The spell-binding ‘Creation of Adam’ painting on the ceiling of the Sistine Chapel is arguably the most poignant ‘point of contact’ in visual arts history. In this lofty depiction, we see a reclining Adam and a hovering manifestation of holiness. It is, however, their cautiously unifying fingers we are drawn to – the touching point through which life itself is drawn (quite literally).
Its gloriousness lies in the subtlety, but also the profound message it brings – sustenance, hope, mankind, existence. While there is no evidence that Adam was a Key Account Manager, this fleeting, epiphanous meeting, and some of its profound themes, are shared whenever pharma sales folk break bread with their healthcare professional counterparts.
Holy alliance
As in Michelangelo’s masterpiece, the point of contact between pharma and the NHS is quite complicated, but also the conduit through which a kaleidoscope of possibilities can be realised, in the right hands. In its greatest moments, it is where a pharma product can blossom and thousands of lives, even millions, can find new resonance, new meaning.
And like that seminal painting, pharma sales is always in a process of reinvention and adaptation. In the last 15 years, the all-encompassing digital tsunami, and regular shifts in healthcare expectations, have inevitably brought about abundant change to the sales landscape, while also serving to reinforce some universal truths about what represents a good approach.
Pierre van Weperen, managing director, UK Commercial and Patient Solutions at Ashfield, explains: “The value in the relationship now lies in the additional benefit that a representative or organisation can bring to the table. This includes creating access, identifying patient populations, regulating usage and creating patient support programmes. There must be added value in the interaction between healthcare professionals and a company – understanding where that added value could be is precisely what modern pharma companies must focus on.”
Dan Spacie, president, Syneos Health Selling Solutions, Europe, has noticed cultural shifts across the pharmaverse, which require a much more expansive outlook. “A number of factors have combined to drive change in the pharma sales ecosystem,” he says. “We are witnessing the rise of the ‘omnichannel’ experience, through which a broader range of clients want to communicate with sales professionals and where the prevalence of data allows us to react faster.”
For all the change, Graham Hawthorn, managing director at CHASE, knows that some things remain sacred and to lose sight of them would be an act of folly: “It is undoubtedly true that the sales approach taken by pharma is regularly evolving, but it is equally true that there is one constant – quality people. We see different trends come in and out of vogue but, ultimately, the most successful sales teams always have great people at their core.”
And Graham is right, for decades pharma sales professionals have been the glove compartment warriors of industry. With the open road in front of them, a playlist of motivational rock music to accompany them and a list of appointments at the hospitals and surgeries of Great Britain to occupy them, they are the de facto late-stage navigators of treatment pathways. While the methods may have changed, they are still – in person or remotely – the trail-blazers for patient access and, by virtue of that, the yardstick by which a product is often judged. That sort of pressure comes with the territory (and, in my experience, it is why many do the job).
Heads and tales
“Selling into the NHS has become hugely complex. We are now seeing multi-tiered decision making, from clinical panels to pricing committees.”
Dan crystallises the conundrum of the pharma sales task force. While the creators of treatment, and those that deliver it, have formed two sides of the same healthcare coin, making it spin in perpetuity for over 70 years has been a constant challenge. When mapping a product’s route to patients and, ultimately, the utopia of ‘making a difference’, there isn’t an algorithm in the universe that can plot the NHS labyrinth, and Michelangelo would soon run out of patience (or ceiling space) if he ever tried to recreate the public health service maze.
“We are seeing a drive towards cost-saving and higher competitive pricing negotiations, along with a push to generics,” continues Dan. “In order to meet these new demands we must increase the use of scientific data, health economic data and patient-centricity.”
Making progress across uncertain terrain makes talent identification all the more essential, as Graham observes: “Due to time and financial pressures on the NHS, having a fundamental understanding of candidates, and what they bring to a role, is vitally important. Make no mistake, one size does not fit all. Getting a hiring decision wrong not only has significant short-term financial consequences, it will have a negative longer-term impact on sales.”
Pierre realises that local market access through clinical commissioning groups (CCGs) and formularies has also become one of the most vital factors influencing the work of pharma field forces, but also acknowledges that considerable tenacity is required in the increasingly restricted environment. “There is very little flexibility for HCPs to go outside the formulary dictate,” he says. “This means that making the case for certain products needs to be highly convincing. All specialties and capabilities within a company need to work together, as a well-conducted orchestra, creating maximum access for patients to the products they need. The sections of this orchestra require finely-tuned local market access, primary and secondary care reps, as well as medical advisors, medical science liaisons and support teams.”
By product
For many decades, the holy grail for sales teams is the ability to reflect the true majesty of a product, even without a continually updating narrative. In the past, reps were bound to an unchanging script and reliant on the force of optimism or improvisation to deliver a nuanced proposal. The missing element was a sense of ‘organic energy’ – the feeling that a product was, in real time, growing in stature, and thereby providing salespeople with the opportunity to add vital flourishes, colour or authority to their pitch.
The sense that a therapy is ‘alive’, with a pulse, has truly emerged in the last decade, providing sales professionals with a feeling that they are part of a compelling journey. As the result of a new data set, received on a smartphone on the morning of a meeting, the course of dialogue and, who knows, even the course of history, can change. Data, digital and edetailing milestones have issued in a different dimension for pharma sales and companies a seizing the day.
Ashfield’s 21st century operation runs many campaigns in real time: “We underpin all our activities with data, like practice level prescribing, targeting and segmentations,” notes Pierre. “At any given point in time, we have projects running with over 100 brands or companies across our channels, incorporating syndicated and dedicated reps, remote detailing, call centre activities, nurse support, adherence programmes and, of course, world class recruitment.”
CHASE, meanwhile, has consistently been motivated by its passion for people and that includes attracting talent into their Graduate Academy – a system which, by definition, keeps industry modern. “In recent years, many pharmaceutical companies realised that their talent pipelines were running dry,” reflects Graham. “One of the reasons for this was the switching off, in previous years, of graduate recruitment programmes. In response, companies are now actively hiring top commercial graduate talent. I’ve personally witnessed the quality of these hires, and the great news is that the future of our industry is in very safe hands.”
At Syneos Health the constant stream of fresh data involving the minutiae of a product adds new depth, allowing sales teams to transform their knowledge and ignite their relationships. Dan says: “We continually utilise data to drive our approach and ensure we maximise opportunities. Use of live data feeds allows us to work with clients to ensure that resources are focused and have optimal chance of impact. Technology also allows our reps to be truly omni-channel, serving clients’ needs in the right manner, on their terms.”
And so it has come to pass, pharma sales crews move with the times – they are formed of ebullient, never-say-die and approachable characters. They are, perhaps, the finest ‘refresh’ hitters in the business. These teams have produced the broad brushstrokes of cross-sector liaisons, the finer brushwork of the present tech-dominated status quo and, even with the manifest challenges, their future holds great promise – reach out and you can almost touch it.
