John Bienko co-wrote this blog post with Sarah Jarvis.
Collaboration across field medical teams and commercial sales teams—what’s allowed and what’s not—is a big point of contention in the U.S. pharmaceutical industry today. No wonder, given the spotlight on compliance: since 2008, ZS estimates U.S. pharma companies have been charged $22 billion in fines for improper marketing alone. But there’s more to the collaboration question than just compliance. As we covered in a previous blog, several factors are driving companies to reassess their medical-commercial interaction, including changes in the overall healthcare landscape, increasing ecosystem complexity, and declining commercial sales rep access to physicians. According to ZS’s AccessMonitor™ survey, the percentage of accessible physicians reached by the majority of reps declined from 77% in 2008 to 47% in 2016. In certain specialty areas like oncology, the decline is even steeper: from nearly 77% to 23%.
The customer engagement model is changing as well. Traditionally, it largely focused on HCPs, but today, doctors aren’t the be-all, end-all decision makers that they once were, and consumers have also become stronger advocates for their own healthcare. Moreover, ZS estimates that service and support roles—such as nurse educators, reimbursement specialists, patient navigators and thought leader liaisons—have more than doubled over the past three years. There are many customer stakeholders now that need to be addressed, so navigating them will take more than just the traditional route, the sales force.
Given these complexities in the marketplace, it’s not surprising that only half of the respondents in the recent ZS Medical Affairs Outlook Report, a survey of more than 100 medical affairs industry personnel on current and future trends facing medical affairs organizations, said that their field medical teams are constantly looking for ways to collaborate with commercial sales teams. We believe there are effective, appropriate ways to bridge the medical-commercial divide:
- Real collaboration throughout the product lifecycle: While we most often think of the need to collaborate in field in the launch and post-launch phases, field medical spans the vast majority of the product life cycle, overlapping with both development and commercial activities. Appropriate collaboration across medical and commercial can definitely happen sooner; medical can also be an important resource for R&D on clinical trial feasibility and design, as well as payer/reimbursement hurdles.
- Improved planning at strategic, and account, levels: ZS recently worked with a pharmaceutical company that was preparing for indication expansion into a new market, involving a near-doubling of the existing customer universe. ZS facilitated a strategic cross-functional workshop which focused on enhancing the customer experience across all accounts. The workshop allowed the company to define new customer archetypes, shared workstreams, and key milestones across multiple functions that had previously tackled these issues in silos: clinical development, marketing, sales, and medical affairs. Moving from strategic guidance to tactical implementation in the field is the next step to cement this joint approach.
- Better in-field coordination and insights-sharing: Recently, we worked with a client’s field leadership to identify opportunities for their medical and commercial teams to collaborate compliantly. We found that collaboration should happen in three areas: strategy (sharing plans, objectives and responsibilities, identifying areas of overlap in role definition and collaborating on sales force approaches in field); tactics (joint review of overlap of customer lists, creation of shared objectives, joint trainings and alignment on educational activities) and implementation (coordinated execution of shared objectives, consistent insight sharing, and joint visits for key opinion leaders in certain situations). Nearly everyone agrees this is the right approach and wants to do the right thing; the challenge comes in how to do this without missteps, both perceived and real. In the absence of clear guidance, most leaders simply throw in the towel for fear of taking the wrong path unintentionally.
- More empathy and understanding: While compliance is most often identified as a barrier by pharma organizations, and is certainly still a challenge, our recent survey found that lack of communication and misunderstanding of medical roles and objectives are also major issues for a lack of collaboration. In many companies we understand from our clients that not understanding the role and value of the medical organization is culturally acceptable. However, to collaborate, you have to understand the other side to make any progress. Companies that are tackling this well are finding multiple opportunities to build understanding and get to know each other. While some are tackling this with big structural changes, others are finding opportunities wherever they can (for example, joint training on similar issues).
While bridging the divide between medical and commercial can be an arduous task, it’s definitely worth it. When started early, this cross-functional collaboration creates development and launch opportunities, helping pharma companies increase organizational efficiency, accelerate and prioritize research, collect compelling evidence to support product value stories, improve customer and competitive insights, and even deliver a superior customer experience.