Surprise pandemic lessons for pharma

Ask people in most western nations to think back to 2019 and consider what they would have said then about the potential impact of a pandemic on their everyday lives and my guess is that the vast majority of us would have had little insight into what would happen.

Residents of Southeast Asia who had experienced the SARS outbreak in 2002-04 would likely have had a much better understanding, but even they could not have imagined just how disorganised the response would be in many other parts the world. The unpredictability of the progress of the pandemic continues to affect our business and personal lives in many different ways. It also continues to surprise us.

Over the last year I have written regularly about what our team at IQVIA sees in the developing picture of commercial activities in the life sciences industry across the world. Throughout this journey there have been a number of surprising developments that I think have important implications and opportunities for our industry in the years ahead.

The vaccines’ success

I recall conversations with colleagues last March, in the early days of the pandemic, about our expectations of when effective vaccines might be available. Past experience led most of us to place an optimistic scenario at 12 months, but more realistically 18 months. How wrong we were.

It is testament to the talented people in our industry and the partners and governments they work alongside that we have a host of effective vaccines already providing millions with a high degree of protection against the virus. Few would have thought it possible to reduce what can be a decade long process of development down to as little as nine months, nor would many of us have predicted the level of positive collaboration between industry and governments to get these vaccines to patients quickly.

Across all our activities, this now presents a once in a generation opportunity for industry to re-position itself in the minds of patients, government, regulators and healthcare providers (HCP). We have shown ourselves to be partners in the solution to the biggest challenges in human health, something we have a duty to emphasise and amplify across everything we do. And we should be confident in representing our value to these same stakeholders.

So, does absence make the heart grow fonder?

For many of our HCP customers this value would appear to be something they have developed a better understanding of when it has been disrupted. The chart below comes from our ChannelDynamics survey for Europe, illustrating the change in attitudes of HCPs towards the different channels of communication used by companies for promotional activities over the period from January 2020 to January 2021. This shows a positive shift in perceptions of all channels irrespective of whether the total activity via the channel has risen during the pandemic (as for telephone and remote e-detailing) or reduced (face-to-face). At the same time every country in the survey saw an overall reduction in total promotional volumes during this period. This suggests HCPs developed a better understanding of the value of promotional activity as it reduced and where there was an increase in experience of any one channel, particularly remote engagement, they found this beneficial.

Indeed, results from a research survey we conducted with HCPs across four European countries supported this more positive view, with one UK Specialty Physician telling us: “I’ve got a lot more out of my interactions with the industry in the past six months than I’ve had before. Virtual interaction has been much more beneficial.”

It may come as a surprise to many, but others focused more on how they missed the personal interactions that come with face to face meetings. As a German Physician told us: “I would very much like personal contact to be maintained… it’s simply at a different level for me. It establishes a trusting relationship.”

The ongoing value of face to face interaction

Much has been written in the last year about how the shift to remote and on-line engagement throughout the pandemic is going to replace a lot of face-to-face engagement in the future. However, qualitative and quantitative data confirms that HCPs still highly value face-to-face interactions. In Italy, for example, face-to-face engagement continues to rise and return towards pre-pandemic levels compared to other channels. This suggests it will continue to be the most important channel post pandemic. Contrast this with the UK, where face-to-face volumes have not recovered even as lockdown restrictions have begun to ease. Even here, both the net promoter scores and feedback from our survey suggest that HCPs still view face-to-face activity positively and value the interaction with industry. Companies operating in the UK will need to think carefully about where face to face interactions can return and add most value and concentrate efforts on a true multi-channel engagement strategy.

Is the ‘new normal’ the ‘old normal’?

The UK is indeed a good example of where the future promotional channel mix is likely to look very different post pandemic. Italy on the other hand is likely to have a situation that looks quite similar to what came before, but with virtual and remote interactions playing a more significant part in a more mixed model. However, it might come as a surprise to many who made bold predictions about changing engagement models that in some countries the future may look very similar to the past. Let’s take Korea for example, where data suggests talk of a ‘new normal’ may well be redundant.

Data suggests Korea is somewhat of an outlier and most countries will likely end up in a place where face-to-face volumes are not what they were and other remote channels in particular become more prevalent to fill the gap. The fact that HCPs globally have had to adopt these channels more significantly as part of their everyday clinical practice (the speed and degree of acceptance of which has been a surprise in itself) will be a key factor in maintaining increased volumes. When it comes to decisions about where to spend promotional resources the main question for companies is going to be ‘when will the channel mix stabilise and what will it look like?’ Here we can draw on the experience from two large markets.

China is somewhat further on in its journey through the pandemic and whilst it has a very different system and pre-pandemic experience to countries like the US it may provide a useful benchmark to the speed and stabilisation of channel activity. In the US we have seen a gradual return of face to face activity over the last six months or so and this continues. At the same time remote engagements are falling as a percentage of the total but maintaining a level well above where they were pre-pandemic. So where will these levels stabilise?

In China face-to-face has been the predominant channel in the past and had recovered around 70% of its pre-pandemic level before the end of 2020. Latest data shows activity levels coming into June 2021 almost identical to where they were in November ’20, suggesting this may indeed be the ‘new normal’. If the US were to follow a similar pattern then we might expect face to face to stabilise at around 40% of total promotional volume sometime in the next three to four months.

Big changes to field forces?

Life Sciences companies across the globe will have already invested much time and effort considering the implications of the pandemic for their future business and how to respond. Our Consulting teams at IQVIA have experienced this first-hand, working with customers on challenges that span the product lifecycle. Surprisingly we have yet to see this translate into companies making very significant or large-scale changes to their sales forces. Here, our insight is more anecdotal than quantitative, but if we look at the feedback from our contract sales teams across the globe a pattern does seem to emerge of a cautious approach from our customers.

Speaking with a top ten pharma leadership team recently we had the same feedback, with their focus more on making small changes now whilst still debating if and when they should introduce fundamental changes to their commercial model. When I first wrote about the impact of the pandemic almost a year ago I indicated that we had observed customers taking a ‘wait and see’ approach and a reluctance to make major changes to sales team sizes in light of the ongoing uncertainty. My sense is that this continues, albeit with companies having a lot more data, insight and experience on which to draw for their decision-making process when they eventually get to it.

More surprises to come?

Looking ahead, the experience of the last 18 months may also provide an insight into a few additional surprises that might come along:

Field force sizes may not decline as predicted, partly driven by HCP interaction preferences, partly due to an improved understanding of the value they add and a reluctance from companies to reduce investment for fear of the competitive impact.
Total promotional volumes could well increase as HCPs take up more remote interactions as well as maintaining some face to face contact.
Alongside this, average call durations may increase, linked to the increased use of remote engagements. Conducting these at more convenient times for HCPs helps extend time spent on promotional and non-promotional contacts.
We see real innovation in HCP engagement being driven by emerging BioPharma and companies with little or no prior commercialisation experience who are not tied to pre-pandemic models of commercial engagement.
Collaborations with healthcare organisations and governments may flourish across the globe as they seek additional help from life sciences companies as trusted partners, creating a more favourable commercial environment.

Uncertainty linked to the pandemic will be with us for some time and making bold decisions against this backdrop will not be easy. However, thinking will eventually have to turn to positive action and those maintaining a ‘wait and see’ approach will eventually find it counter-productive. Indeed, companies can take positive action despite this uncertainty – as leadership theorist Peter Drucker is credited with saying “You cannot predict the future, but you can create it”.

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.

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.
Learn more at www.iqvia.com.

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