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Novo Nordisk, EMD Serono, Akebia Execs on Digital engagement vs. face-to-face: helping your field force adapt

INSIGHTS FROM NOVO NORDISK, EMD SERONO AND AKEBIA EXECS

Over the last several years, sales forces have learned to use their digital tools more and more to ramp up efficiency, access information, and otherwise improve their communication with customers. Now that the pandemic has severely reduced face-to-face contact, those digital tools are even more important. Reuters Events looked into the implications of this recently as part of their virtual Pharma Marketing USA conference. The panel was called Position Your Field Force for the Future. Here are some highlights and a video of the full discussion.

Moderator

Matt Atkinson

Global Projects Director, Reuters Events Pharma

Panelists

Chetak Buaria

Global Head of Commercial Excellence, Merck Healthcare KGaA, Darmstadt, Germany (EMD Serono in USA)

Frank Armenante

Director, Commercial Execution South Area, Novo Nordisk

Candy Liang

Senior Director, Field Strategy and Commercial Operations, Akebia Therapeutics

ATKINSON: The pharma-HCP relationship has changed for good. How can we maintain positive momentum within our communities by preserving the current valued culture? How do we continue getting the most from our salesforces by upskilling and building a mindset that helps to find new ways to connect with customers?

LIANG: Prior to the Covid pandemic, virtual was a very, very small percentage of what we do. We had limited tools. So we have a CRM that’s Veeva and that’s essentially a support for them to lock their information and support their planning, but certainly not in a way to support their calls. So the field interaction is primarily in person, and our market is very special in the way that the care team, some multiple people within the dialysis clinic, play a key role, not only the doctor as well as the renal dietician, the anemia manager. Post-Covid we decided to call back our field and because that was the safest that we could do. Everyone was mandated to work from home until about May. So through March, our operations have been primarily virtual and it’s about 90 percent of customer engagement will be virtual and 10 percent is live. And that was basically an upside down 180 in terms of how we serve our customers.

ARMENANTE: Yeah, we had a similar situation, our timing was March 16th. You know, it depended upon the company’s liberal or conservative approach to it. And, yeah, it went from almost 100 percent interactions that are live to about 100 percent digital. And I think we had a few systems like you had with Veeva that were quickly able to get up to speed to have digital interactions. But things like our sampling approach to the business, even just the normal interactions that you would have with your offices, changed overnight. And I think that what we worked on in the beginning, there was a lot of systemic behind the scene changes to get us up to speed, making sure people had the digital tools to use, making sure things that would normally be used in a in a live setting could now be transferred to that. And then the biggest thing was skill building. How do you communicate with customers now in using a digital medium? Some people quickly picked it up. And I think that they were able to have really good interactions with the customer impact. A lot of the calls in the beginning were a lot around  how things were impacting HCPs, showing a lot of empathy for what’s going on. Because their world was completely turned over and they’re on the front lines. So I think that the combination of systemic skill building and the customer impact and being able to morph and change with them in the conversations led us to a lot of success early on until we could start to transition back to a more traditional method of getting face to face with people.

ATKINSON: And so we were just discussing how you operated pre Covid and what are the big changes you’ve seen as we’ve sort of got to this point?

BUARIA: I also have an opportunity to see a across our affiliates around the world. And it was interesting to see how the way it started from Asia. And you see, lockdown’s emerging first in China and the rest of Asia. So for us, we were also fortunate to capitalize on a lot of learnings that were extracted out of the early countries and then how quickly we could share some of those learnings and best practices, which also helped us to accelerate the rewiring of the organization, so to speak, in later countries. Of course, the Americas are still kind of finishing with one while we are already into the second wave in Europe. So it’s interesting to see how we are adapting across this continuum. On one hand, completely face to face and then completely digital. Now somewhere in between is where we are. And probably this is what will be the future.

ATKINSON: Frank and Chetak, you’re obviously in sort of different stages of that reemergence. Can you give the audience some tips about things to be mindful of about when they are coming back out, what they should be looking for, not just from sort of a safety and a personal perspective, but from a selling perspective as well, and how to manage those digital skills with those hard skills that people obviously need to have as well.

ARMENANTE: I’d say 95 percent of everything that goes on is face to face again. But there’s still the digital aspect. And I think there’s a couple of things that came out of it. When we started doing the digital interactions, we were actually able to contact some customers that normally we couldn’t get into their offices because of access or maybe their health system, et cetera, would not want to have representatives. So this created some avenues for us that we never had before to certain parts of our customer base, which was great. I think the other big thing was you found a lot of places also saying, no, right now we’re not ready for you. So you’ve got to be savvy as a as a field sales person figuring out what is it I still can provide for you. Are there other emails that I can send to you to give you information to be able to look at, and our systems allow us to do that very easily now. Is there any way that I can meet you out in the parking lot right where we can be safe, et cetera? And the other big thing to remember is when you were doing everything digital, you’ve got to have a nice transition phase for your customers who still want certain digital things like we used to. But we have a sample system that they can get samples digitally. You don’t want to turn everything off immediately because that could turn off some customers. Or again, if you’re having a digital face, you know, virtual interaction and they like that. Keep that going. Keep the skills going.  

BUARIA: Just to build on what Frank was saying, for all of us, I think this was like probably a couple of years of change management effort. From awareness to advocacy, cramped into kind of a dash as we went into this pandemic situation. There were colleagues and countries around the world where there was a huge push around awareness – to tell us what we can do, how can we still manage business continuity. This whole virtual outreach for customer engagement has been new and this is something that we have been advocating for the last three to four years. But overnight, you see the trend from the search to find what the tools that are available around us. And then you take the folks through a training program, how do you do the demos and kind of walk through the solutions? And then came the question of, OK, I’m so used to detailing face to face, how do I adapt to this kind of a remote setting? You need to be natural. So, we are not fundamentally changing the selling model. It is still the same. And that gave a lot of confidence as well to get a feel for that, that we don’t have to completely reinvent ourselves. The other point was around content. You cannot simply carry the same material that you were using for physical into a digital conversation. And that was probably the biggest challenge because these things take time. You can’t in pharma world overnight churn out the content and push it to customer. It goes through the approvals and reviews, et cetera. And that is still an ongoing pain point. More channels means you need to also have that much variety of content. Also, when you get 20 minutes, 25 minutes with physicians, it also demands that much of richness of the content. Then for the next engagement, you need to come up with something new.  

LIANG: : We definitely observed similar things, especially on the content side. I mean, overnight, our marketing organization converted everything that’s print out to PDF to enable digital delivery. But we did learn a couple of surprising things from virtual interactions. Number one, we saw productivity jumped up. We are a very metrics driven organization. So we track to understand how productivity and effort leads to performance. So prior to that fateful day in March, we’ve been leading the organization to target better and have more calls and more effort towards our high value customers.  And then once you switch to virtual, productivity really shot up and we hear from reps that they could do four virtual lunches a day. And now they’re much more efficient. So more checkpoints, more touchpoint with customer.

We also ran a study during the summer because we wanted to know what’s the best way to engage customers in virtual. We saw metrics that people using Veeva Engage or platforms like this that enable more show and tell than just a phone call, it’s more effective. And we ran a study and learned that the folks that performed the best in virtual were the folks that still sell naturally or carry through the clinical selling model that we’ve trained them on. So in the long haul, now we are actually thinking as we continue, there will be a virtual as part of our mix going forward, regardless of how Covid lands in the future.  But we think virtual is here to stay, in some capacity, and we need to think about how do they engage customers differently. So we polled the field and a lot of them say they want new material. An average of 20 minutes is much longer than prior in-person meetings. And they run through all the messaging that we have.

ARMENANTE:  Yeah, it’s a great point because when you have them on one on one virtual call, you’ve got a captive audience there. And it’s not like they’re being distracted by outside sources where you’re standing in front of them, a nurse walks up, et cetera. They’re usually in their office or on a computer. The other big thing that I’ve seen is we do a lot of peer to peer type of meetings. It’s usually where you’re going to a restaurant. You’ve got a physician coming in speaking to him. Now you can do one and you can see up to one hundred people, that are showing up to these. And it’s more than just the physicians. And they’re getting that messaging cost is low because it’s all done digitally. And what you’re seeing there is we’re reaping a lot of benefits. And now you’re able to follow up live and get some good, rich, engaging conversations off of those events. And we’re still getting the same level of engagement. A lot of people coming out to them. I would recommend to the companies who are thinking about how do you get that peer to peer interaction right now is a great time to take advantage of the digital side of it.

LIANG:  As we try to reemerge from virtual, I think we are serving a population that is more likely to catch Covid and have a death rate higher than the general population. So I think our customers  might be, just because of the safety issue, slower to  reengage in person. I saw that specifically in these cases, we saw the performance actually dropped for the reps who were permitted to safely meet in person. So in Q2, they were high performers, their productivity was high. They were doing five, six meetings a day. They were doing these long calls and then they were so eager, every rep wanted to get back out there. When they went back, first thing you see their core activity comes down. And we did a couple of deep dives with them because they serve as kind of guiding blocks for the rest of the field to navigate this mix of virtual and in-person. And we found that because they were eager to get out, they spent a lot of time driving and then your productivity goes down. So now we have to help guide them toward balancing your workload between the two approaches.  

ARMENANTE: There was a big appetite from the customers of getting some face to face. And depending on the state you were in, some states were not seeing the level of Covid like, say, New York or California, New Jersey, Arizona. So I think what we saw was a drop in productivity on the amount of calls and execution that they’re doing. Then once you get in the field, we’re now very, very close to where we were pre-Covid. And I think that, again, it’s about 90 percent live and about 10 percent that that’s in the virtual and the phone calls and things like that. But now you’re starting to see a little bit of a bump because you’re getting back to a regular level of face to face, but you still have a nice bolus of a virtual interaction. So my prediction is by the end of the year, we should be closer to maybe 10 to 15 percent above productivity because people are balancing the two different things.  

BUARIA: Indeed, the other element which we were debating is how do you make sure that the personalized experience that you want to provide to your customer is equally delivered through these two different types of engagement? Let’s face it, in a traditional context, face-to-face only model, reps are the best possible personalization engine that anyone can think of because that guy is processing every possible data point that he or she knows about the customer and delivering a highly personalized experience. And then you have webinars being delivered by Home Office. You have email marketing or email engagement going on, and it can turn out to be a bit chaotic as well. And all this has to be orchestrated, or It could very quickly backfire and give a huge blow to the credibility in front of the customer. So I think that’s where the energy is right now, curating the content that is getting delivered face to face or digital to provide that personalized experience and treating as many customers as individuals as possible.

ATKINSON: Are there any tips that you would give our audience to sort of break through those barriers in terms of a channel to be using or a different sort of skill that they might be able to employ to try and break through some of those barriers to really be hitting on those directions again?

LIANG We hear that many HCPs are now doing telemedicine all day and some have expressed that they are no longer as eager to hop on the phone, and therefore accessibility changes. I observe from the field some interesting use of innovation. One  rep identified a resistance to Zoom meetings was related to scheduling. A lot of time has been spent on scheduling. Which day should we meet? How to find the right day and opening? So our rep used a scheduling app and basically were able to change the conversation to say, “Here are my availabilities and here’s when you can book me.” So he was able to change the conversation to when I’m available, you can find me. We saw the engagement rate went up for that territory.  So I think the lesson learned for us was anything innovative in finding the pain point of that lack of engagement and trying solve it in different ways.

ARMENANTE: And I think the digital fatigue is definitely there, once all companies started to get their platforms up and running, it was like all of a sudden too many digital engagements for each physician. That’s how they were feeling. What I’ve heard from some of the representatives is they would reach out a little bit further in their call plan. They would look for some people that they didn’t get a chance to engage with maybe during April and May and say, hey, we’ve had good four months practice. This is going to be a really good rich environment. And those physicians would be open to signing up. 

I think the second thing that you do is switch it up, because once you’ve had that one 30 minute digital engagement and you’ve talked about all the different things, I think that’s where we would introduce, hey, we’re going to be doing a speaker program that you can jump in and listen. So now you’ve got a whole different medium, different perspective, usually at night or during lunch and then it creates that opportunity for you to still engage with them digitally. You had a chance to listen to the speaker.  Let me follow up with you. When will that work? So now you’ve parlayed one into three. We overcame that by giving them some of those different options on different mediums.    

BUARIA: Some of the basic stuff is still valid. You need to know your customer. You need to segment them appropriately. That will be a section who is tied up with Covid duties, et cetera, and there’s no point chasing them just to connect with them. When we looked around to see pockets of excellence, we found that there were reps who were more tenured in their territory. They were more experienced, they knew their customers. They were the best personalization engine in action. They segment. They say that these are my customers who are willing to engage and then we concentrate our energy there. And there are others who are probably busy or there are others who probably had a completely different need, that they were looking for specific advice on how to manage patients and cope with the situation. What kind of comorbidities should I be aware of?

ARMENANTE: Marketers never thought that they’d have segmentation of digital friendly and digital non friendly. That’s really the first time ever for that. One thing actually worked out for us really well. Obviously, patients who suffer from diabetes have extreme risk for Covid-19. And we did come up with a digital and a print version that we could share with customers on some of the things to keep in mind. And that opened up some really good doors, because right now that’s a huge thing on the on the customer’s and the patient’s mind. And that really worked well to transition into a normal product type of conversation. So if you’re not doing that, I would imagine that that’s an opportunity for the marketing teams to look at and say, hey, how can we how can we implement this and integrate this into our customer base and give them some understanding of what they may want to look out for in the disease state that you might be following.

ATKINSON: I want to talk about the way that you’ve communicated with your field force also because obviously working in a virtual world and having digital burnout doesn’t just apply to our customers. It does apply to us as well. And I’d just like to hear the way that you have sort of in your isolation, continued to work with your staff to upskill them, continue to update them on not only internal changes, but changes to the way that they might be selling or the way that they might need to be interacting with their customers.  

ARMENANTE: I kind of watch when my kids were doing. And they do a lot of watching other people do other things, whether it’s on Twitch or YouTube, et cetera. So I came to my boss and I said, hey, why don’t you do a live stream to the field, right? Once a month? Very casual, very unscripted. We’ve got some slides and some themes, but let the conversation go where it may. So when Covid hit and we people were kind of trapped at home, it worked perfectly. We were able to continue to keep people’s engagement. We kept it light. We kept the digital training platforms up. So we have area trainers that were able to their masters so they could they could do almost training on demand. And, you know, even right now where our field force is still out in the field live.

But we’re struggling. We don’t travel to get to national meetings or area or even regional meetings. You know, we’re trying to use a combination of the clinical things that people need to know with good information and most importantly, fun. Because that keeps people coming. That keeps them thirsting for more information. So that’s where I would say look at maybe some different ways that you want to be able to communicate using digital means. Again, video goes a long way.  

How are you dealing with your kids being home and you’re working and figuring out how to balance that, or a loved one that you’re taking care of because, you know, maybe they’re older. So we try to put the human nature into it as well. And that goes a long way toward keeping people engaged. And then that creates more productivity. People are ready to work when they when their situations changed.

LIANG: That’s a great idea, Frank. I would love to be on one of those just as you guys do free flow. Prior to Covid, we had a video training platform, like YouTube, but compliant. And it’s a specific one that we set up to enable training so any regional manager or trainer can do like a 30 second blurb, best practice. You can look at it on a phone, iPad, computer. It’s very similar to YouTube. It’s just kind of combined version and it worked really post-Covid. People we’re posting how do I set up my home office? How the heck do I use my computer because I don’t use my computer? So these were really kind of lighthearted as well as more serious. And we also use that channel to push up how to use Veeva Engage. So I reiterate things that we talk about and then I think back I kept it digestible.  

BUARIA: This is a rare occasion, we have a common unifying point which is affecting everyone on this planet. So irrespective of geographical boundaries, you talk to anyone and you have this kind of connection that you are somehow a part of the same battle. To help each other through shared learning and that feeling of community, I think is difficult to describe, but something hopefully will stay with us in a positive manner going forward. And that was, at least for me, one of the other factors that we observed. As you interact with colleagues, you check in about their personal challenges from different parts of the world.  

ATKINSON: Are there any skills that we should be mindful of, of losing a little bit if we if we go down one path too much in terms of a digital or back to the face to face? Is there anything that the audience should be mindful of about some of those core skills?

BUARIA: One of the major skills that will be helpful to navigate through that evolution would be your agility and adaptability to change. I think that’s the core skill and that is something which has kind of helped us to sail through the challenge right now. But if we can somehow make that part of our DNA and also systematically impose that kind of a little bit of injected volatility to the business just to make sure that we are future proofing ourselves, how we quickly adapt to that world doesn’t mean that it will be completely digital. But if we start thinking that world will be digital by default, and then you work backwards, that then if I can do face to face, that’s a big bonus.

ARMENANTE: The one thing that that I’ve observed is that you’re seeing a big surge in telehealth with doctors. I think we have to be thinking a little bit about how do we have conversations with doctors who are splitting their time between an office and the work that they’re doing with telemedicine, because there are pockets in the US where now I think you’re seeing a big change in the way doctors are doing things. So we’ve got to figure out as a sales force, how do we have conversations around that as well. And even as a marketing team, we’ve got to figure out how do we integrate with that? How do we help them if they’re with a customer and they’re digital what have we given them to help them if they’re trying to say initiate a prescription and how they do dosing or whatever it is that they’re working with? That’s a new paradigm that I haven’t seen a lot being written about and I haven’t heard a lot about what we’re doing.

LIANG: I think what we do see is the managers also need a lot of support, and that’s something kind of fresh in my mind. So I’m going to bring up coaching. How do you, coach, for agility and change? That is a thing that is top of mind that we’re working on. I think when we saw when Covid hit, based on our surveys, managers rated   lower than reps in questions related to motivation and mood.  We believe they felt they needed more tools to help them virtually coach their reps. And I think that speaks to now, as I said, you know, it’s just going to be agility training going forward because it’s going to be whack-a-mole. And we don’t know when it ends after Covid, there might be something else. But I think that enabling our workforce, especially those starting with the leadership team, the managers, to be more agile is something that we currently focus a lot more on.

ARMENANTE:  Yeah, that’s a great point, and how do you coach digitally? How do you coach remotely? You’re used to being side by side with somebody in a car, for instance, and now you’ve got to make sure that your cars are six feet away from each other.  

ATKINSON: And this might be a little bit meta, but obviously you want to be able to train and coach your staff. But how do you yourselves make sure that you have the skill sets to do that? Because being able to learn those things yourself so that you can pass that knowledge on, is I think probably half the challenge as well. How do you try and adapt yourselves during this period?

BUARIA: I think the best learning, at least I have acquired is just interacting with friends and colleagues, which is very practical, which is very important, because we might be coming from different companies, but a lot of the contexts are similar and how you adapt has evolved rapidly along the way. So we all have technology partners and they have been a great source of learning as well. I think these were a couple of things that helped me at least.

ARMENANTE: I watch my kids, they’re so ahead of the curve from everything we’re doing — how are they talking to their friends right now? How are they interacting with their ideas? You know, even watching them do gym class over Zoom is just hilarious. But it works. And I think I would I highly encourage people. Watch what your children, or if you have relatives that have children, ask your nieces and nephews or friends’ kids, what are they doing? How are you guys working together? You’ll learn a ton. And they’re going to be way ahead of anything that we’re doing in the pharmaceutical industry.

Panel: Position your field force for the future

Moderator

Matt Atkinson

Global Project DirectorReuters Events Pharma

Matt grew up in New Zealand and began his career at Seafood New Zealand. He moved to Petrochemical Update as Sales Executive, EyeforTravel in a similar position, and came to Reuters Events Pharma in 2019, first as Account Manager and now as Global Project Director.

Reuters Events is the global leader in business intelligence products for the healthcare industry.

Panelists

Frank Armenante

Director, Commercial Execution South Area, Novo Nordisk

For a decade, Frank was Manager of Incentive Compensation for Bristol-Myers Squibb before coming to Novo Nordisk. He has served there as Sr. Manager,  Incentive compensation, Sr. Area Support Manager, MMS Institutions, Associate Director, Institutions Operations, and District Business Manager before moving to his current assignment in 2016.

Novo Nordisk has been driving change to defeat diabetes for almost 100 years, which has given them the experience and capability to help defeat other serious chronic diseases, including obesity, hemophilia and growth hormone disorders.

Chetak Buaria

Global Head of Commercial Excellence, Merck Healthcare KGaA, Darmstadt, Germany (EMD Serono in USA)

Chetak began his career in pharma as Marketing Manager for Alembic Pharmaceuticals, Ltd., and then moved to Mehta Partners as Head of Operations and Director of Research. He served at Merck Group as Director and Head of Business Development & Strategic Marketing and Director of Business Development for Biosimilars, and Global Head of Commercial Excellence.  

Merck Healthcare KGaA designs and develops medicines and intelligent devices that strive to provide ongoing care for patients beyond their treatment. This includes medications to treat conditions such as cancer or multiple sclerosis (MS). For example, they offer an injection device and disease monitoring software outside USA and Canada that allow patients with MS to self-inject their medicine and track its administration. With cancer, they are researching the use of biomarkers that can match potential treatment to individual patients. As a global market leader in fertility treatments, they have complemented their legacy with the launch of a dedicated Fertility Technologies unit to help improve treatment outcomes in the lab.

Candy Liang

Senior Director, Field Strategy and Commercial Operations, Akebia Therapeutics    

Candy has been a Senior Consultant for Marketing and Pricing Strategy for Simon-Kucher & Partners, Corporate Strategy Associate for Groupon Japan, and Engagement Manager for Global Life Sciences and Med Tech Strategy at Monitor Deloitte. She came to Akebia as Director of Strategic Planning, and has since worked as Director of Commercial Effectiveness before assuming her role as Senior Director of Field Strategy and Commercial Ops.

Akebia Therapeutics is a fully integrated biopharmaceutical company working to address complications of kidney disease. It has both a commercially available medicine and a late stage oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), vadadustat, in global Phase 3 clinical development for the treatment of anemia due to CKD. Vadadustat and other HIF-PHIs are based on Nobel Prize-winning science.

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