For decades intrepid pharma sales forces navigated the road network of Great Britain with little more than paper, pen and personality – hoping that one day the tools of their trade would mirror the cutting-edge science of the products they showcased. In recent years, the digital era has truly arrived, but as 2020 looms, big challenges still remain

It’s the year 2000 and you’re working in pharma sales. You’re in your Honda Accord, you’ve got Eminem playing on your multi-disk car stereo (Travis is next up, for reasons you cannot explain) and there’s a new Nokia 3310 mobile in your pocket (the temptation to play ‘Snake’, yet again, is almost overwhelming). Last night you saw The Matrix on video and there was all sorts of stuff about influential data and the possibilities of mobile phone technology. The future seems within touching distance. But, for the time being, you’ve got a list of appointments with healthcare professionals and some of them may even seem genuinely pleased to see you. Life, quite simply, does not get better than this!

In reality, it was tough on the road, 20 years ago. Pharma sales people were essentially pill pilgrims (pill-grims, if you will), with the task of spreading the word about life-transforming medicine, but with the stark limitations of the predigital age – often just a dog- eared script and a laptop which seemed to actively enjoy tormenting its owner.

Okay, we had dial-up internet, but that’s not much consolation when you’re stuck on the M25 and you have advanced one mile in the last 45 minutes. There were no smartphones, no iPads, no digitally enhanced visual aids, no real-time data, no wearables and no instant updates on clinical trials. The horse and cart had been upgraded to an Audi, but not much more. Truth be told, pharma sales was one of the toughest gigs in the industry.

Back then, people who had previously worked in pharma sales used to say that they had “carried the bag for 10, 15 or 20 years” – done their time. It was as if they had repented for a heinous felony committed in a previous life, but one which had now been settled through the sheer weight of miles and relentless enthusiasm, but also the ability to fundamentally change patient’s lives for the better. And, as those bags were carried across the hallowed tarmac of countless hospital car parks across Britain, it was patients that formed the prime motivation. It was always thus, and thus it will always be.

Magic moments in medicine

In the ‘tree’ of a treatment’s life, with its roots in the laboratory and its foliage representing new, improved and transformed lives, it is easy to forget the middle stages of growth, foundation and knowledge. Despite the digital health revolution giving rise to the endlessly curious and rebooted ‘Patient 2.0’, wider public awareness about the nurturing of products in the UK is sketchy to say the least. For many, their only frame of reference is Love and Other Drugs – a film which prescribes romantic japery through the prism of American pharma sales, and has no resemblance to the reality of visiting a British surgery in Slough or Doncaster on a bitterly cold Tuesday morning.

We should never underestimate the meeting of minds between pharma sales and HCPs, and the challenges that exist therein. After all, these liaisons constitute the precise centre point of a medicine’s journey – equidistant between science and patient. These exchanges underline one of the great anomalies of our time: the sector-defying pharma/NHS soap opera, currently being shown seven days a week and entirely reliant on relatively harmonious relations between its two stars.

The image of the sales representative, bringing news of treatments that may save lives, is one that perhaps most epitomises the omnipresent obstacles that pharma sales teams still face, even in the era of remote appointments, big data and grandiose technological advances. It remains a complex, finely balanced relationship, which exists outside social or even professional norms, such is the unique yin and yang structure of the pharma/NHS dynamic.

Fork in the road

As the collective pharma sales force gradually turned onto the digital superhighway, it began a new era for pharma sales. The direction of travel changed, and it was at once exciting and disorientating – after all, pharma sales had been in a routine for decades and was now entering a new, entirely alien ecosystem.

David Bennett, VP Business Development Leader, Deployment Solutions at Syneos Health, remembers some significant cultural shifts. “I had those early discussions with my team about whether we should provide everyone with iPads and digital visual aids,” he recalls. “During the early days HCPs were fascinated with these new ways and were often keen to take control of the iPad themselves. We didn’t know it at the time, but while the sales team was moving to the use of digital visual aids, the HCPs were already jumping to self-detailing, in some cases, literally!”

The rapid evolution of the digital world has changed how everyone in pharma sales operates, with head offices receiving a constant stream of activity data, in addition to an information feed relating to the interests and responses of HCPs. Clearly, the one- size-fits-all presentation has been well and truly consigned to the glove compartment of pharma past. The big challenge for pharma sales teams now lies in recognising the nuances of every encounter.

David explains: “We are all adopting multichannel marketing, with the knowledge that every HCP and product is different, and requires a personalised approach. Our methodology at Syneos Health is to ensure our clients integrate digital and field teams seamlessly, and therefore complement each other, and broaden the overall experience for HCPs.”

Sign of the times

Pharma sales’ immersion into the digital sphere has inevitably created some awkward terrain. While the wizardry of modern visual aids, the minutiae of instant data and the convenience of e-detailing are all changing the game, sales teams are not only having to keep up with the pace of tech, but also having to manage other external forces.

“The market has changed so much over the last ten years, and pharma has had to change with it,” reflects David. “Across both pharma and the NHS, budgets are tighter and more heavily scrutinised than ever before. We all want more for less.”

Consequently, teams are generally smaller, with larger geographical territories. Representatives now have to carefully consider where and how they spend their time. Correspondingly, David believes there has also been an interesting shift in strategy, by many companies, to focus on the smaller, more niche, therapeutic areas.

In spite of the numerous advantages of digital, it is notable that some of the ‘open road’ freedom, afforded to the ghosts of pharma past, has been traded-in for the instant gratification that has come to define the 21st Century. Pharma is now competing with an endless carousel of distraction and targeted marketing from elsewhere. As a result, time is a precious commodity and the human elements of curiosity and instinct have never been more important.

“Access is difficult, so today’s representatives use a variety of tools to communicate with their customers, but the most successful reps are the inquisitive ones,” says David. “It is not just about relaying information to HCPs, but asking relevant questions and listening to the answers. Over the years, I have always taught my teams to consider themselves ‘detectives’ – they need to gather evidence to develop solutions and remove the barriers which, in turn, increase product adoption.”

I believe in pharma Christmas

As sales teams reflect on another year, some will cast their minds back to the turn of the century and the sort of mind-boggling, futuristic leaps that have been made in the ensuing years – the sort of milestones which even Marty McFly would find unfathomable. But if we did enter ‘2021’ into the DeLorean interface, what would we find?

“Markets will have altered continuously and there will have been further legislative changes. Meanwhile, flexible and knowledgeable solutions will be on the increase,” concludes David. “Anticipating the future is paramount. Within our deployment solutions team we have the privilege of seeing the changes taking place before most pharma companies. On top of this, with the flexible and bespoke teams we provide, we are able to be nimble, reacting much quicker and more efficiently than most pharma companies. The pharma sales future will, inevitably, require an increasingly personalised approach.”

Evidently, there is much to ponder, as we all take the unpredictable sleigh ride into the last Christmas of the decade. Indeed, amid the blizzard of rampant consumerism and carnage of the general election, perhaps we should ask the disembodied (and usually unhelpful) voice in the corner, about “the true meaning of Christmas”. Alexa (or the father/mother-in-law, where applicable) may even surprise us, by speaking of an important journey, an incredible destination, a remarkable saviour and the spreading of hope to thousands of people.

These themes remind us of the ‘greatest story ever told’ but, in a different way, they also tell the story of what happens when pharma sales and NHS break bread...

Happy New Year, everyone.