Karan Dhundia co-wrote this blog post with Jude Konzelmann.

In our last blog post, we discussed three pressing challenges for commercial organizations within the biopharmaceutical industry: the increasing evolution and (often uneven) consolidation of healthcare customers, the complexity of each geography’s key influencers and how they work together to deliver care in different therapy areas, and stakeholders’ inconsistent definitions of value. To address these challenges, we proposed a four-part transition framework—covering deployment, roles, structure and marketing—and we delved into step one: the reorganization of field-based commercial personnel. Now let’s get to step two.

Roles: Moving From Fewer Generalist Roles to More Specialized Roles

Some of the transformation to customization has begun and is evidenced by the proliferation of different customer-facing roles that we see in the industry. This trend is a response to the increasing number of stakeholders who are involved in the decision-making process to get a patient initiated or maintained on a particular therapy. While physicians historically have held nearly all of the decision-making power, physicians’ influence is decreasing in many markets and they’re being replaced by a host of decision makers within institutions and networks, many of whom are non-clinicians. The industry’s response has been to create many more roles to serve these customers. We’ve counted 30 or more different customer-facing roles in the industry today. (Transformation to the new environment also requires changes in headquarters-based roles, especially in the marketing department, but we’ll discuss that in a subsequent post.)

Specialized roles are and will continue to be a critical part of succeeding in the new environment, but companies need to be thoughtful in how they create them and deploy them locally. To start, companies need to consider a few key inputs. First, you need to have an evolved customer insights capability to understand the needs of your different types of customers. Many customers are no longer just individuals; instead, biopharmaceutical companies’ customers now can be complex accounts or networks. Not only do you need to gather insights on prioritized stakeholders within these customers, you also need the ability to understand these customers as an organized entity.

The second key input is the ability to create and shape offerings and value propositions that will resonate with customers. Without this ability, you’re creating roles but not equipping them to create more value for customers.

Third, you need to understand the geographic variation that forms the context in which your customers operate. Organizations need to be prepared to customize their go-to-market approaches in different markets, so they need to understand how stakeholders in a market interrelate and who holds more power in decision-making.


BLOG POST: How Biopharma Companies Can Adapt to Industry Changes: Step One

ARTICLE: Commercial Models for a New Healthcare Ecosystem

With these inputs gathered, companies need to have a systematic process for determining roles both overall and in specific geographies. The building blocks of field roles are activities that we would perform with specific customer groups. All activities are essentially helping to advance patients along the treatment journey. For example, the activity to provide support to an office manager or billing coordinator in navigating prior authorization forms can help increase the rate of fulfillment once the prescriber has made the brand choice to get a patient started on therapy.

The first logical step in the process, therefore, is mapping out all of the activities that your company intends to deliver against all relevant customer stakeholders. A matrix of customer stakeholders and activities, or at least activity groups, is a great starting point. Once this matrix is established, the second step is combining the relevant customer/activity groups to form roles. Be prepared to think through a few related questions or tradeoffs as you work through this step, including the classic question between effectiveness and efficiency. Specializing in particular activities should lead to high effectiveness or impact at executing those activities. The challenge with specialization is that it comes with a cost of lost efficiency, especially in the geographic sense. If you specialize around three dominant activities, that necessitates having three people cover every customer in the country, and will lead to larger geographic responsibility and more travel.

The second step in the process, which relates to the effectiveness question, comes down to understanding the skills required to execute the activities. There are many types of skills: leadership, selling, analytical, relationship, subject expertise, administrative, etc. Of course, individuals have many skills, so it’s critical to think through the combinations of skills and the availability of individuals with such combinations in the market when determining how to shape roles.

With roles established, the final step is considering the extent to which all of the roles need to exist in all of the markets. When organizations only had a few roles, having those present in all markets made sense. Now, local markets and customers have evolved and more roles are needed, but you don’t need all roles in all geographies. The input on geographical variation is critical here because, ideally, it should dictate which activities are delivered to which customer groups based on their local influence and needs. In essence, you can reconsider some of what you did in the first step with an adjusted activity matrix shaped by local variations. Keep in mind that the roles don’t need to be the same everywhere, and that this is one place where local variation can directly impact your approach.

Stay tuned for the third part of this blog series, in which we’ll outline the next step for adapting your commercial organization to the new biopharmaceutical environment.


Topics: Jude Konzelmann, commercial operations, Pharma, Sales force decisions, Sales operations, healthcare ecosystem, sales force design, biopharmaceuticals, local healthcare market, karan dhundia, commercial organization design