whether Covid hit or not, it’s forced us to look at this and how it may be the best approach moving forward. •

Hiring Insights from The Pandemic

Hiring Insights from The Pandemic By Cari Kraft, Jacobs Management Group