Accenture published a paper on the “Rebirth of the Pharmaceutical Sales Force”. Accenture states that he sales rep is not disappearing, but rather is evolving.  With a change in buyer profiles, the audience pharmaceutical reps are responsible for is becoming more complex.  This is especially true when you consider the role of Integrated Delivery Networks.  According to Accenture, IDNs own more than 60 percent of physician group practices.  It’s these IDNs that now define treatment protocols.


I reached out industry thought leader and Director at Nuvera Life Science Consulting, Brad Davidson.  As a social scientist with a background in linguistics and anthropology, Brad has studied the art and science of medicine and medical interactions, including rep interactions, in particular.  Now focused on helping companies optimize the customer experience, Brad was very frank about the role IDNs can and should play in optimizing that patient or caregiver experience.  We discussed the role of IDNs, their impact on pharma, and considerations for the industry moving forward. 14d43b8.jpg


What is the impact of IDNs on treatment?

We’ve always thought about the clinician as a decision-maker but they don’t make as many decisions as they used to. What people don’t fully understand is that we’re in an era of full on de-professionalization, where professionals can no longer act as they see fit in a vacuum. .    In the past, doctors selected doctors and doctors trained doctors, and doctors were free to prescribe however they wanted to prescribe—no one challenged them.  But today, doctors don’t run hospitals anymore, hospital administrators do.  The individual experts are no longer in charge of the decisions, the system increasingly is.  Today, even if the physician writes a prescription, if it’s not on label the patient likely won’t get it.


We’ve moved to a system-based process and we’ve come to despise expertise.  We’ve created a push-pull system where doctors have very little autonomy. The push is that doctors have become, essentially, employees in many cases, not independent professionals, and thisplays into therapy selection.  The pull is better data--companies can run real-world experiments in what works and what doesn’t, that extend beyond the limits of clinical trials and leverage financial modeling, health economics modeling, and experiential modeling.  No one doctor can keep up with all of these trials and all of this data.  You don’t want one physician treating patients eleven years behind the curve, and in an integrated system, you can’t do it anyway. To manage the emerging level of data, systems are needed for decision making.


What is the impact of IDNs on the sales model?

The industry as a whole is a laggard in making changes to their business model and is struggling with the transactional nature of the business.  Younger HCPs would rather self-educate via edetailing at home in the evening.  This leaves many companies wondering “how do we keep the field force busy?”


Small biotech companies are performing better because they didn’t grow up in the age of large sales forces free to walk the halls.  There are also some medical device companies that are getting back to a field force focus to train clinicians on device usage, because that fits an educational need. 


The big thing, I think, when selling to the IDNs is to be able to answer the “prove it” and “show me” questions that tend to be their response.  Pilot programs are trending as is the desire for content relevant to their interests.  There’s a huge gap in content delivered.  .


If pharmaceutical sales reps are going to succeed, they must be able to talk about experiential outcomes.


How can pharmaceutical companies adjust for the role of IDNs?

  1. Communicate more aggressively to patients.  Patients are taking more responsibility for their health and treatment.  They are researching their condition and evaluating treatment options.  Companies cannot discount the role of the patient.
  2. Talk to new audiences.   Companies that are best-in-class are dedicating resources and effort to identifying underutilized audiences.  There’s an example of one company that has an entire sales force targeted to pathologist. While the pathologists don’t make decisions, this company is trying to build relationships with those people who have lived in the hospital basement looking at slides because the tests pathologists run are determining treatment algorithms.  Remember that modeling is being done by payers, health economics research groups, and chief medical officers.  Influencers to those audience groups are key.
  3. Communicate to payers.  Communicate value regarding health data outcomes and budget impact models.  Call on new people and bring new data to the conversation.
  4. Improve your segmentation.  Consider segmentation by context.  Is your HCP audience constrained by formulary?  If so, don’t waste efforts on those outside of the approved formulary. Work more at a policy level.  Understand the decision-making algorithms about how and when to treat.


The shift in decision-making is having an impact on both the marketing and sales models for life science companies. More than ever, companies must segment, target, and personalize communications and educational information. Companies must understand the needs of defined audiences, and identify the opportunity in new audience segments. Sales must also have insight into the behavior and interests of each of these audiences, as well as the relationships across key influencers.


Brad concluded our discussion with this piece of advice; “We’re moving to algorithmic advice.  But it’s becoming impersonal.  The group that can tie algorithmic advice to personal experience will win.”


How is your organization working to personalize the oftentimes impersonal experience?