17-19 - INDUSTRY: Moving on up

In the January edition of PharmaTimes I explored how pharma is still struggling with customer-centricity and shared examples of organisations pushing the boundaries of what’s possible when you get serious about customer needs.

The article was welcomed by the community; job done. Only, it isn’t. Far from it. Like my dog, Tommy, with his bone (or rather, a revolting rubber doughnut thing), I can’t let it go. An organisation’s ability to meet actual customer and patient needs is too fundamentally important for everyone. So, here comes round two. Ding ding.

Pharmaceutical companies have four main stakeholder groups – shareholders, employees, patients and customers – with healthcare providers, regulators and policymakers, delivering a potential fifth. Let’s take a quick look at what kind of attention each group gets.

Shareholders – a 2020 study found that pharma companies significantly outperform other industries in the S&P 500 Index on revenue and profit metrics in the longterm. Check.

Employees – there are three pharma companies in the latest global top 25 best places to work ranking, which is a positive indication. Check.

I focused on the values espoused by the 20 largest pharma companies, to get an indication of what they say they care about.

Patients – of the 76 values in total, there were five hits for ‘patient-focus/value/care’ etc. Half-check at best.

Customers – ‘customers’ or ‘healthcare providers or systems’ etc. are mentioned once. Once! No check. This really concerns me. I’ll be generous and blame my methodology. Let’s look at some other data, like metrics.

Metrics are not to be taken lightly. W Edwards Deming warned us decades ago about obsessing over targets and measurement: “When management sets targets and makes people’s jobs dependent on meeting them, they will likely meet the targets – even if they have to destroy the enterprise to do it.”

There’s plenty of evidence to support this – from traffic wardens fabricating evidence to meet their ticketing targets – to bank staff selling unsuitable products to ‘make the numbers’ (contributing to a global financial meltdown in the process).

What does it look like in pharma? “Pharma is obsessed with metrics. It’s not the only industry but it is more focused on measuring activity than others. Things like call rate and share of voice have become institutionalised,” notes Paul Frith, Partner at Rubica Change & Analytics, who works with some of the biggest names in pharma.

Indeed, that’s supported by the data Rubica has gathered. It asked global pharma companies how they measure commercial success and in considering four stages of ‘maturity’, almost 70% self-report that they are in Stage 2.

That means that they focus on sales, share and growth measures. They count the number of touchpoints (coverage and frequency) and use some measures of potential impact (share of voice or intent to prescribe).

That sounds like more shareholder focus to me. Why this focus though? Frith again, “Pharma companies struggle to measure what they are really aiming for – their impact on patient quality of life etc so they measure what they can, and what’s easy – activity of individuals, but with no real understand of that activity or whether it’s actually causing the desired results.

“It’s also because in times gone by, getting in front of a doctor as often as possible, could drive sales because the HCP had freer hands in deciding which drugs to prescribe. This is still the case in some markets – where the power is still with individual prescribers over the payers – but in high governance markets or complicated healthcare systems like much of Europe, it’s often a wasted effort”.

Dom Knights, Director of Customer Engagement with the nyzyme group, is seeing a return to this in the UK: “In a post-pandemic phase of flux and uncertainty, some pharma companies have tried to revert to traditional activity and vanity metrics, which don’t really serve the current NHS customer effectively or add value.”

I can certainly empathise. Craving certainty, after the turbulence of recent years, however, is like eating a huge tub of ice cream, it might feel good at the time, but it’s probably not recommended in the long run. So, what can we do instead of chasing unhelpful numbers?

People from every industry I have worked with have told me that what they do is special. Most of the time, what they mean is ‘I am going to pretend to myself and others that the alternative ways of working and behaving from other industries can’t work, because I am scared of changing’.

I am going to grant a concession to pharma though, because it is special in one sense, which is the dominance of the intermediary between producer (pharma company) and end consumer (patient).

The intermediary is the healthcare provider of course. Loads of producers have distributers like supermarkets or your local bike shop.

Yes, consumers consider the intermediary, but they also have a relationship with the producer. We form opinions and make choices about Oatly ‘milk’ and Trek bikes, through advertising, free tasters/ tests, Facebook groups etc.

This allows producers to create or destroy customer value irrespective of the distribution channel through which there is a ‘relationship’ between buyer and seller. In most pharma markets, compliance rules mean you can’t do this. Pharma talks like it’s in the business to consumer market but it’s not – it’s business to business.

The other business is the healthcare provider, public or private. What I am advocating for is a little less focus on patients and a little more focus on customers, i.e. healthcare professionals (HCPs) and systems.

Somewhere in that Venn diagram of external stakeholders is a common goal that unites shareholder, customer and patient needs. For Parisa Rahmani, Nordic Franchise Head for Haematology at AstraZeneca, the way to finding the common goal is by “becoming the best listener in the industry”.

People with chronic lymphocytic leukaemia (CLL) are largely ignored by the pharma industry, as it’s a relatively benign form of cancer. Understandably though, those who are diagnosed panic and turn to HCPs, distracting them from more urgent patients.

By listening to its customers and working above brand, AstraZeneca started providing a CLL patient support programme in Europe and Canada, increasing its own presence and the understanding of patients, while also providing a valuable service.

Rahmani’s team then set shared metrics for things like how patients are engaging with the support programmes, and individual KPIs for the key results that generate the shared outcomes.

I spoke with a global medical solutions supplier who are all too familiar with the pressure health systems are under. They could have reacted to that by competing on price and trying to win more market share, but they took another approach. “We asked the biggest hospitals what would make the most difference. One of the aspects they measured on is infection rates”, shared a Commercial Director for Europe, the Middle East and Africa.

Infections impact patient outcomes, leading to government fines and clean-up costs, and downtime (when of course they aren’t using the supplier’s products). Getting infection rates down is therefore a great example of a common goal.

While the company knows a thing or two about healthcare hygiene, they also know their limitations, so they teamed up with other companies to be able to offer the holistic solution hospitals need, that they couldn’t do by themselves. In so doing they have become a true partner, measuring themselves on achieving that goal, and creating so much more joint value than a traditional supplier can.

Step 2: Build insight. Gather data and information on patient flow (which starts way before and ends long after the treatment pathway); health system priorities at local, regional and national levels – things like sustainability and digital healthcare might be high on the agenda; ask stakeholders in your healthcare services about their targets and what they really care about (it’s not your brands). Then put the pieces together to build an insightful picture of the reality for your customers and their patients.

Step 3: Link insights, customer problems and your strategy. Take the insights to him or her and talk about the problems that matter most to them. Think about why these problems exist and what’s getting in the way of resolving it. Finally, see where the connections are with your strategy. Be creative but don’t force a match. If what’s important to you doesn’t match what’s important for your customer, it’s not going to end well.

Step 4: Find the common goal. Once you’re aligned with the customers on the problems you are going to try and crack, sit down with them, have them write down the common goal together and agree how you are going to collaborate to get there; maybe create a charter to outline your commitments. Look for ways to be equitable partners rather than the traditional “joint working” initiatives financed by the bank of pharma.

Partnering with customers in this way is not typical Account Manager territory but it can be. At the global medical supplier, it starts by making sure that everyone appreciates the organisational strategy (and 97% do) – customer-centricity is one of the three pillars.

It also fosters personal accountability for making decisions to help achieve it. Account managers feel comfortable working with customers in this way because, “you win or you learn”.

All these steps could be initiated by healthcare providers of course, but at a time when ageing populations, insufficient budgets, recruitment challenges, Covid-19 and flu are bringing healthcare systems across Europe to their knees, we all need pharma to step up.