Adapting to the multichannel imperative: A special report

Pharma’s gradual evolution into digital-first commercial has become urgent in the COVID-19 world. A comprehensive multi-channel approach including the use of digital tools to enhance customer engagement will transform pharma sales.

After diagnosing a chronic disease, a treatment pathway is set and over time, all being well, the patient responds and returns to better health. 
Before the pandemic, pharma’s commercial leaders had been addressing their own slowly progressing disease - the increasing difficulty MRs have faced in reaching busy, overworked and ever more disengaged HCPs.
But a heart attack is a different matter, requiring urgent intervention.
COVID-19 has been that heart attack for pharma’s existing go-to-market strategy in Japan. The sudden stop in all face-to-face interactions has only been partially made up for by MRs’ adoption of remote engagement via phone, email and web conferencing. 
Suddenly pharma in Japan has found it needs all the digital capabilities the industry has been talking about in recent years. And it needs them now.
In this special report Reuters Events Pharma explores the challenges commercial departments in Japan face as they seek to make this rapid transition and looks at the processes, approaches and technologies they can adopt to ensure success.
The transformation this year has been stark, says Toshihiro Maeda, Head of Commercial Operations & Customer Experience at Bristol-Myers Squibb K.K. “90% of our promotion activities used to be face-to-face communication between HCPs and Medical Representative(MR) in the Japanese pharmaceutical industry, while the rest of the communication with HCPs was done via digital tools. Now some say that digital channels can replace MRs’ promotional activities and that 90% of promotional activities will be digital and 10% will be face-to-face.”
Bristol-Myers Squibb’s approach has completely changed from before the pandemic from thinking in terms of a ‘push’ promotion model and focusing on product key messages, doctors’ prescription behaviours and measuring Share Of Voice. 
Now it is seeking to understand doctors’ unmet needs much more closely, and is seeking to be more responsive to HCP needs. “We are trying to understand which information they really need since we cannot meet face to face now,” says Maeda. “We need to understand various HCPs’ real demand and respond to it.” 
It is then working to meet these needs via website enhancements, chatbots and more on-demand content, says Maeda.
While many other organisations will have also adapted in similar ways with amazing speed, no pharma organisation today truly has the digital, flexible, omnichannel capabilities in place today that enables them to engage with HCPs in the way they would like. 
As Maeda points out, the challenge is working out how best to adopt such capabilities over timelines that are now measured in weeks and months rather than years.
But what is on the one hand a pressing emergency is, on the other, a great opportunity. The pandemic has given pharma’s commercial leaders a clear imperative to invest in and build the capabilities to create a multichannel strategy that serves HCPs with what they want, when they want it, how they want it. 
Many leaders will find a lot of the cultural and budgetary barriers they may have faced before are no longer there as everyone works together to respond to unique circumstances. The challenge is now to build these capabilities to work for the long term, creating robust flexible and agile commercial capabilities that prove their worth long after the pandemic is over.
So what will the ideal omni-channel commercial set up look like? 
It will understand the customer deeply, on an individual level. It will serve them with the information they need in the format and medium they require it in, blending offline and online responses that are perfectly tailored to the needs and preferences of the individual doctor. 
The ultimate goal is for sales teams to operate within self-sustaining, agile feedback loops, via intelligent systems that can identify the best content for a particular doctor. They will deliver that automatically to them based on their preference gathered from field calls digitally, for example via mini surveys, that in turn drive the further and faster generation of insights.
In order to do this, commercial teams will need to achieve several things.
1. Gathering data and turning it into insights
These include:
Gaining a deep understanding of the customer journey and their unmet needs
The ability to gather and synthesise these insights so the organisation is ready to respond appropriately
All the information HCPs might need delivered in a format and at a time of the individual doctor’s choosing
An ability to create agile feedback loops that drive deeper, more granular customer knowledge at a faster pace
All this is easier described than actually achieved. There are multiple challenges to achieving such flexible, responsive commercial capabilities.
2. Overcoming organisational and technical roadblocks
These challenges will typically include:
A lack of data on customer needs
An inability to gather and integrate disparate data sets from organisational silos
An IT infrastructure that is not fit for purpose
A shortage of content and a narrow channel breadth
Once the challenges have been identified, commercial leaders must address the solutions. A successful digital response will need each of the following building blocks to be in place:
3. Executing on the plan: Getting the omnichannel strategy right
A process for two-way communication with HCPs
The creation of the digital backbone capable of serving HCPs on an omnichannel basis
Adopting the right digital tools for the job
The leadership capable of driving commercial excellence in an omnichannel context 
Winning support for change across the commercial function and redefining the role of the rep
Blending the digital and the personal to get the best from each
Below, we explore these topics in more detail.
1. Gathering data and turning it into insights
The opportunity to produce qualitative data and so better understand the efficacy (or otherwise) of particular sales initiatives has never been greater. Digital tools offer the scope to personalise and segment in ways that have not been possible until recently.
Applied in the right ways, such knowledge affords a wealth of dramatic improvements. Sales teams can get relevant content to customers faster, even automating some of this altogether. More intelligent systems can identify the best content for a particular doctor and deliver that automatically to them based on their preference.
Better use of digital tools should also mean sales and marketing efforts can dovetail much more effectively, with marketing sharing its campaign data so that sales colleagues can blend this with personalised data gathered remotely and face to face. 
“Digital channels can help MRs’ productivity by suggesting tailored promotion activities and required information for each HCP in real time,” says Shuji Adachi, Sales Manager of enterprise customer data platform Treasure Data. “This can be a benefit for businesses. If MRs or digital channels can provide useful and timely information to HCPs, it can also save their time and help them work efficiently.” 
“In Japan, traditionally, medical doctors have worked long hours, this has now become a pressing issue to be solved. If communication between pharma and HCPs is improved and done more efficiently, this can also solve the social issue of doctors’ long working time.”
This is something Bristol-Myers Squibb is working on, says Maeda. “We already integrate data from market research and local data from MRs’ promotion activities and identify which information HCPs really need. In the future, we would like to correct HCPs’ detailed information, such as personal preference, at the micro-level from a variety of internal and external sources. Then, we we will truly be able to tailor promotions for individual doctors.”
Pfizer too, is well into its own digital journey. Its strategy - called Customer Facing 2020 - aims to enhance the customer experience. A variety of initiatives come under the umbrella of a process it began in 2016. The aim is to truly embed a digital approach in the company culture.
One of its key aspects has been working to understand the needs of doctors and how best to then serve them, which it has been running in pilot form since 2018 and is now rolling out.
“The way we did it was simple,” says Fumihiko Tsutsumi, Director, Digital Channel Enablement Business Partner, Pfizer Japan Inc. “We created a customer journey map to map their unmet needs when it came to information. We then defined a message to disseminate and decided which channels were most suitable to disseminate those messages.”
Gathering data is also vital, says Tsutsumi. “For us data is an asset, so to have a good strategy about how to accumulate data is important.”
Crucially this is a core activity for Pfizer, not something to rely on outside partners for, he adds. “We should not rely on a third party. We have to be able to do that ourselves.”
Working in partnership with HCPs is also important in a world where they are no longer content to be passively served information, says Tsutsumi. “The way we did things at Pfizer in the past was the one-way, unilateral provision of information to physicians. Now the emphasis is on shifting to working with patients and physicians, how we can help them with adherence and how we also incorporate other stakeholders.”
Pfizer measures the success of its new approach by tracking Net Promoter Scores (NPS), which are a useful measure of the success of digital engagement, says Tsutsumi. “Our judgement is that rather than focusing on sales revenues…[using]…NPS, we can focus more on customer satisfaction than on pursuing sales revenues exclusively.”
Having a dedicated customer journey team is another lesson Pfizer has learned about developing a deeper customer understanding , says Tsutsumi. “By having a dedicated team, we can start working on the customer journey over several different products and product groups and the experiences from each can be shared very effectively. 
“It enables us to think from a customer centric perspective because we do not focus on a single product but rather on groups of product by therapeutic area. Even if the products are different, often the issues are common.”
2. Overcoming organisational and technical roadblocks
Gathering information is not enough. In order to turn this into actionable insights, data must be able to flow freely from wherever it is gathered and held to those who seek to analyse it to create value from it.
Yet, while data may be abundant in the organisation, it is often not accessible. The fragmentation of data, siloed in disparate databases and systems between medical affairs, marketing and sales, is a significant challenge to transformational change. “Where data is siloed, it cannot be used to drive more effective commercial promotion,” says Adachi. 
It is not unknown, for example, for a marketing department to have doctors’ contact email addresses, but not MRs as their activity logs are not connected, says Adachi. “Commercial data silos are not effectively integrated, which causes a loss of many opportunities to provide tailored promotion for individual HCPs.” 
Pharma companies may need to address a range of other data issues, adds Adachi. “One pharmaceutical company may fail to update its data warehouse regularly in real time, another might be struggling to integrate commercial data owing to a lack of professional engineers or experts. Another might struggle to create usable visualisations of its data analysis for commercial teams to learn from and act on.” 
An IT infrastructure, and culture that is not fit for purpose
It is an uncomfortable reality for many pharma organisations that their IT is simply not fit for the task at hand. Many systems are one or two decades old, says Torsten Kanisch, who describes himself as a ‘battle scarred commercial operations veteran’ of several leading pharma firms in Japan and beyond. “We need to unlock an agile IT infrastructure.”
Pharma companies in Japan are not alone here. An online survey of 800 people by Reuters Events Pharma in July 2019 revealed that only 2% of respondents consider their level of data sharing effective today. Meanwhile, 26% believe that meaningful technical capabilities to effectively share data are lacking. 
IT hardware and software is not the only issue either. Human factors are also holding back pharma from unlocking its data from silos. The same Reuters survey also found that two out of five industry executives consider cultural factors as the biggest hurdle facing pharma companies as they sought to overcome data silos.
A shortage of content and a narrow channel breadth
Creating compelling multi-channel stories that will serve doctors in this brave new digital on-demand world is a further challenge. Good customer engagement needs great marketing and compelling stories that bring the clinical data and key messages to life. Creating compelling, on-demand content entails significant effort and expense.
This is important in a world where HCPs are increasingly in control of what information they engage with and can tune out and ignore conventionally pushed commercial messaging. 
3. Executing on the plan: Getting the omnichannel strategy right
Thanks to new, flexible ways of managing data, enabled by cloud computing and flexible digital platforms, the twin challenges of data silos and ageing IT systems are ones that pharma can now overcome with greater ease than ever before. 
Modern data platforms, can solve many of these problems, by offering the means to integrate and analyze various data from different channels, such as CRM system, MA tools, information related to medical conference and so on, says Adachi. 
Expensive, multi-year IT projects that kill the chances of innovating should now be a thing of the past. It is no longer necessary to built a complex internal IT infrastructure and in a matter of weeks data sources can be freed from individual silos and complex analysis run on them, offering a fast time to insight.
Building in capabilities for data visualisation and the ability to tailor suggestions about commercial promotion activities for each individual HCP without the need for engineers or IT experts to get involved is a further benefit of these new platforms.
The speed of deployment onto such platforms has also become a key element in their appeal in the current circumstances, adds Adachi. "If pharmaceutical companies do it by themselves, it takes longer and that does not include the costs for recruiting appropriate experts.”
The role of the rep in a multichannel world
While the new digital capabilities will enable far better remote engagement, it is likely to result in the oft made prediction of the death of the rep. “Japan is a relationship focused country, says Kanisch. “The role of the sales rep will not go away.”
Nevertheless, commercial leaders will need to bring their MRs with them on the digital journey.  “If we do not convince the sales force, we will not change because it is the majority of our staff and our costs,” says Kanisch. “That means we need to convince and change the mindset of the district manger, the regional sales director, the national sales direct and the business unit head.” 
MRs will need to be persuaded of the need to evolve to suit the omni-channel world, says Kanisch. “Knowing your customer at a granular leave is critical…[and]…we need to get a lot of that data from our sales force, so our sales force needs to understand why we need that data, what we can do with it and they need to not feel threatened by it.”
Happily the current situation offers an ideal opportunity to repurpose the rep as a central element of it, says Igor Rudychev, Head, US Data & Innovations, Oncology Business Unit, AstraZeneca. “I see additional synergies between digital and field force. We’ve been talking about digital transformation for years and the current situation is helping us, navigating us to start a new digital transformation.
“We can’t digitise everything but we can build true omni channel where there is a strong interaction between old traditional promotional channels and the digital channels, where rep interactions become more digital.”
Reps can help focus and personalise omni-channel approaches, says Rudychev. “We currently send omni-channel communications more or less generically. We send communications to the whole segment. Reps should be able to make creative inputs, make recommendations to each individual physician because who knows HCPs better than that reps? They spend so much time with them.”
Blending the digital and the personal
Maeda agrees and predicts a more blended model is likely to offer the best of the capabilities of the digital and the human, resulting in an enhanced service. “We would like to realize a well-integrated commercial operation between digital and human (MRs), depending on individuals’ preferences,” he says. 
“An older doctor might prefer getting necessary information online rather than from MRs, for example. We need to understand each HCP’s preference and tailor our commercial promotion activities by preparing diverse promotional channels and contents.”
In general, digital cannot manage rare and unexpected cases either, adds Maeda, situations that MRs are well able to address with greater efficiency and at greater speed. “At the moment, MRs respond to HCPs’ rare and unusual requests or questions in person. There is sometimes no robust answer or a lack of evidence for a question from a doctor. In these cases, digital channels cannot handle it accordingly and need to learn more cases.”
Making your sales colleagues data gatherers
With enough data, commercial teams will create ever more personalised customer experiences.
Embedding effective digital practices so that sales teams actually end up gathering the right insights and then know how to act on them is therefore an imperative. It is therefore necessary to rethink how sales teams work with these new blended approaches to the digital and the personal and to train them appropriately.
Sales teams need to be trained to use CRM systems to best effect and there is much work to be done here. Too seldom commercial teams’ use of these systems does little to capture customer dialogues, to personalise an engagement or tie in other relevant data from marketing.
Finding Data Talent
Creating a truly omnichannel commercial capability goes beyond skilling up the sales and MRs, however. Finding and hiring the right talent with skillsets that can make the most of the new digital capabilities are essential too.
Some of the most in demand skills may be best brought into the organisation from beyond the pharma sector.
Design thinking, empathy and ideation are creative processes that senior data leaders from outside the industry can often bring to pharma organizations, which can help transform the culture of data sharing, says Kanisch.
In some cases, pharma will need to work to nurture entirely new roles and capabilities, he adds.
“We are seeing other new roles evolving - data scientists, multichannel coaches, digital content design experts, customer experience coordinators, innovation partnership scouts, AI and RPA evangelists - these are the kinds of expertise we need.”
Filling the content gap
And of course pharma also needs to meet the information needs of doctors. The sheer volume and variety of content that is required to create and maintain this digital engagement ecosystem entails a lot more investment beyond investing in IT platforms and the digital tools that sit on them. 
It entails a radical re-working of relationships with content creators, content agencies and also with regulatory groups to enable better tailored content to be created faster. “To attract more HCPs online, we need to create and update content across various channels, which respond to HCP demand in a timely manner,” says Maeda.
Creating the right tools to track and measure their consumption of it is also important, says Adachi. “It is necessary to trace the data in the digital channels. Surprisingly, only some pharma companies in Japan can manage it at this moment. 
“And pharma should analyse data and integrate with off-line channel data from MRs to realise more tailored promotion activities. Ideally they will also aggregate data from call centers or MSLs as well and integrate it with other data to make outcomes more accurate.”
For those sales leaders that succeed in getting the new rules of engagement right, the prizes are great.
The scope to use digital tools to gather better and more timely information, to enhance engagement and to build deeper understanding that improves the job the sales team does, is vast. 
It stands to reason that more relevant insights into the needs and preferences of doctors leads to better discussions with them, in turn generating valuable new insights. 
Better use of digital tools should also mean sales and marketing efforts can dovetail much more effectively, with marketing sharing its campaign data so that sales colleagues can blend it with personalised data gathered remotely and face to face.
Providing post webinar or conference portals offers another opportunity to use digital tools to engage more closely by offering relevant information and gather actionable insights, offering a ‘before, during and after’ customer experience that is sustained and consistent.
Thanks to new digital tools and the growth of rich data sets to which they can be applied, those able to understand their customers almost down to the individual will be able to quickly adapt and can expect to see accelerating returns from their sales and marketing efforts.
The positive feedback loops they establish, with results over weeks or even days in some cases, will leave less nimble rivals behind.