It is no secret that the pharmaceutical and healthcare industries aren’t exactly on the forefront of digitization. A 2015 report by McKinsey1 specifically calls out the pharmaceutical industry as one that is highly profitable but not very digitized. The verdict for the healthcare industry is even bleaker: digitization is lacking severely across most dimensions (assets, usage, and labor).
Since then, things haven’t changed all that much. As recently as 20192, the pharmaceutical industry was still lagging behind when it comes to its digital footprint.
A lot of analysis has gone into how the pharmaceutical industry has to change and adapt and how digitization can be a driver of success.
Now, along with every industry and the entire world economy, the pharmaceutical sector is experiencing an unprecedented system-wide stress test in form of the COVID-19 pandemic impacting efforts across R&D, commercial, and medical affairs. Medical field teams have been especially challenged by social distancing requirements: digital detailing, meetings, and exchanges are now, almost overnight, the only way MSLs can interact with their customers.
In this blog, we discuss the possible long-term impact of this instant digitalization on medical field teams.
Does the Fate of Pharmaceutical Sales Reps Hang in the Balance?
Scheduling a face-to-face meeting with healthcare providers has been a struggle for sales reps for some time. An often-cited figure states that only around 45% of physicians are routinely accessible to sales reps3, down from 80% as recently as 2008. Access also varies quite dramatically by specialty, with unrestricted access to oncologists, nephrologists, and pediatricians being especially limited.
Now, for a period of weeks, maybe months, healthcare providers will be inaccessible as they focus on the impact of the pandemic. The question is, whether physicians who were previously accessible will reevaluate their accessibility once business is back to normal. Will even more restricted access become the new normal?
During this period the industry has the opportunity to evaluate impact across all field teams and ultimately reallocate funding and align headcount to areas focused on addressing need and driving patient outcomes.
“Time will tell” says Robert Groebel, VP of Global Medical Strategy at Monocl “to what degree HCPs will limit access to in-person discussions or be constrained by emerging organizational standards. Pharma companies will need to develop new strategies and leverage digital channels to support the scientific needs of the treating community.”
The number of pharmaceutical sales reps has been holding relatively steady at around 70,000 for several years now4 so predicting their imminent demise is premature. However, the COVID-19 pandemic might contribute to field medical’s already growing importance. What will happen to size and scope for a sales organization? One must ask, can these heads be deployed to new and novel field roles with an emerging remit?
Digital Expert Engagement – Temporary or Permanent?
One of the key components of digital success in the pharmaceutical industry is more comprehensive digital engagement of customers in general and external experts in particular. So far, in-person meetings dominate the industry, according to a study5 less than 15% of both one-on-one and one-to-many engagements were conducted virtually before COVID-19. These are low numbers, particularly when one considers the rapidly changing demographic of HCPs. By 2025, the vast majority of the HCPs of the baby boomer generation will have retired and been replaced by millennials.
This demographic change is important, because age is a good indicator of learning and engagement preferences: baby boomers favor face-to-face meetings and lectures, while millennials favor remote, mobile, and multichannel engagement, ranking in-person interactions lower. The stable group of Gen Xers in the middle like their personal meetings but are also ready to engage in the virtual world.
To address these channel preferences, medical affairs will need to transition to more virtual engagement to remain relevant with the almost 90% of their customers that are either digital natives or comfortable with digital engagement.
For now, virtual engagement, like it or not, is the only game in town and the question is whether the complete digitization of interactions will be short-term and (almost) fully revert back or whether it will accelerate the digital reset that is expected to happen in the longer run anyway.
The latest report by the MSL Society6 provides insights into what MSLs themselves believe. Of the survey participants who answered the open form question, “What do you think will be the long-term impact or changes to the MSL profession as a result of the COVID-19 pandemic?” 51% commented that they expect an increase in virtual engagement.
Selected answers from the survey:
- “Virtual meetings will now be integrated routinely as KOL engagements.”
- “Greater proficiency in virtual connectivity and less reliance on in-person interactions to build relationships and share information.”
- “I think that companies will be more flexible to virtual meetings and full time ‘virtual’ MSLs.”
These and other data points from the report indicate that industry players expect some lasting effects, specifically increased use of virtual tools.
Lack of Tools and Infrastructure Can Be a Roadblock
Going predominantly virtual would be a dramatic change of the engagement model for medical affairs and the ability of healthcare providers and experts to adapt, is just one, albeit important, consideration. Access to the appropriate tools and infrastructure to drive efficient engagement is another critical component.
Challenges include consolidating fragmented IT infrastructure, updating or overhauling outdated legacy systems, the willingness to experiment with different channels and ways to collaborate with customers virtually against the backdrop of regulatory requirements, and a continuously evolving regulatory framework.
Developing and integrating these tools requires agility and resources as well as strategic direction and sponsorship from senior management.
The lack of standardization around remote engagement can also create challenges. While an increasing number of HCPs can be found on Twitter and a recent survey found that 92% of polled MSLs and MSL managers considered digital opinion leaders at least somewhat important, it is unclear where MSLs can efficiently interact remotely with HCPs. Twitter is certainly not the platform for deep scientific exchange and physicians have traditionally not embraced platforms like LinkedIn. Even if they were to adopt them, such platforms are not well-suited for the exchange of potentially proprietary medical and scientific information.
On the other hand, if pharma companies each develop their proprietary platform for KOL interaction, there is a high risk of confusing HCPs. Especially the less digitally savvy ones might have trouble navigating multiple apps and services, switching back and forth between them, and keeping them updated to receive information from MSLs representing different companies.
Back to Business as Usual or Digital Reset?
Once the shelter in place rules are lifted and people start moving again, the world will be a different place. Just how different it will be for pharmaceutical field teams remains to be seen. Physicians will still create demand for scientific information and the industry will still need to determine how this information will be delivered and to whom. But will MSLs create more value by engaging effectively in the digital world, limiting in-person visits for critically important discussions? Will virtual conferences with their much lower overhead deliver superior impact or was participation low because networking in-person is a critical component and absent from virtual conferences? Will new medical field teams emerge or will others expand to address the needs of healthcare professionals?
By necessity people have been forced to adopt new ways of communicating and may find them suitable or even preferable to the traditional way of doing things. It is therefore highly likely that digital engagement will become a more utilized and important channel going forward. The experience we are having today might just propel us into a more digital future with new commercial models.
The pharmaceutical industry is not known for sudden and dramatic changes in course and therefore even an accelerated timeline towards digitalization in medical affairs would be a remarkable outcome.
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1 Manyika, J et al (2015). Digital America: A tale of the haves and the have-mores. https://www.mckinsey.com/industries/technology-media-and-telecommunications/our-insights/digital-america-a-tale-of-the-haves-and-have-mores
2 Mehta, S. (2019). Pharma companies must leverage the digital medium better. https://www.financialexpress.com/brandwagon/pharma-companies-must-leverage-the-digital-medium-better/1738871/lite/
3 ZS AccessMonitor (2016). Want better access to physicians? Understand what’s top of mind. https://www.zs.com/-/media/pdfs/ph_mar_wp_afm_acm_2016_es_v4.pdf
4 Pharmaceutical Commerce (2017). Sales rep count holds relatively steady at 70,000, says ZS. https://pharmaceuticalcommerce.com/brand-marketing-communications/sales-rep-count-holds-relatively-steady-70000-says-zs/
5 Best Practices. Benchmarking field medical & field outcomes and pricing KOL engagement strategies. https://www.best-in-class.com/bestp/domrep.nsf/products/benchmarking-field-medical-outcomes-pricing-kol-engagement-strategies
6 The MSL Society (2020). MSL activities during the COVID-19 pandemic. https://www.themsls.org/covid-19-survey-results/