Pharmas pull plug on rep visits, begin fast-tracking new models

Most pharma companies are mothballing their face-to-face sales teams for the COVID-19 crisis. Could this signal a paradigm shift in the rep education model?

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By the end of the week nearly all the major pharmaceutical companies in Australia will have pulled their face-to-face sales forces from the field, citing concerns around the current priorities for doctors amid the coronavirus crisis.

One of the early companies to announce was Novartis, but soon most majors began to follow suite. The Medical Republic understands at this stage that Astra Zeneca, Pfizer, Merck, Menarini and Boehringer Ingelheim, have, or are about to, confirm some form of withdrawal of their face-to-face sales forces effective by the end of the week.

In an announcement earlier this week, Novartis said: “From March 16, until further notice, we will suspend all face-to-face engagement with healthcare professionals (HCPs), and utilise virtual options as necessary. The only exception are those essential engagements that ensure continuity of supply of our medicines or care in a clinical trial setting, where no viable alternative to a face-to-face meeting is available. This applies to all employees across all divisions throughout Australia and New Zealand. We are making these changes to our face-to-face external meeting protocols to protect the health of our communities, including healthcare professionals and the patients we serve.”

Yesterday, Astra Zeneca put out this statement: “As a precautionary measure, to protect the wellbeing of our employees and to respect the urgent containment efforts of our healthcare system, as of 17 March 2020, we have temporarily suspended our sales and medical teams from engaging in face-to-face interactions with health care professionals. To ensure our focus on patients and providing latest updates on our products, we will be continuing our activities using virtual means.”

And GSK has implemented the following measures: GSK and ViiV Healthcare field-based employees will work from home and pause customer-facing activities and office-based employees are now encouraged to work from home where practical.

“These measures are in addition to actions which have already taken by the business which include ceasing all non-business critical international and domestic air travel and cancelling GSK attendance to meetings with more than 10 people until further notice,” the company aid in a statement.

Most other major groups have issued, or are currently organising, similar announcements.

There are currently about 1800 sales pharma representatives working across the country, about 75% of which are directly employed by the companies, and the rest by contract sales teams run by organisations such as Hahn Healthcare.

Most pharma brand managers are reporting the majority of GP practices are either cancelling appointments, or expressing no desire at this stage to see representatives given the more pressing issues.

“It’s neither practical, nor sensible under the circumstances,” one manager told The Medical Republic. “We are also very concerned for the safety of our staff, given that GPs are at the frontline of this, and around the risk just one rep could pose to the system if infected. The last thing we want to do is go from GP practice to GP practice with a rep who we don’t know is infected.”

Yesterday, one of the country’s largest provider of contract sales forces to the pharma sector, Hahn Healthcare, was reporting that not all activity has ceased, and over 95% of practices still had appointments available via RxTro. RxTro runs a booking system for large practices in which about 13,000 GPs can find and make appointments themselves and handles about 250,000 GP rep bookings per year.

Hahn Healthcare Director Craig Moore told The Medical Republic that things were moving very fast and that by this morning, nearly all his clients had restricted their sales forces to virtual calls only.

According to Moore, whose company  supplies face to face and virtual reps for major pharmas, stats from Rxstro indicate that from a practice perspective, and against what many people are thinking, practices aren’t actually cancelling many appointments in the system. He said that in some cases it was likely that still seeing a rep, even virtually, was providing some GPs with a break from very stressful days.

Moore said that his company would be asking practices via survey how they want to handle educational and drug update information over the next few months, provided that various virtual options  are already established and available, albeit they haven’t been used as the main means of communication int he past. He said that while there was a clear priority to keep GPs at the frontline for the time being, there was always going to be some need  to be communicating certain information to doctors from pharmas, and his company and his clients were working on the most effective ways to do that while assisting doctors to do their jobs during the crisis.

But whether practices are actually cancelling appointments or not, most pharmas are for the time being taking the position of no face-to-face meetings. That leaves some of the major pharmaceutical companies with sales forces of between 50 150 sales staff which have very little to do.

The Medical Republic has been told the companies will be asking the staff to get on top of their training and administration, and take as much leave as they can. But some managers are thinking that this will still leave these staff with time on their hands.

In that respect, some companies are already considering strategies on how they can deploy their staff in a manner that helps practices, or any other part of the healthcare system, in dealing with the COVID-19 crisis. Some of these plans are likely to be revealed in the coming week.

As well as face-to-face sales repping, most companies have also implemented a policy of no physical meetings, so all are ramping up their ability to do virtual events and rep meetings.

In this respect, several companies already provide and are scaling up their offerings to the pharmas to enable them to work virtually with doctors. Key among those companies are Veeva Healthcare, IQVIA and Hahn Healthcare. All these companies have been developing products and services in this area for some years, including virtual rep meeting services and virtual event services.

Says Mr Moore: “Telephone meetings have been a part of our suite of virtual services for more than four years now, and in the right circumstances can be very effective for a doctor. Often a rep will organise lunch for a doctor via Uber Eats, and call them for the meeting over part of their normal lunch break. Most often these meetings are requested by the doctor.”

Veeva Healthcare is a global business that has, until now, been a sharemarket darling because of its rapid growth in cloud-based services for pharma companies, including sales rep customer relationship management systems (CRMs) which link to various virtual services, and the core medical documentation approvals systems, called Vault. COVID-19 has already seen a near 11% drop in the stock price of Veeva, but analysts point out it is not near the overall drop in markets (which is more than 25%), and are recommending it as a key stock to buy, given its positioning. As pharmas around the world start withdrawing face-to-face sales, it would not be surprising if this stock became more popular.

The rapid rise of Veeva and its cloud services has tracked, to some degree, the increasing difficulty that pharma companies are having getting physical access to doctors. That, and the desire for pharma companies to seek greater efficiencies in their sales forces, which traditionally have been the most significant cost in their marketing spend.

The COVID-19 crisis is about to create a sudden and rapid upscaling of virtual services, which some analysts speculate could provide pharma companies with fresh insights into the ability of new technologies to help educate doctors on new products and product changes, which might normally have taken a few more years to realise.

One manager, who did not want to be named, told The Medical Republic that though in the short term the withdrawal of sales reps was going to be painful for the companies, in the longer term the experience going more virtual may forever change the way they interact with GPs.

Pfizer put this announcement out yesterday:

 

In response to the rapidly evolving COVID-19 situation, Pfizer Australia & New Zealand has decided to take all customer-facing contact with HCPs virtual until 30 April 2020. 

This decision has been made out of an abundance of caution based on how quickly the COVID-19 situation is evolving, and is in line with the Federal and State Government’s intent to prioritise frontline healthcare service availability to meet the needs of the community during this time.  

Where HCPs retain the capacity to interact with us, we will ensure continuity of communication through a range of interactive online tools, such as our Pfizer Connect website for HCPs and also through virtual?appointments.