Preparing for a conventional business problem like a product launch is a familiar process for pharmaceutical companies: First, design the structures and processes, and then get the talent in place. But there's nothing typical about managing the field force during a crisis like the COVID-19 pandemic—while preparing for the challenges to come. Because the future is uncertain, companies don't have the luxury of designing structural changes in advance, and instead must focus on having the right capabilities, skillsets and talent in place.
More than 45 senior pharma sales and business leaders recently gathered for the second virtual roundtable discussion in ZS's Determining the Way Forward After COVID-19 series. In a quick poll, we learned that nearly half of the participants have begun to plan for what we've been calling the "business unusual" phase of the pandemic, and nearly 40% are focusing their time and energy on the "new normal." We presented six points of view and accompanying no-regret moves (investments that companies can benefit from now and during the new normal) to spark dialogue about adapting field forces to continually meet customers' changing needs, and more. Here are a few of the highlights from our discussion:
- Virtual engagement will have to increase: The pandemic has left the field force with little choice but to convert their face-to-face physician meetings to virtual channels, but the burning question is whether this approach will prevail post-crisis. Nearly 90% of the roundtable participants agreed or strongly agreed with our hypothesis that virtual engagement will play a bigger role in a post-COVID world.
One way that companies can prepare now is by upskilling the field force to operate in a hybrid in-person/virtual role. As one participant told us, "embracing a hybrid role moving forward is something that's an absolute must." The key is to coordinate the touchpoints to ensure that the customer experience is continuous and engaging across multiple points of contact.
It's safe to say that this will be a good investment of time: ZS research found that 34% of physicians say they'll prefer engaging virtually with manufacturers in the "new normal" phase. One participant added that, "The field-facing team has become more adept at using the virtual interactions as well as the physicians being more open to it. What we've seen recently is beyond the physicians we've called on live, access to physicians that were in closed environments like IDNs were more open to virtual as well. I see this expanding beyond the current physicians to give us more access to areas that before were a lockdown situation."
- The crisis has driven dramatic geographic variability and change: There will be a greater level of variability in healthcare policy and delivery, across regions and over time. More than 80% of the roundtable participants either agreed or strongly agreed that the challenges of dealing with local outbreaks, legislation and capacity will drive greater heterogeneity.
Most importantly, these qualitative differences could be significant enough to drive different customer engagement models. But will they? As one participant shared, "The level of sophistication that it takes to drive customer engagement models from a regional perspective, I'm just not sure it's there yet…To me, it's a no-brainer that it's going to have to take place, but I just don't know if it can be pulled off effectively."
One of the no-regret moves that we propose is to re-design role descriptions to incorporate flexibility. In the post-pandemic world, it will be more important than ever to adapt customer engagement models to allow the field force to potentially flex between different activities and roles. With the right insights in place, local decisions can be made by the sales leaders that are best suited to the situation. As one pharma sales leader shared, "It's not going to be stagnant, we have to put some things in place to have continuous insights coming in. I do think it's going to evolve tremendously over the next 12 to 18 months and beyond."
- Customers will want more patient-focused input from manufacturers: In post-COVID interactions with manufacturers, a larger proportion of physicians will be interested in discussing the whole patient treatment journey rather than features of a brand or brand choice. In a poll conducted during the roundtable, 78% of participants agreed or strongly agreed that customers' needs from manufacturers will shift toward the patient.
We recommend that companies focus on developing leaders' ability to expand their teams' adaptive skills. This approach requires an important cognitive and capability shift for people in field management. By developing a new success profile for reps, your team will be ready to make the right selection decisions for physicians. One participant mentioned, "One thing I'd add is the ability to embrace the omnichannel approach. The idea that the sales rep's call will be augmented…can we bring in a virtual MSL to answer a physician's question that a rep can't answer, can you bring in a virtual reimbursement specialist, are we going to embrace more of the rep-triggered emails and follow-ups? If a representative doesn't understand how to use those various channels, they're quickly going to be left behind in this new environment."
- The re-initiation of whole classes of patients will trigger a move into greater levels of patient support: With patient visits down by 38% (that figure is as high as 55% in some therapeutic categories like rheumatology) during COVID, the number of new diagnoses, treatment initiations and product switches have declined. When sites of care begin to reopen, there will be a large backlog of patients whose treatment has been postponed. Healthcare systems will struggle to care for all of them and will look to manufacturers for support.
The pharma field force has an opportunity to step in and help ease the transition for their customers. One of the no-regret moves that we recommend is upskilling the field force to provide patient support activities and ensuring that they can do so in a compliant manner. This could make a real difference as more than 30% of patients identify in-person physician visits as a key post-crisis concern.
- The cost of treating COVID-19 will generate financial pressure in all aspects of healthcare: Manufacturers will need to learn to navigate some of the financial pressures that are coming on the back of the pandemic and recognize how that might translate into accelerating the move to value-based care. Value will no longer be the preserve of payers, managers and pharmacists, now physicians will be expected to engage with manufacturers on the cost/benefit aspect of healthcare. In fact, 77% of the roundtable participants agreed or strongly agreed that the cost (and opportunity cost) of treating COVID-19 will generate financial pressure in all aspects of healthcare.
This is a good time for companies to upskill the field force to play a role in value-based communications, while meeting compliance and legal requirements. One senior leader mentioned that he's already "seen a shift with value-based care focused on outcomes and decisions being made by large IDNs in relation to the disease state we're in and our products, etc. But I foresee cost being highlighted, outcomes being the focus, CMS guidelines, etc., and especially the institution level, there will be a dramatic increase, not that the focus wasn't there before but it will be that much more critical."
There's also an increasing need for the field force to operate cross-functionally and across silos and for local teams to have the flexibility to bring the right resources to the account or customer. As one participant shared, "I think that building the explicit local teams would involve some kind of an omnichannel approach. In some cases, not for all, a lot of time there's not enough depth across all of it. You have people doing in-person visits, the marketing teams doing NPP and your digital specialists but to have those skills that are blended across those functions is key…Some of that goes beyond just the 'what' to the 'how.'"
- The crisis will cause a level of change that will be hard for both healthcare and society to navigate: The crisis has created an environment of high change and uncertainty, much greater than the pressure of an internal restructure or a product launch. People are accustomed to one-step changes and then returning to business. The changes during the pandemic will be continuous, fast and uncertain. The teams that succeed will deliberately develop their ability to thrive and adapt through change. One key no-regret move is to equip people with higher levels of self-awareness which is a fundamental part of coping through change. It's also important to enable managers to have more flexibility in the way that they manage people, to leverage diversity, and to think more from a system perspective.
According to the pharma business and sales leaders who participated in our roundtable discussion, they're most focused on three no-regret moves: upgrading virtual engagement capabilities, being prepared to change enablement models in response to variable needs, and developing the leadership, skills and behaviors needed to thrive during change. What no-regret moves are part of your company's COVID-19 action plan?
For more ZS insights on the impact of COVID-19, visit zs.com/COVID19.