Digital at the Intersection of Field Force and Oncologists

By: Jason Luis, EVP, Channel Strategy and Analytics, Evoke Group and Christine Franklin, Executive Director, The DHC Group

At this month’s DHC Summit, hosted at Genentech, attendees heard from Mandy Breckbill (Healthcare Executive Director, Genentech) and Jim Whitaker (VP, Business Consulting Lead, Veeva) on the rep experience, focusing on progress made since COVID, drawing on insights from across the industry, and discussing how to best reinforce ‘new’ engagement habits. As a follow-up to this dynamic session, we worked with Jim, Mandy, and fellow DHCG members, Evoke and Sermo, to conduct a survey of oncologists to further expand on the insights shared at Genentech. This research builds on the presentation key takeaways around efficiency challenges, HCP rep engagements, and potential barriers to future success. The survey was conducted using the Sermo RealTime platform with 50 currently practicing US oncologists.

Overall takeaway

A personalized, omnichannel approach is both a recognized and needed approach to providing Oncologists with the information to make well-informed clinical decisions. Pharma is doing a fair job at providing information as self-reported by Oncologists, and using technology to do so, but there is room for improvement. Understanding and responding to an Oncologist’s information channel preferences, and content needs can increase access to Oncologists, and improve the overall effectiveness of their interactions. While predicting the Next Best Action (NBA) has been the goal for the past few years, we as pharma should not solely focus on digital transformation, but rather lean into better listening, data collection, and better collaboration between sales and marketing to get us to the next stage in Pharma marketing’s evolutionary journey.

Situation

Pharma’s access to Oncologists has bounced back to pre-pandemic levels hovering around 70% being able to see reps. For years, there have been forecasts of declining access due to centralization of clinical decision from payers and the growing consolidation of influence and power of Integrated Delivery Networks (IDNs). There were also predictions that the post pandemic new normal would see bring new lows in access to Oncologists by pharma sales reps. In reality, there has not been mass declines, though a hybrid new-normal way of communication such as through the use of the phone, email and lastly video is key to meet Oncologists where and how they want to interact with pharma.

“Unfortunately, at my institution, they aren’t allowed to bring lunch for staff unless there’s CME attached, which there almost never is. I would take the time to make sure my folks get fed because food = morale booster. But barring that, I try to limit my interactions with pharma reps to scheduled appointments and after hours encounters so that I’m not ever at risk of rushing through a patient encounter, knowing that someone is waiting.”

Dr. Zachary Horne, Radiation Oncology and member of the Sermo Medical Advisory Board

46% Oncologists surveyed reported that only 1 sales rep visits their office in a typical week. The same percentage of 46% reporting seeing 1-2 reps a week, so access is not an issue. 58% of Oncologists surveyed reported that they only had made between 0-5 requests to a rep to contact them. While it is unclear whether reps are contacting Oncologists as frequently as appropriate and desired, it is clear that most Oncologists are not asking very many reps to contact them given how many different therapeutics there are available to them. These data points taken collectively suggest that pharma is doing an equitable job in helping Oncologists getting their information in the various ways they seek it out.

Oncologists prefer communicating with reps using email or phone calls about once a month. They are least likely to converse using text or Interactions are less likely through a video call or text. When meeting through a video conferencing app, Zoom and Microsoft teams are used.

Pharma is adequately providing patient educational information whether that is directly provided by the rep or asked for by the HCP. 64% of Oncologists also had a favorable view of a pharma reps’ ability to provide relevant patient education materials and 64% reported favorably in the ability to ask for these materials from pharma companies.

Complications

It is important to plan ahead when visiting Oncologists in person to be seen. 54% of the Oncologists surveyed reported that reps visit their office without an appointment, while 36% reported never seeing a rep who didn’t make one. 76% of Oncologists said that this would increase their chances of being seen. Other ways to increase the chances of being seen include bringing lunch, meeting before or after hours, or willingness to conduct the meeting using zoom or teams. Better yet, time the visit when the doctor has a need such as when they are about to see a new patient or will see a bolus of cases. Patient-triggered data from HCP review sites such as Healthgrades can be provided sales reps for example to get this intel.

Opportunities

Relationships are key, and most Oncologists would rather work with one rep. 58% of Oncologists surveyed preferred to work with one person that they know personally, compared to having a concierge who helps navigate the best person to answer their questions. Note that this is similar to the 62% of Oncologists who reported clinical knowledge of the medicine being detailed would improve interactions. Large pharma where multiple reps are employed for various products may want to take note of their account-based approaches when there are shared doctors among reps and to streamline the number of contacts an HCP has to work with.

Personalizing the experience is second only behind clinical knowledge of the medicine being detailed. 60% of Oncologists surveyed reported that understanding their specific content preferences and needs was the most asked for improvement to interactions with pharma sales representatives. Understanding and remembering these preferences through disciplined data collection practices is key (see previous point).

The initial introduction to a product will likely occur without a rep present and a hybrid, personalized multichannel strategy is key. It is unlikely today that an Oncologists wait for sales reps to come by to share what’s new given the use of pharmaceutical product websites, medical drug apps, and the pervasive use of Google throughout the workday. In fact, 70% reported in a recent survey that they prefer to self-navigated details where they view information on their own on a website. 64% preferred receiving information from pharma companies in a hybrid way – some resources digitally and some from a sales rep. 56% prefer a detail led by a sales rep in person and 44% preferred a co-browse via online video teleconferencing software such as Zoom, Teams, or Google Meets. Thus, the role of a pharma sales rep is increasingly to not introduce a product, but rather to provide deeper information or connect with an MSL to get into the science more deeply than can be covered on general website. Working with pre-commercialization teams such as Medical Affairs enable brands to get out ahead and plant the seeds that new medical innovations are coming.

Veeva’s Jim Whitaker agrees “HCP access is returning, but it is more selective and increasingly more virtual, with HCPs limiting the companies they decide to spend time with.  Companies who embrace hybrid engagement models have improved the quality of their interactions and relationships by maximizing the HCP’s time and consistently delivering relevant content.“. 

“If a rep comes in person, bringing physical information (ie flyers) makes sense. If requested, a followup email with digital materials may be helpful. The main issue with digital materials is just that, since it is so easy to massively spam these to thousands of people, I get dozens of emails a day and it becomes “noise” unless I am specifically looking for the information. Even when I receive digital communication, I usually end up printing them off to read them so physical copies from the get-go save me a step. The benefit of digital information is that it is easy to pull up again quickly if needed, whereas physical copies are often misplaced. I suspect this is the reason most Oncologists prefer a hybrid approach.”

Dr. Guy Jones, Radiation Medicine, Oncology and member of the Sermo Medical Advisory Board

People first, not digital-first content format with rep interactions. Just as with medical journals[1], the majority (64% of Oncologists) surveyed still prefer to receive their information in physically printed form. It is important then for marketing and sales organizations to align around the main objective in detailing which is engage Oncologists and speak to them how they wanted to be spoken. Let’s face it. Many years of organizations aligning around recording every nuance via eDetailing hasn’t gotten us very far in terms of improving personalize nor predictions such as next best action. Perhaps, we can drive better measurement compliance through incentivization by envisioning success, and not by mandating to do so.

Use of digital communications tool will likely grow. While the use of some of the mediums such as Video and text are low, pharma should keep an eye on them. 54% reported that usage will stay the same and 42% reported usage growing leaving only 4% reporting that they will be using digital tools less when meeting with a sales rep.

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