A true partnership evolves to serve the industry
Ten years ago pharmaceutical sales meant sending in multiple teams of representatives to secure scripts for blockbuster drugs. Today the sales environment has become much more complex. The loss of exclusivity for many blockbuster drugs, the shift to specialty medicines, the lack of physician access, the difficulties of selling within Integrated Delivery Networks (IDNs), the emphasis on patient centricity and “service beyond the pill,” the shift to smart phone and notepad technology – all while needing to lower sales costs – are just some of the reasons selling pharmaceuticals is truly challenging, even on a good day.
This ever-shifting sales landscape calls for a nimble, responsive sales approach–one often problematic for the behemoth infrastructures of many large pharmaceutical organizations and the experience level of emerging biotechnology firms. As a result, Commercial Services Partners offer a stronger than ever value proposition to the industry.
Once labeled at Contract Sales Organization (CSO) and used to provide mirrored details or handle lesser brands in their mature or declining phases, today’s commercial services partner has become a go-to resource in addressing a variety of needs. No longer viewed as simply a rental organization, today’s commercial services companies and their pharmaceutical clients have become true business partners bringing a full suite of commercial and clinical offerings to the physician and patient. As a result, commercial outsourcing prospects have risen and continue to do so. Cap Gemini projected 12% growth in revenues from 2008 to 2015 with continued escalation moving forward.(1) Let’s take a look at why.
The Old CSO Model Evolves to Meet Today’s Healthcare Marketplace
When the pharmaceutical industry reacted to the evolving sales environment with restructuring and layoffs, companies offering outsourced commercial services saw the opportunity to forge an alliance with their clients to better serve physicians and patients. And because outsourcing providers could leverage investments and resources across many clients, they were ideally poised to develop the teams and infrastructure needed. As a result, today’s commercial services partners are fielding a variety of field and non-personal teams to meet the needs of the pharmaceutical industry.
An outsourcing model gaining in popularity is that of the clinical nurse educator (CNE) where nurses are used to improve communication between the pharmaceutical company, prescribing physician and the patient population served. It is widely acknowledged that better communication fosters patient adherence, particularly with the increasing complexity of today’s specialty medicines, and in so doing, helps to keep down healthcare system costs. Nurses have been found to be particularly effective in helping patients and their caregivers better understand and use medications.
A case in point is an outsourced program offering an integrated, multi-touch patient care approach combining CNEs, contact center patient advocates and field representatives along with multi-channel interfaces. In this model, contact center patient advocates first assess patients on their non-adherence risk in order to tailor an appropriate program. Patients are then provided with in-home or contact center support by a CNE, depending on patient preference. Patients receive verbal and written and/or video instruction that can be viewed as needed by the patient and/or their caregivers. Follow up is scheduled and engagement monitored through back end databases subsequently reviewed with the physician. HIPAA compliant information is provided to the field representative to address pertinent scientific data in physician details. Such programs achieve strong results. One program resulted in a 3:1 ROI and patient and physician satisfaction scores for quality averaging 98%.
CNEs are also very effective in educating physicians and their staff on the efficacy and proper usage of a medication. In a recent engagement, a small, outsourced on-call CNE team integrated with a field sales team’s efforts to cover a broad geographic territory for a medicine used within hospitals. The nurses set up hospital staff meetings, educational seminars and in-services resulting in a 58% increase in sales over the prior year. Perhaps, even more telling, the field reps were very positive about the nurse team, recognizing the value this integrated approach brought to the field – a true endorsement of the changing models now working.
Responding to Access Limitations
Physician access is certainly key to addressing the healthcare needs of today’s patient. Although recent studies point to a slight improvement in access, this varies by specialty. According to a 2015 physician survey report by CMI/Compass, 19% of physicians indicated they would not see reps in person, down from 25% in 2014. This improved percentage varies by specialty, with PCPs, cardiologists and oncologists providing more access; gastroenterologists allowing more access but within restricted times; and dermatologists and OB/GYNs moving towards restricted access. (2)
With traditional rep access still difficult in most cases, and costly when one considers that 50% of the rep’s time is spent servicing the practice rather than in scientific details, commercial services partners have responded with a customer service model to improve access and costs per call.
These customer service representatives (CSR) have strong interpersonal and service skills and are given general training on the brands they represent. They are not required to have scientific pedigrees. The CSR team is used to cover short, face-to-face physician meetings on patient messages and services, with the more costly field representative covering scientific details. The CSR team also handles practice support functions. They drop off formulary updates, brand literature, scientific information, vouchers and product samples; notify the physician of CME meetings; train staff on patient usage where required; and provide tips for patients as well as other family members and caregivers.
The customer service team can cover multiple brands during a call, further reducing the cost per call relative to a traditional field rep. In a recent deployment where the CSR team covered two brands, their single call costs were only 15% of that of the field rep. By using the customer service team, the client improved its ability to stave off brand substitution for one product, thereby maintaining, and ultimately improving its brand level by several percentage points. In addition, it was able to increase the Rx share of the second product represented by the team – a growth brand. Practice reaction to the customer service team was also very favorable. (See figure 2.)
The 2015 CMI/Compass survey also reported a divergence of approaches to satisfy physician preferences. Physicians do prefer a live meeting when they have contact with a representative. This preference is followed by e-detailing, and then web conferencing/video calls, and finally, phone calls, depending on the specialty. These interface preferences clearly demonstrate the need for flexibility in the field where the rep can seize appropriate channels in reaching targets. Such flexibility requires the significant infrastructure investment available with today’s commercial services partners.
As a result, commercial services organizations continue to offer traditional field based teams and medical liaisons, with increased emphasis on key account managers to orchestrate personal and digital contact across a wide variety of assignments. Their ability to ramp up quickly with quality candidates in any specialty and provide full support across multiple channels, in most instances integrating with the client’s in-house sales force automation (SFA) platforms, has become extremely valuable to the industry. Commercial services partners also offer flexibility in deployment, providing different solutions to fit the assignment such as full and part-time representatives, service representatives and insides sales, as well as recruiting and onboarding services.
A recent case demonstrates this flexibility. Here the commercial services partner was hired to represent a mature brand. The client had been using a part-time sales team and was disappointed in sales results. Its plan was to convert to full-time coverage while refining geographic coverage. Ideally, the client wanted to deploy a mixture of full and part-time representatives as well as inside sales representatives to maximize budget, better target coverage and improve sales. The outsourcing partner converted the part-time sales force to full and part-time, recruiting new team members for vacancies. They also increased the inside sales team. As a result of this effort, there was 7% sales growth in the first six months of partnering. Subsequently, the commercial services partner fielded an 85-person customer service team, further enhancing the client’s market share.
The pharmaceutical industry has come to recognize that we are all in this together. And just as research, manufacturing and packaging are outsourced, the core sales and marketing functions are also benefitting from the resources commercial services partners offer. What makes us so attractive is our ability to leverage our resources and expertise across multiple clients, bringing the benefit of shared insights that might otherwise escape our clients. As a result of our broad exposure, we are able to offer innovative, solutions-based services that can be customized to the engagement, hiring top talent who can be rapidly onboarded and assimilated into the client culture — all without permanent investments or repercussions for the client when the assignment is over. That’s an extremely valuable and attractive proposition – no matter what the industry.
(1) Benoit Berthoux, “Disrupting the Traditional Commercial Model: The Rise and Evolution of Contract Sales Organizations in Life Sciences as published in Cap Gemini’s Accelerating Life Sciences Transformation Blog, May 2013. www.capgemini-consulting.com/blog/accelerating-life-sciences-transformation/2013/05/disrupting-the-traditional-commercial-model
(2) CMI/Compass, Inc, “What Prescribers Want and Need from Pharma – A Look Across 10 Specialties, ” Media Vitals™ 2015, pg. 13.