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Pfizer’s recently departed chief marketing officer was among the latest in a long line of C-level execs hired by pharma from the consumer world. Others previously held the title of chief digital officer and were brought in to jumpstart digital transformation.

These CDOs and CMOs have arguably achieved more success in transforming the first two of pharma’s major capabilities — drug discovery and manufacturing — than in the marketing of treatments.

“We are starting to see more chief marketing officers in the industry,” notes Publicis Health chief connected health officer Brendan Gallagher. “They’re not always called CMOs, but they have that role of lifting up digital marketing, and marketing in general, by its bootstraps. We see sometimes those individuals struggle to break legacy commercial models.”

In terms of setting up foundational transformation capabilities at big biopharmas, “It’s a slog every day,” Gallagher adds. “It’s hard to rip the tablecloth off and say that the flowers are still standing.” 

Omnichannel’s ‘last mile’

Industry sources say that’s due to a digital disconnect. There’s a gap in knowledge and understanding of commercial productivity at the board level at pharma, especially compared with what the market and landscape dynamic looks like down in the trenches of omnichannel and NPP delivery and engagement.

“Pharma has made great strides in implementing omnichannel infrastructure and capabilities in recent years, but the last mile — between headquarters and field — remains a yawning gap,” wrote Epsilon senior director of strategic healthcare consulting Bruce Grant in a recent thought piece.

Grant goes on to explain that the disconnect lies in the final interface between broad infrastructure or capabilities and actual user adoption. In other words, the field force is akin to omnichannel’s “last mile.” 

While new digital tools have been rolled out, not enough attention has been paid to coordinating capabilities and efforts. 

To wit: Over a three-month study period, only about a quarter (27%) of HCPs received both advertising and field communications, according to data compiled by Veeva’s Crossix and CRM units. Moreover, during that time frame, 73% of brand interaction with HCPs was “unsynchronized,” per a 2023 report by the cloud-based software firm.

The resulting fault lines are not only felt between pharma sales and marketing. Grant has observed a similar divide between the in-house medical unit and field-based medical science liaisons, as well as between corporate market-access groups and access teams negotiating with regional payers. 

These groups struggle to communicate, and the fallout negatively impacts campaigns, messaging and customer relationships. Unsurprisingly, such breakdowns have a lot to do with the historical silos between sales and marketing . 

“Sales is focused on personal promotion. Marketing is focused on those nonpersonal promotional engagements,” explains Dan Rizzo, global head of business consulting at Veeva Systems. “They’re effectively two separate towers. Sometimes, the communication isn’t always tight and it can feel like we’re engaging with HCPs on totally different or disconnected plans and engagement and data.”

Diving into the disconnect

Those legacy silos have proven quite resilient to change (more on that later). Among other reasons for the divide, there’s a kind of conceptual barrier in large pharma corporations, according to Mark Bard, founder of the Digital Health Coalition and co-founder/managing partner of advisory firm DHC Group.

“This is similar to how the C-suite brings in consultants to do a big-picture strategy, and then that gets pushed down the org chart to brands/marketers who question its value or logic,” he observes.

Those at the C-level may step up and declare where the organization needs to go, whether that involves becoming an AI-first organization in three years’ time or investing in technology to become more patient-centric. “Yet the detailed steps of, ‘Okay, in year one we’re going to do this; year two, we’re going to do that’ and so on, aren’t always super clear,” Gallagher acknowledges.

In other words: It’s one thing to make a bold, strategic bet on paper. It’s something entirely different to pull it through an entire organization.

“It’s not a straight line from C-level to brands,” notes Gallagher. “You have centers of excellence, therapeutic areas and country leads, all these people with mixed bags of accountability.”

Not only are the ones tasked with executing the digital plans left pondering whether their leaders really understand “how this gets done on the front lines” or “the challenges of making this work with the end customer.” According to Bard, company performance — the immediacy of a firm’s one- or two-year revenue and pipeline forecast — can push aside long-term change management.

And make no mistake: Onboarding a CRM stack among brand or marketing leads takes a great deal of change management. Quite often, in-house marketers just don’t have the bandwidth to flip the on switch without a good deal of training.

Even when someone new is brought in to lead the change, that person may arrive 

without a lot of legacy thinking around how the company operates. They often struggle to pull through the work they’re trying to get done, Gallagher notes.

Another reason for that is what he characterizes as “the wall of historical thinking.” 

“We’ve been talking for years about how sales reps are going away, and that more and more hospital systems are decreasing access,” he recalls. “But a detail aid might be the first thing we still work on on a brand level. So even these marketers who come in and try to disrupt the status quo run into this.” 

 All of which may be exacerbated by semantics and size differences. Phrases like omnichannel or NPP or even engagement mean different things to different people, depending on context and what they’re trying to accomplish. “I see an accountability and an ownership gap,” Gallagher says.

Chase Feiger, founder of life sciences digital commercialization firm Ostro, agrees, adding, “The bigger the company, the bigger the disconnect.”

Whereas digital marketing capabilities, platforms and technologies have enabled single-launch biotechs to be more turnkey, large biopharmas with huge commercial organizations employing hundreds of sales reps aren’t able to make data-driven decisions as quickly.

From ‘push’ to ‘pull’

From Feiger’s perspective, though, the story that the boardroom hears about the overall impact of commercial activity on prescribing — not just the sales organization’s narrative — is starting to change. It kind of has to.

“There are so many new technologies. You can’t expect the push model to be the only one that HCPs look for,” Feiger explains. He notes that doctors avail themselves of technology like anyone else; they’re using consumer platforms like DoorDash to order food while on duty and watching Netflix when their white coats and scrubs are off.

Take oncology, for example. With 44% of pharma’s clinical pipeline devoted to cancer drugs, many of which have multiple indications, it’s not realistic to expect a sales rep — or even an MSL, for that matter — to be conversant in multiple areas. Pharma must enable real-time, on-demand engagements for oncologists who need answers to product-related questions.

Marketers, for their part, need to become much more attentive to physicians’ informational needs. Many brand.com sites, Feiger notes, don’t personalize for clinicians. They don’t distinguish among specialties or amount of professional experience. 

Conversational AI is designed to foster convenience, but Feiger cites the all-too-familiar example of chatbots that fail on the job. As opposed to one-size-fits-all models, pharma’s digital assets should help clinicians get the information they’re looking for without having to hunt endlessly. 

“When the pull happens, it should be as frictionless and personalized for the doctor as possible,” Feiger urges.

To be sure, there have been some examples of connected engagement, in which sales, marketing and medical work together seamlessly. Evidence suggests such synchronization can boost brand touchpoints. 

According to Veeva, HCPs who engaged with both sales and marketing activities were exposed to double the number of digital touchpoints per month — and without losing in-person frequency. In turn, organizations that have designed sales call plans which coincide with a physician’s exposure to digital advertising saw a 23% lift in marketing effectiveness for those campaigns, versus all HCP campaigns studied.

In evolving from push to pull, though, life sciences marketing is about 10 years behind other industries. The issue, as always, is that everything has to be done in a regulatorily compliant manner and because marketers need to align boardrooms with brand managers.

Gallagher says he sees the disconnect narrowing — but adds a caveat.  “It’s just not happening as fast as everybody would like.”

One factor slowing the transition is the industry’s tendency to cling to outdated paradigms. As sales reps gain access to clinicians again post-COVID, there is a mistaken notion that reps have an extended shelf life. 

Even though research points to the contrary, the rep channel has the biggest impact when a drug first launches, and its effectiveness dips precipitously after that. Indeed, when McKinsey analyzed a random sample of 20 drugs launched in the U.S. between 2005 and 2008, after the first six months of launch only 15% had achieved a significant improvement in market share in their therapeutic area, the consultancy found.

Moreover, in the immediate aftermath of the pandemic, 60% of HCPs were accessible to biopharmas, many in hybrid fashion. Banking that a sizable portion of meetings with HCPs would stay that way post-COVID, bellwether Pfizer announced a sales staff draw-down in early 2022. 

This prediction has been borne out, at least partly. Relative to prior years, an increasing share of HCPs interacts with industry through in-person visits and/or televisits, an industry analysis shows. 

Yet Veeva, which performed the analysis, found that the post-pandemic access bubble has popped. The share of U.S.-based HCPs who engage with companies fell to 45% this year. That’s due to a number of factors, like the increasingly institutional nature of medicine. 

Along those lines, many companies have yet to make the necessary shifts precipitated by the consumerization of health. As consumers have assumed more control over their own care, telemedicine platforms have in some cases disintermediated the traditional patient/doctor relationship. 

Consider the D2C models recently launched by Eli Lilly and Pfizer, which sell medicines directly to consumers with migraines, respiratory illness and obesity. “Every single one of our clients is trying to do some form of direct-to-consumer,” Gallagher stresses.

Another outdated notion is what digital data truly influences C-level decision-makers. Ways of assessing marketing ROI are moving beyond simply counting the volume of eyeballs on digital content to something akin to a patient-engagement ROI, with things like patient services and/or connected health partnerships all laddering up. 

“Collectively as an industry, we want to move toward a place where we’re doing value-based engagements, where everybody wins when the patient wins,” Gallagher says. “Ultimately, those patient outcomes become the primary KPI for decision-making. The investments that C-level folks make are based on that.”

As the Inflation Reduction Act chips away at pharma’s blockbuster margins, some companies are trimming promotional budgets. They’re looking for other ways to drive efficiency and growth, and some may be changing the way they invest in marketing. Roles or functions that were once outsourced to agencies, consultants or other external partners may now be insourced. 

“Instead of paying us to execute a program, brand managers will pay us to work with them to stand up that capability,” Gallagher says, pointing to areas ranging from CRM to dynamic patient journeys to setting up data infrastructure.

‘More siloed than ever’

Clearly, companies need to bridge the HQ/field force divide for the overall success of their commercialization efforts. Omnichannel strategies offer a chance to do so. 

Designed to align various teams, systems and data to provide a unified view around the customer, omnichannel capabilities, in Grant’s words, offer the “building blocks of this bridge across the HQ/field last mile.”

Sales organizations are feeding frontline customer insight into NPP and other

kinds of white-space revenue generators. “We’re seeing some really important steps forward to where the rep is actually orchestrating the journey in some organizations,” Rizzo notes.

However, as marketing technology spreads, it’s spawned a new kind of siloing. In the last five or 10 years, Rizzo has seen various functions in pharma organizations take up point solutions. The result: It’s become more difficult to understand what’s happening across teams. 

Companies are struggling to scale their interactions due to too many point solutions and disconnected databases, he says. In other words, the lenses into what’s actually happening from a marketing engagement to a sales or a medical affairs engagement are disjointed.

Thus, physicians dealing with complex medications requiring different people to interact with them — reps and MSLs, for instance — are experiencing isolated interactions. They’re growing frustrated because it seems like field teams aren’t coordinating with one another. They’re all echoing the same talking points.

“These point solutions are allowing me to have more conversations and engagements and push communication than I had before as a physician,” Rizzo notes. “But it seems even more siloed than it’s ever been.”

The bottom line: Omnichannel, when its technological components are properly implemented, can bust the silos and foster organizational transformation. But bridging the digital disconnect requires, in Grant’s words, finding “common ground” between groups so that the platform is truly a shared tool.

“The majority of organizations are not connecting field promotions with digital advertising,” says Rizzo. “We’re seeing some glimmers of hope, but the majority of organizations are just not there yet.”