The coronavirus disease 2019 (COVID-19) has swiftly changed priorities in the healthcare industry, and in some cases, activities have come to a grinding halt.
For pharmaceutical companies that had ambitions to launch biosimilars and other drug products this year, major revisions of sales strategy may have become necessary, according to Jamie Peck, Managing Director of iON, a digital services arm of the healthcare marketing company Indegene, which is based in India with offices in Princeton, New Jersey.
Field sales reps have been sidelined by COVID-19 quarantines, leaving companies to figure out other ways to get the message out about new products.
“A lot of companies have reached out to us and said ‘How can we get through this? What can we do to keep our reps engaged with physicians?’ ” Peck said.
An Entirely Different Game
And further, companies are cognizant that in a post —COVID-19 world, the sales game may be an entirely different creature that cannot be herded back into a traditional model. “They’re asking what they can put into place long term, because they have this sense that things are not going to get back to where they were pre-pandemic,” Peck said.
The biosimilar launch pad saw a handful of products positioned for marketing in the first quarter of 2020. Among them were 2 biosimilars by Pfizer: Ruxience, a rituximab product; and Trazimera, a trastuzumab biosimilar.
A Pfizer spokesperson said the company has handled those launches with a combination of field reps and other forms of promotion.
“We have launched our biosimilars with a committed field force and will also be offering broad educational resources and support services to patients and physicians,” said the spokesperson, Jessica Smith, who said Pfizer declined to comment further on its commercialization strategy.
Large companies are in a boat of their own in this pandemic, Peck said. They have size and resources to their advantage. In this group, Sandoz, Biocon, and Pfizer number among clients that iON/Indegene have worked with.
“They’re not necessarily worried about this as much from an immediate, acute business need. They have security. We’ve already talked to them before about how to use digital in their launches,” Peck said.
Much More at Stake for Smaller Companies
Smaller companies may have more at stake. Among the general pharma companies that Peck advises is one that had aspirations to launch a product in July. It had a spring 2020 PDUFA, or Prescription Drug User Fee Act, date, ”which by all indications will probably get pushed back by the FDA,” owing to COVID-19 preoccupations. This, in turn, will push back the launch, he said.
It’s the company’s first launch, and so it’s important to members of the board and to investors to see it comes off on schedule and successfully. “They hired several hundred reps to do this, and they stopped the hiring process. They’re planning now on moving the entire launch to a digital platform,” Peck said.
Bluebird bio is another example of a medium–size biotechnology company that has been caught in the middle of the COVID-19 storm, Peck noted.
“Generally, the company expects the COVID-19 pandemic to shift the timing of enrollment and completion of clinical studies by at least 3 months,” bluebird bio said in a March 26 update on how it was faring amid the pandemic.
COVID-19 issues have delayed interaction with the FDA on product applications, and a launch of Zynteglo, a treatment for β–thalassemia, was planned for January 2020 but “given the evolving COVID-19 situation, the company expects the treatment of the first commercial patient in Germany to be shifted to the second half of 2020,” bluebird bio said.
FDA Is Highly Focused on COVID-19
The FDA has given priority to COVID-19 matters, which leaves it short of attention for routine matters, observers say. Peck agreed. “The bandwidth at the FDA is creating scenarios where some of these companies may not be able to hang around and wait for their product. Their investors and their boards may get impatient and they just may run out of runway. They don’t have the safety cushion that big pharma has,” he said.
Although this is the new reality for pharma, it has been a long time coming. With the rise and reach of digital marketing, such as email blasts, telemarketing, and artificial intelligence systems that can dig for sales prospects and eliminate wasted effort by human sales reps, the role of the sales rep has diminished steadily over the past 15 years. According to ZS, the number of pharmaceutical sales reps numbered just over 101,800 in 2005 and descended to 68,400 in 2017.
Concurrently, access to physicians has declined. The percentage of physicians described as “accessible” to sales reps dropped from 65% in 2012 to 44% in 2016, also according to ZS.
Accessibility varies widely according to specialty. For example, urologists were the most accessible, at 77%, according to the ZS report. Rheumatologists came in second, at 68%. Neurologists were 54% accessible, and oncologists were just 17% accessible. The old days of being able to spend quality time with a physician are gone. Instead, physicians get much of their information from digital channels, and reports indicate they are often more comfortable receiving data this way than from salespeople.
iON/Indegene markets what it calls an “omni-channel” constellation of services that include heavy emphasis on smart technology and digital reach. The ongoing pandemic is going to prove or disprove the concept of a vastly reduced salesforce supplemented by digital, Peck says. “It’s really going to be a test of our model, which says you may not need 500 reps; you may need 50. It’s going to be a real test to see whether can we do this.”