A year on: pandemic driven trends in HCP engagement

IQVIA’s John Procter explores why the industry should be paying attention to the changing HCP customer experience in the wake of COVID-19.

It is now just over a year since the WHO declared COVID-19 a global pandemic. For many nations it has been their first experience of responding to such a global emergency in living memory. It has also represented the first time that the sales operating models for global, mass-market pharmaceuticals have been severely and consistently disrupted around the world.

A year on, that disruption continues as third and fourth waves of cases affect many countries and vaccination rates vary markedly between nations. I wrote last year about the impacts and trends we at IQVIA had seen in HCP engagement across the globe, many of which have continued into 2021 as the pandemic effects continue to be felt.

As we reach the end of the first quarter of 2021, our customers continue to be challenged by the question of what they need to do to be successful whilst the uncertainty induced by pandemic disruption continues. Data from across the globe is increasingly giving clues as to the likely answer.

Managing uncertainty

The first thing to recognise is that we are still some way from an established ‘new normal’ and in most countries our industry remains in a transition period, somewhere between the initial ‘crisis response’ and an established future state (see Fig 1).

Fig 1. Adapted from Gartner 2020

Managing effectively during this period of uncertainty, both in terms of what is done and the way it is done, will likely set the trajectory for post pandemic performance. So, those companies who for example make a better job of introducing multi-channel HCP interactions in terms of volume delivered and perceived value to the HCP will have an advantage when it comes to deploying these channels in the re-imagined salesforce of the post-pandemic future. They will have the practical experience and customer insights necessary to build successful future strategies. More importantly, successful companies will also pay equal attention to the customer experience, a theme I will return to later.

The current state of promotional activity volumes

Back in October I used data on sales activity collected across multiple countries by IQVIA ChannelDynamics since the start of 2020 to identify three main themes for the impact on direct promotional activity with HCPs (data covers face to face detailing and meetings, postal and email, phone detailing, live and automated e-detailing, live and automated e-meetings). Using data from March 2021 I can update this picture:

1. Promotional activity volumes have recovered somewhat compared to a year ago but in most countries are still well below those pre-pandemic (Fig.2). Spain and the US are the only countries yet to see recovery to where they were a year ago, whilst Germany and Japan have actually increased to levels above where they were pre-pandemic. More granular data from the US demonstrates a wide variation across specialities, with oncology particularly lagging behind in total promotional activity.

% Change in promotional volume March’20 – March’21 Total activity volume compared to pre-pandemic
Brazil +22% down arrow
China +11% down arrow
France +8% down arrow
Germany +35%
Italy +26% down arrow
Japan +24%
Mexico +24% down arrow
Spain -13% down arrow
UK 0%
US -5% down arrow

Fig 2. Data source: IQVIA European Thought Leadership; ChannelDynamics 21/03/2021

2. The proportion of promotional activity conducted via channels other than face to face has fluctuated across the year to fill some of the gap. In Spain, other channels went from 12% of total activity in January 2020, to 94% in May and back to 62% in March 2021. Italy has seen a larger fluctuation, from 9% to 96% and back to 28% in March 2021. Meanwhile in the UK there has been virtually no change across the last 12 months, with other channels running around 95% of total promotional volume. Interestingly, the two countries showing growth in total promotional volume in March 2021 compared to pre-pandemic levels – Germany and Japan – have both experienced growth in already large non-personal interaction volumes. In Germany use of postal and email has grown to 82% of total promotional activity and in Japan automated e-detailing has risen to 61% of the total (see Fig 3).

Fig 3. Data source: IQVIA European Thought Leadership; ChannelDynamics 21/03/2021

3. Face to face activity levels have continued to recover across most countries, with the notable exception of the UK. The strongest recoveries have been seen in China, Brazil and Italy, with the latter coming close to the activity level pre-pandemic. In the US we continue to see significant variation across specialities with overall activity levels at 52% of their pre-pandemic levels (see Fig 4).

Fig 4. Data source: IQVIA Monitoring the Impact of COVID-19 on the US Pharmaceutical Market April 2021

Alongside this it is worth also taking note of what is happening with the use of remote interactions such as e-detailing, e-meetings and phone detailing. These multichannel engagements grew significantly in response to the pandemic across every country where we capture data and in most cases this increase has remained a feature of the promotional mix even as rates of face to face engagement have recovered. In the US latest data suggests the use of these channels is steady at around 23% of the promotional volume, up from just 2% pre pandemic. This supports the argument I made back in October that the increased use of these channels will likely continue in many countries even as face to face interactions recover, driven by increased experience and comfort with their use by pharma companies and HCPs.

Delivering success in 2021 and beyond

Learning from the experience of 2020 and its impact on healthcare systems around the globe, my colleague Sarah Rickwood has written about nine themes that will drive change in our industry in 2021 and beyond. Two of these are particularly pertinent to discussion of promotional channels and how to successfully practical deployment of resources.

The first is a focus on customer engagement impact. We have consistently seen feedback from HCPs that they have become more favourable to the use of remote engagements by pharma company representatives as their experience of their use has grown. In addition, the increased use of telehealth for patient consultations during the pandemic has further helped drive acceptance of online interactions in healthcare. Recent research conducted by IQVIA in the US demonstrates how perceptions have evolved since the beginning of 2020, when video enabled activity represented less than 1% of total promotional volume. Now, around a third of HCPs view videoconference interaction with pharma representatives as more valuable than face to face meetings (see Fig 5), and most expect their use to remain high due to factors such as convenience and policy changes in hospitals.

Fig 5. IQVIA Primary Market Research Feb 2021

Shifting to these channels is one thing, but doing it successfully is another. Inadequate subject matter, poor content delivery and a lack of online communications skills are all factors that can significantly affect the customer experience of these interactions. This can particularly be the case with younger and more digitally savvy HCPs who have trained in an online world and who from their personal experience will have high expectations of online delivered content.

So, shifting the focus of promotional activity to alternate channels alongside face to face is an important strategy for the industry but will not be a successful one without careful thought and preparation going into developing the right skills, content and approach to deliver an excellent experience that each HCP wants to repeat.

The second relevant theme concerns the non-COVID patient backlog that healthcare systems around the world will be facing for some time ahead and the associated impact on prescribing dynamics. As an example, in the US it is estimated that over one billion diagnostic visits were lost in 2020 and as many as 300 million will be lost in 20211, contributing to a projected reduction in prescription volumes of over 100 million in the first six months of the year. As well as creating significant opportunities for pharma to be active in helping to address this backlog, through initiatives such as supporting the use of telehealth, facilitating patient pathway changes or increasing the efficiency of diagnostic activity, it almost certainly will add to the access challenge. HCPs are likely to be overstretched and under-resourced in many key specialities, reducing the opportunities for, and likely duration of, promotional interactions.

In this context making effective use of every in-person or digitally enabled interaction with HCPs becomes critical for success. Finding the right combination of channels and skills of your salesforce to deliver the right messages to the right audience whilst ensuring an excellent HCP customer experience will be a significant challenge in increasingly time constrained healthcare systems.

Pay attention to customer experience

As our industry grapples with managing uncertainty whilst re-imagining promotional models in the post pandemic world I believe paying attention to the HCP customer experience is as important, if not more important, as thinking about the practicalities of channel mix.

The term ‘Omnichannel’ is increasingly used across our industry to describe the type of co-ordinated, integrated set of promotional activities companies will need to move towards in the ‘new reality’. Whilst this is undoubtedly true, it is important to recognise the risk of this creating low value noise for HCPs already overburdened with too much to catch-up on in too little time.

Smart use of the channel mix will be the differentiating factor. Paying attention to the changing way that HCPs want to receive information, segmenting approaches to recognise the differing needs of different specialties, of those comfortable using telehealth in everyday practice versus those who are not and making sure face to face visits are optimised for the right objective all become part of that smart approach.

Behind all of this are the most important resource companies have: the skills, experience, and commitment of their people. It is their job to bring the value of every product to patients and their HCPs, to use great communication, technology, data and analytics to bring this value to life in everyday practice. If they are to deliver a great HCP customer experience it is equally important for companies to pay attention to equipping them with the right tools and skills to be successful in this changed environment. 

The acceleration in the use of digitally enabled engagement we have seen in the last twelve months has challenged pharma to adapt at speed and with this speed comes risk – a risk that in their haste companies fail to pay attention to the importance of developing their people as much as they develop their methods, something that may ultimately determine success or failure. 

1 Source: IQVIA Medical Claims data analysis



IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. Powered by the IQVIA CORE™, IQVIA delivers unique and actionable insights at the intersection of large-scale analytics, transformative technology and extensive domain expertise, as well as execution capabilities. Formed through the merger of IMS Health and Quintiles, IQVIA has approximately 68,000 employees worldwide.

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About the author

John Procter

John Procter is VP offering development, IQVIA’s Contract Sales & Medical Solutions Global Business Unit (CSMS GBU)​. John leads global strategy and service development for IQVIA’s CSMS, covering patient services, medical affairs and contract sales.​ His expert knowledge in health solutions comes from 30 years in the healthcare industry. He joined Quintiles in October 2010 to run the Patient Services, Medical Affairs and Market Access business in the UK and then moved on to work in global service development and then head of Europe for these businesses. He took up his new role in the GBU global team in January 2018.​ Prior to joining Quintiles John spent eleven years at Pfizer.

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