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Thought leadership and innovation for the Pharmaceutical Industry

The pandemic has, it will surprise no one, upended traditional ways of working for pharma’s Australian field force. “I don't think that we will ever go back to working the way we did pre-COVID,” says David Grolman, Medical Director at Pfizer Australia and New Zealand.” 

 

But arguably this is less of a revolution than it might first seem. The havoc and disruption it has wreaked has merely accelerated change that was happening anyway, much of it positive, says Matthew Britland, VP of the Australian Pharmaceutical medical and scientific Professionals Association (APPA). “It’s changed everything, but the medical and sales models were looking for an overhaul.”

 

“It’s obviously reduced our interactions with internal and external stakeholders. But it's also given medical leaders a unique opportunity to demonstrate the value of medical affairs on a magnitude we've never seen before and we're already seeing that in six months. Medical affairs really used to be almost a supportive function to the organisation and I think people have realised it’s now a fundamental division, a trusted partner.” 

 

The shift from commercial to medical

COVID-19 has accelerated the shift in how pharma was engaging with HCPs, professional organisations and even patients in Australia from a commercial to more of a medical footing, says Grolman. “We've seen bigger and bigger MSL teams in all the big companies.” 

 

This is in large part owing to the medical needs of HCPs moving from common chronic diseases – such as diabetes and hypertension –towards more complex medicine – monoclonal antibodies, biologics, anti-cancer drugs and treating rare diseases. These are areas which are more challenging for the traditional sales rep to negotiate. 

 

This means the traditional sales rep’s role had also been evolving in line with these trends. They are finding a new purpose as more educative partners in Australia, says Sophie Hibburd, Director, Ethics and Compliance at Medicines Australia, the body representing the country’s discovery-driven medicines industry. “Many companies have reduced or removed incentivising staff on sales and focused more on building engagements and relationships,” says Hibburd. 

 

Reps have a valuable role to play that is distinct from their colleagues in medical affairs, adds Hibburd. “There is still a need for industry to own the narrative about the products that they create.”

 

And this is where the rep comes in. “We've received feedback from HCPs individually and through our kindred organisations that the sales rep plays an important role in providing valuable and timely information,” she says. “In an HCP’s six-minute consultation cycle, they need to have different sources of information and it is still a very valuable bite-sized snapshot of information.”

 

Embracing digital and its reach

The sudden and dramatic disappearance of face-to-face interactions owing to the lockdown, and the corresponding rise in remote engagement in everything from field force visits through to congressing is the other big trend the field force is adapting to. “Everyone's been talking about digital for years, but they haven't really embraced it and now they've been forced to,” says Grolman.

 

This has also extended to activities including advisory boards and roundtables, says Mutsa Madondo, Medical Manager, Lung ImmunoOncology, AstraZeneca Australia and New Zealand, something there wouldn’t have been the appetite for pre-pandemic. 

 

While not all of it will stick when restrictions ease, such as advisory boards where the face-to-face component can be important in facilitating a deep conversation, the increased use of digital does have one big advantage for the field force: it helps overcome geography.

 

“When we're actually engaging people face-to-face, it seems to be a Melbourne, Sydney, Brisbane thing,” says Grolman. “Companies don't have the field force or head counts to be able to go to those secondary places like the Townsvilles and the Bendigos. Even Canberra – it’s the capital city, but it's a small centre and we don't get there very often. Whereas once you do things remotely and digitally you can get to everyone easily – everyone is online.” 

 

Bringing clear added value

Field force teams are now focusing hard on how to operate effectively in this sudden new digital era. The key to making digital engagement work is realising what its virtues are and maximising them. 

 

Doing things digitally can enhance the experience for stakeholders, by giving them access beyond the MSL interface, says Britland. “Now we can connect so many people to HCPs. For the past few months, we've had the full medical team – medical directors, advisors, MSLs, evidence generation, clinical operations –  talking to three, four, five, six HCPs in half an hour. It's the most fantastic use of time.” 

 

It is also important to be sympathetic to the experience of HCPS who are increasingly time poor, making it more important than ever to bring a clear added value, says Madondo. “My observation in terms of what is working is where there is a clear mutual value add, both for the clinician and the medical strategy.” 

 

Many of the medical relationships which are thriving in the virtual environment are existing, trusted partnerships, says Britland. “We've not really seen vast reduction in that engagement – the valued relationships have just changed medium.”

 

But it is also possible to make new connections digitally if you can break the ice. “HCPs have had a crash course in digital literacy, so we're all on the same playing field now,” says Britland. “All you need to do to build a relationship from scratch is to have a really good reason to start that relationship in the first place. If you go into that first virtual meeting and create an immense value, then they'll see you again.”

 

New skillsets required

In order to make the most of the field force’s potential, it is also important to realise that the 2020 environment demands a slightly different skillset. “I'm noticing an important capability for MSLs to have is strategic thinking,” says Madondo. “Being able to link the different preferences of the external stakeholder with the medical strategic imperatives, has to come from an MSL who can join the dots.” 

 

‘Softer’ skills are also really coming to the fore in medical, says Britland. “Historically the first thing people looked at was your qualifications. But if you've not got communication skills, emotional intelligence and business acumen, the qualifications are completely academic. 

 

“These have all been amplified, but particularly emotional intelligence, because when you're having digital interactions, if you can't pick up on the cues that person is giving on a video call, that interaction is going suffer.” 

 

The new sales and medical balance

The relative importance of sales and medical field force colleagues is still finding its level. There is always going to be a role for sales reps with established, trusted relationships with doctors and other HCPs across the country, says Grolman. 

 

While the sales rep is likely to remain the first port of call for a GP, he believes that specialists will go directly to medical. “I think the high-powered discussions will become predominantly medical. We’re already seeing that now with COVID-19. I get phoned by specialists throughout the country on a daily basis, so medical has become the point of contact for a lot of specialty groups.”

 

The extent to which digital interactions will become pervasive in Australia is up for debate. “I think we are 90% virtual whereas in January we were 90% physical and I think after this is all over it's probably going be somewhere in the region of 50/50,” says Britland. “The pendulum will go back, but nowhere near where it used to be.”