Please note, this article contains references to Ashfield Engage which has now become Inizio Engage
Even as recently as the first decade of the 21st century, the pharmaceutical marketplace was a simpler environment. Large pharma companies primarily engaged with HCPs face-to-face via sales reps and medical science liaisons (MSLs). Patients visited their doctors in their respective offices or clinics. Payers were faced with fewer, high-cost speciality drugs to consider for reimbursement. Indeed, only 27% of spending on medicines in the U.S. in 2010 was for speciality medications, compared to 53% of spending in 2021; a growth mostly attributable to autoimmune and oncology therapies.1
However, in recent years the landscape has evolved significantly. In many ways, the pandemic accelerated changes that had been already been taking place in the marketplace, and has compounded the challenges faced by pharmaceutical companies in gaining physician, and ultimately patient, access.
Big pharma companies are witnessing increasing competition from smaller, nimbler biopharmaceutical firms. The blockbuster drugs serving large populations on which many pharmaceutical companies relied to generate profits, have lost exclusivity and lower priced generic competitors have significantly eroded their market share. Speciality medicines aimed at patients with rare diseases are now the focus of the industry, but they come with significant development, go-to-market and patient price tags.
Many new drug approvals or uses have been slowed down as agencies struggle to rebound from strains experienced during the pandemic. Indeed, the UK is working to rebound from a 25% drop in Health Technology Appraisal publications in 2020 vs. the 2015-2019 average.2 Further compounding this strain on pharma, more and more studies are emerging on the number of patients who went undiagnosed during the pandemic with serious and/or life-threatening conditions now requiring medication and patient support.
During the COVID pandemic, the remote physician details and digital interactions that had begun to gain traction prior to the pandemic became the norm, and are still very much in favor with many physicians. Patients also turned to telehealth visits and home treatment and self-administration, often successfully supported virtually by clinical educators. Indeed, according to a study published by McKinsey in 2021, telehealth visits in the U.S. have now stabilized at a 38X greater rate than pre-pandemic levels.3 Further, patients are becoming more savvy and controlling of their healthcare experience, often requiring a more personalized healthcare approach where relevant information is available instantly through the channel of their choice.
Finally, access to medication, particularly to speciality medicines and controlled substances, is becoming increasingly difficult. According to research by ZS Associates, payers expect their budgets to be cut by 15-25% as a result of the pandemic.4
Payers, both private and public, and the many intermediaries along the distribution chain, control both the flow and eventual patient price, often necessitating significant couponing and manufacturer rebates.
Even with the easing of COVID restrictions by most countries now in mid-2022, the trends established during the lockdown and subsequent periods have gained acceptance. It is becoming increasingly clear that a more hybrid commercialization model is here to stay. In light of this, any pharmaceutical company looking to launch products in today’s changed and uncertain environment faces new, significant challenges and opportunities that should be addressed to achieve successful commercialisation.
Today’s patient lives in a world surrounded by messaging that often just becomes background noise. To overcome this static and truly engage with the patient, one should work to Identify and then execute strategies based on moments that matter in the patient’s disease journey. In so doing, one provides messaging that will resonate and engage that patient. Nuvera, an Ashfield Engage company, works with pharma client companies to assist in optimum engagement strategies. They specialize in partnering with life science companies to define and align patient, care partner, and HCP needs with organizational capabilities in order to deliver an enhanced treatment experience.
Following a four-step methodology entitled the Treatment Experience Blueprint©, Nuvera works to clearly align the cross functional teams within a life sciences company around a consistent understanding, focus, and development of strategic and tactical plans that build the capabilities for putting the patient front and centre. Working to position the organization around a “single source of truth”, the Treatment Experience Blueprint integrates multiple inputs – both internal and external – and takes into account the various stakeholders, activities and steps resulting in a holistic treatment experience plan. By giving cross functional groups the ability to gain alignment and momentum, it allows organizations to take the appropriate action to build the support capabilities that best meet the needs of patients and providers.
Data today is key to meaningful decision making and engagement. Yet, pharma is often faced with disaggregated data from disparate sources, thereby hampered from using it to its full potential. The analytics leading to actionable insights on customers and brand performance requires the right sets of integrated data at the right stages.
In 2022, Ashfield Engage acquired PROPENSITY4, a data analytics company specializing in optimizing omnichannel outreach and engagement through the integration of data, analytics and evidence-driven insights. PROPENSITY4 has the capability to transform disparate data into integrated insight platforms on customers, performance, promotion and relationships to best meet objectives. As a result, pharma gets a big picture approach to drive strategies across payers, patients and healthcare professionals.
Recently, they helped one of our clients who wanted to optimize resources while maximizing the growth potential of its product portfolio across various life cycle stages.
We integrated the analytics from promotion response modelling, most probable forecast modelling, performance tracking and resource re-optimization with customer archetypes, channel mix, frequency of contact and messaging. This integration of data with customer types and engagement tactics allowed us to identify, deploy, track and refine the ideal sales, service and remote channel mix for each customer archetype leading to a double-digit return on investment within one year.
“At Ashfield Engage, we support our clients by designing exceptional experiences. These are delivered through live and digital resources that work in harmony across specialist areas, and which are orchestrated by data and analytics capabilities.”
– Christopher Savage, Senior Vice President, Global Strategy
New product launches require a highly coordinated, cross-functional effort across medical affairs, market access, patient support services, commercial operations, marketing and more. Being able to have cross-functional expertise dedicated to your brand when you need it is a huge advantage, yet not all companies have the capability or resources to do so. Whether a company is well established or emerging in the marketplace, the challenge resides in knowing how to best allocate the precious resources available to create the biggest impact.
Working with strategic partners having capabilities across the commercialization spectrum can help companies achieve their desired outcomes with the resources they have available. A case in point is a pharma company looking to expand across Europe while also preparing for new product launches in several countries where they had no existing presence. Ashfield Engage helped them enact a holistic approach to the expansion and launches, including marketing, sales, general management, medico-legal sign-off and distribution operations, as well as establishing a pan-EU customer relationship management service.
Due to our capabilities in multiple operational areas, we were able to advise the best cross-functional solutions for each country, create a menu of joined-up services and then manage the entire, coordinated approach at a central level. We established a commercial, medical and marketing presence in ten countries, which led to significantly higher product sales than the client had targeted.
Although HCP engagement through digital channels was becoming more acceptable prior to the pandemic, no one was prepared for the complete transformation brought on by COVID-19. Despite the lifting of most restrictions throughout the world, and the ability once again for sales reps and MSLs to meet face-to-face with healthcare professionals, the HCP engagement landscape has fundamentally changed. More and more physicians are willing to see their sales reps virtually or obtain the information they need via digital channels. Patients are now far more willing to work with a virtual interaction as well.
As a result, one’s commercialization strategy must take into account omnichannel outreach and develop sales, MSL and patient support teams that are effective in both a face-to-face and digital scenario. This requires not only proper training with the interpersonal and technological skills, but an ability to understand the nuances and limitations of each channel using content that is adapted to each.
One size definitely no longer fits all, and with the data and analytical insights now available on targets and channel usage, pharma companies can build a deep understanding of customers and their preferences in order to customize engagement tactics while maximizing resources and minimizing costs.
For instance, in a program designed with our client serving a specific rare disease population, we wanted to help patients better understand and adhere to their medication and advise HCPs on the therapy and the support available to patients. Due to the relatively small patient population spread across a wide geography, coupled with tight promotional budgets, we worked with the client to develop some omnichannel strategies with patients and prescribing HCPs.
To identify the characteristics of the patient types being served, we first posed some basic onboarding questions which were presented to them on the therapy website.
The subsequent patient outreach programs were then designed to specifically address the characteristics of the patient type. Examples included guiding them to reach a treatment goal, or offering a multitude of ways to continue to track progress and take record of goals and milestones achieved. Educational information about their medication and how it can help with their condition was also provided where needed. To optimize engagement in the email program, we used data and AI to do subject line testing in order to deliver the most eye-catching wording to drive engagement with the email.
To round out this program, we also developed email programs for the HCPs in this community. These were designed to create awareness of the treatment options with this disorder. Again, outreach met the characteristic profile of the target. For those unaware of the therapy, emails discussed its availability and how it might help their patients. For those already prescribing the therapy, we provided more detailed information highlighting the medication’s benefits and also educated them to the existing support programs available to help their patient remain adherent to the therapy.
Ultimately, today’s commercial models must be highly agile, able to quickly respond to rapidly changing dynamics, and be truly customer- and patient-centric. Technology has a vital role, but companies and their commercial leadership teams need to understand that their brands require an insight-driven bespoke, nuanced approach to how they best leverage different channels to achieve desired outcomes.
“Ashfield Engage, with our companies Nuvera, PROPENSITY4 and The Creative Engagement Group, works with clients to fully understand customer needs and preferences, design exceptional experiences and deliver true omnichannel engagement. We can also help build internal sales, medical and patient engagement teams in-house to support commercialization strategies.”
– Isobel Donaldson, Head of Strategy, Europe
The rise in specialty and rare disease medicines and their inherent complexities of access and administration has created a strong need for patient support to drive adherence and better patient outcomes. Couple this with a healthcare landscape rife with post-pandemic exhaustion, and pharma companies have an opportunity to provide added patient-centric services to help differentiate their brands. These can include creating apps or educational materials to support disease management and lifestyle changes, running round-the-clock helplines or employing clinical educators to ensure adherence.
However, creating and managing these types of services in-house can be costly and impractical. Outsourcing to a partner with the skills and infrastructure already in place can prove more cost effective and provide the flexibility to scale based on product performance.
Ashfield Engage offers tailored patient support services to reinforce brand value and create better healthcare outcomes. Drawing upon two decades of experience, we offer field-based and contact center clinical educators and omnichannel content delivery supported by Trak360, a proprietary digital health platform creating a holistic view of the patient to deliver desired content and report on progress to client, care partner and HCP.
In one of our patient support programs, we hired a team of 84 highly skilled clinical educators. Their remit was to educate patients on their medication and disease-state and train the patients on administering the medication so they could have a positive treatment experience with their new therapy. This hybrid team of full-time, part-time and on-demand clinical educators worked across various territories providing engagement and education to patients and HCPs. Over three years, they enrolled over 35,000 patients into the support program, with independent audits showing a significant increase in treatment adherence and recording a 97% customer satisfaction score.
Despite all the changes in the market over the past two decades, one constant has been the ‘six-month rule’ – that being new products establish their success within those critical first months of post-launch.
Being well-prepared for launch is hugely important. It is essential to have the insights and strategy; messages; sales, MSL and patient-engagement teams all lined up and ready to go. Such depth of coverage stretches the resources of most, and having a partner with the capability to help hit the ground running is crucial to success.
An emerging biopharma client bringing its first product-to-market needed just such support. Using a consultative strategic approach we worked with the client to forecast, segment their customer targets, design their territories and size their sales force; build their data warehouse integrating more than 35 different data sources to support med affairs, market access, sales, marketing and trade/distribution; develop custom reporting and advanced analytics; hire, onboard and train a field and virtual field force; deploy an MSL team, develop and deploy a CRM; and conduct a national launch meeting.
For those who need a rapid build to launch, Ashfield Engage has the capabilities to meet global launch requirements. For instance, during the pandemic, one of our clients was launching a COVID-19 vaccine after an unprecedented development period. They needed a partner to support a massive, fast-paced global roll-out across more than 40 countries. Coordinating our expertise across Ashfield Engage, we quickly created a package of commercial and scientific engagement services. This included organizing more than a dozen virtual educational seminars and symposia, creating supporting literature, hiring teams of medical science liaisons, running global customer contact centers handling 1,500 calls a day across 32 languages, and providing a comprehensive medical communications program for a range of audiences.
We’re in a new and uncertain period. The market has changed and pharmaceutical companies face complex challenges that need to be carefully navigated. By pairing the smart use of data and analytics, a cross-functional approach, the ability to act with speed and flexibility to engage across multiple channels, coupled with a range of value-added services to differentiate the product, the product launch will have the best possible chance of commercial success.
“The reason we partnered with Ashfield Engage is because we’re small and we don’t have the infrastructure to start with. We need them because they have this infrastructure already built and that helps us tremendously.”
– VP of Sales, US
Dr. Joachim Hirt (M.A.)
Mit circa 30 Pharma-Professionals war das Vitamin C Frühstücksevent von Inizio Engage und ysura ein voller Erfolg.
Read moreDr. Joseph Mejia MD, a dedicated Medical Science Liaison shares his passion for learning, relationships with KOLs and leaving a positive impact.
Read more
Steve Fields
Viewpoints through the lens of Field Management and HR Business Partner
Read more