shutterstock_430551286.jpgFor years, oncologists have leaned on a variety of chemotherapies to battle cancer. They could use these versatile agents to battle multiple types of cancer, from non-Hodgkin lymphoma to colorectal cancer.

Now, a new wave of immunotherapy agents is sweeping the cancer landscape and offering hope and excitement across a similarly diverse set of tumor types. Some platforms are ambitious: One therapy is claiming to launch 50-plus indications. In totality, marketed products with multiple indications are expected to increase by more than 40% by 2020, according to the Office of Health Economics. These new entries are set to join increasingly crowded spaces, amplifying the need for a careful, differentiated strategy.

To compete in this new multi-indication world, sales and marketing teams need to be armed with more detailed, indication-specific knowledge than ever before.

Planning for multiple indications certainly will affect all areas of sales operations (targeting, CRM, sales compensation and reporting), but before reinventing the wheel, we need to first ask ourselves, Is this something that I even need to worry about? The extent to which you design operations to provide visibility into individual indications actually depends on several factors:

1. Similarity of indications and customers
2. Available indication-level data
3. Timing and sequence of each indication launch
4. Requirements or pressure from compliance teams


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Once you’ve decided that multiple indications should be woven into the commercial operations “fabric,” it’s important to consider how best to account for it across each sales operations function. Here are a few tips:

  • Customer targeting and effort allocation: Strive to design targeting and provide insight by brand and tumor. Customers and their value tend to differ significantly enough across tumor types to warrant distinction. Breaking out in targeting and even differentiating calls or effort by tumor type will help the field force prioritize the right indication for the right customers. If multiple teams are promoting the same product for different indications, add one more step: Facilitate a team-based review of the call plan. It’s crucial to maximize coordination among difficult-to-reach oncologists.
  • Sales compensation: Use the most granular data that you have available, and get creative with it. Perfectly clean, “IC-grade” data split by indication is hard to come by, but without it, you can still try a few approaches. If you have partial data, consider using it within a smaller component of your plan, or roll it up to a higher team level, such as district or region. If you have no data at this level but still want to account for indication performance, consider an MBO or national kicker.

If you have even a little data, find ways to be creative. Explore newer metrics, such as patient starts in specialty pharmacy data or KPIs from market research chart audits. With limited capture or small volume, it can be difficult to differentiate and reward individual performance, but it’s absolutely critical for motivating your force and your top performers. Even reserving a small piece of the plan—say, 20%—or rolling out an individual sales contest alongside your plan can go a long way.

  • Reporting: Share within your comfort zone. When it comes to reporting and sharing data, assess your confidence in your indication-level data and your level of comfort with the questions that it could raise in the field. As I’ve observed, companies currently operate across a spectrum:
    • 1. They share limited data. This tactic reduces field insight, but it’s more efficient for operations and communications.
    • 2. They share some data with higher confidence. This empowers the field to better understand their market and customers, but not all reps may be savvy enough to benefit.
    • 3. They share it all. There’s full transparency, but it’s potentially distracting and difficult for the average rep to mine.

In the end, a company needs to assess their options across each of these work streams and plan for multiple indications in the way that best meets their business needs.

Ultimately, the right approach should enable coordination and pull-through of brand strategy through all operations functions, and provide the field with the ability to extract and share insights for ongoing learning and improvement.

When the indications come, will you be operations-ready?


Topics: oncology, Sales operations, David Kriesman, multiple indications