August / September 2018 by Healthcare Sales and Marketing Magazine

™ AUGUST/SEPTEMBER 2018

the publication for healthcare sales & marketing leaders™

TOP 50 pharma COMPANIES IN THIS ISSUE

PHARMA COMPANIES

Roundtable: Marketing Innovation Wisdom from MDcentRx, Sunovion, PTC, Wipro Executive Spotlight: Otsuka and Spark— Firsts in Digital and Gene Therapy Takeda Exec on Breaking Down Silos Patient Services: AstraZeneca and Accenture Rep of the Future: BMS, Daiichi Sankyo, Sunovion New Feature: Agency and Provider Spotlight

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the publication for healthcare sales & marketing leaders™

TABLE OF CONTENTS Publisher’s Letter..............................................................................................................................................4 Editor’s Letter.....................................................................................................................................................5 Editorial Board....................................................................................................................................................7

ARTICLES Executive Spotlight: Otsuka and Spark—Firsts in Digital and Gene Therapy..............................9 Roundtable: Sales strategy insights from Sunovion, MDcentRx, PTC, Wipro........................... 15 Rep of the Future: BMS, Daiichi Sankyo, Sunovion Predictions..................................................... 23 Top 50 Leading Pharma Companies......................................................................................................... 29 Patient Services: AstraZeneca Case History and Accenture Study.............................................. 33 Industry Trends: By The Numbers.............................................................................................................41 Takeda Head of Commercial Learning on Breaking Down Silos...................................................... 43 Motovideos: To Use In Your Meetings.................................................................................................... 47 Why I Work in Healthcare............................................................................................................................. 51 New Feature: Agency and Provider Spotlight....................................................................................... 54 What if Dr. House Used Twitter?.............................................................................................................. 57 AARP Report on Digital Habits of Seniors..............................................................................................61

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Publisher’s Letter

Want Good News? We Have It! The chaos, contentiousness and calamity that face you on your news feeds every morning can be discouraging. Thank goodness we’re in an industry that continues to see up arrows.

cari kraft

Oh, we have our problems, of course: an unsure future for new discoveries, increasing costs to launch, a less-than-ideal public image, a changing media landscape that presents challenges about reaching HCPs, the difficulties in educating patients and improving adherence.

Still, the numbers show that we’re moving in the right direction. In this issue’s Top 50 Pharma Companies, we are observing increased growth: 2017 revenue was up $56.9B over the previous year, a jump of 7% after 5% growth the year before. The biggest keep getting bigger: the Top 50 are growing faster than the total market. Worldwide total prescription drug sales grew at a rate of 2.6%. R&D spend is growing as well at $165B, up 3.9% over 159B in 2016. And we saw a 104% increase in FDA approvals of NMEs & Biologicals for a total of 55, vs. 2016’s low of 27. Oncology drugs lead the share of the total market with $104B, Anti-rheumatics are next at $55.7B and anti-diabetics at $46.1B. And mergers and acquisitions are proceeding at a hot pace: the J&J acquisition of Actelion, Gilead’s purchase of Kite Pharma, Thermo Fischer’s takeover of Patheon, Takeda’s $5.2B purchase of Ariad, and numerous others. In addition, we see positive signs in the development of new technologies and therapeutics. As reported in this issue, the outlook for both digital medicines and gene therapy is bright. We anticipate that this rise will continue. Look for our report on the Cleveland Clinic’s Top Ten interesting trends later this year. And check out futurist Bertalan Mesco’s article in this issue. He has been featured on numerous programs, in major publications, and has spoken at top conferences on what this industry can look forward to. Bad news? It will always be with us. But our attitude is that good news will always outrun it. And the inspiring things we see happening are further evidence of that. Forward! And always, please keep the feedback coming. It all goes to making the magazine better for all of us.

Cari Kraft, Publisher

Click here to get Top 50 pharma companies

Click to download to your mobile device of choice

HS&M AUGUST/SEPTEMBER 2018 | 4

Letter from the Editor

Doctor You You work in healthcare. By nature, then, you tend to be much more aware of the developments, advances, positives, negatives, news, trends and other aspects of this field than your friends, neighbors and relatives. So what are you doing about that? No, seriously—do you share what you know, or let other people linger in ignorance? neil greenberg

I think this is a very important responsibility for those of us who are exposed to information that others don’t get.

For instance, I have a relative with diabetes. Now, it’s true that she has a doctor to give her advice, but that doctor has only so much time to spend with each patient—many of whom also have diabetes. So I consider it my function, as someone who loves her, to be a bit of a nag about telling her the importance of diet and exercise, because, she’s not focused enough on either one of those things. Yes, she heard her doctor’s advice, but a little extra prod from someone who cares can’t hurt. Or what about all those people who think that pharmaceutical companies are more intent on keeping you alive while sick, rather than actually curing you? You’ve heard this, too, I’m sure: “They could cure cancer tomorrow, but then they wouldn’t make as much money off of you!” It’s tragic that so many otherwise intelligent, knowledgeable people really believe this nonsense. And who’s going to help disabuse them, if not us? And then there’s adherence. We’ve run a number of articles in HS&M about how many billions are lost each year because people are “off their meds”—or never even start them! Do you know if those close to you are following their therapeutic protocols? If not, do you know why? Cost, lack of confidence, multiple medications, anxiety about side effects? There are numerous reasons, and they add up to too much unnecessary sickness, not to mention lost revenue. What it comes down to is that, even without a medical degree on the wall, we have the information and, I would argue, the obligation to help those around us understand how to help themselves and how not to be cynical about our industry. Think about it, Doctor You. Who can you help today? We try to keep up with all this, and bring you the people who have a grasp on change. We hope that it will be informative, and assist you in furthering the work you do every day. Let us know what topics will be most useful to you!

Neil Greenberg, Editor To become an HS&M contributing author or provide feedback, please email me at ngreenberg@hsandm.com.

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There are some things people just won’t tell you But they’ll tell us in confidence. And we’ll tell you. There are a lot of opinions people never offer you about your company. What the pain is. What you could be doing better. What they think of your competition. How to talk to them effectively. Big corporations get these answers through expensive research. Small to medium-sized companies don’t have that luxury. That’s why we created the Private Process . It’s a quick, cost-effective way of compiling information that people will offer us in complete confidence. Then we assess the results and give you the insight you need to adapt your sales and marketing messages accordingly. ©

For details on how the Private Process works, and the kinds of answers you can get, contact us now at ngreenberg@hsandm.com.

™

Editorial Board

the publication for healthcare sales & marketing leaders™

Chris Bergstrom Publisher Cari Kraft Editor Neil Greenberg Contributing Editor Jill Donahue Creative Director Hedy Sirico Digital News Rick Cataldo Digital News Chris Manning Sales Director Andrew McSherry Editorial Board: Kristen Sharron-Albright Head of Marketing at Noven Pharmaceuticals Chris Bergstrom Associate Director, Digital Health Expert at Boston Consulting Group Sebastian “Sebby” Borriello Vice President, Chief Commercial Officer SK Life Science Lewis Chapman Vice President, Global Commercial Operations AllCells, LLC Maria Finlay, MBA Associate Director of Oncology Marketing, Teva Oncology Nick Gurreri Vice President New Products at Alexion Pharmaceuticals, Inc. Bob Roda VP and General Manager at BD © 2018 CL Media Inc., Philadelphia, PA CL Media is not responsible for any unsolicited contributions of any type. Unless otherwise agreed in writing, CL Media retains all rights on material published in HS&M for a period of one year after publication and reprint rights after that period expires. Email ckraft@hsandm.com.

To advertise in HS&M, please contact Andrew McSherry at amcsherry@hsandm.com

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Associate Director, Digital Health Expert at Boston Consulting Group Chris brings almost two decades of commercial expertise as an entrepreneurial executive at large medical device and high-growth digital health companies, and he provides “on the ground” advice for implementing digital health solutions. He currently serves as the expert on digital health at The Boston Consulting Group (BCG). Before joining BCG, Chris was the chief commercial officer (CCO) at WellDoc, a pioneer in digital health. He also held progressive roles at P&G, Roche, and Becton Dickinson. Chris was a senior advisor to several digital health innovators, including MyOwnMed, LiftOff Health, HelpAround, Heart Beam, iSageRx, and Alere Home Monitoring. He also advised the Leona Helmsley Charitable Trust and the Saatchi & Saatchi Wellness Board. Chris holds two digital health patents and has won multiple awards.. Chris holds a Bachelor of Science degree from the Kelley School of Business at Indiana University and earned his MBA from Columbia University.

Sebastian “Sebby” Borriello Vice President, Chief Commercial Officer SK Life Science Sebby is currently service as the Vice President, Chief Commercial Officer at SK Life Science. Sebby’s career has included executive sales and marketing positions at Cempra, Mentor Worldwide LLC, Johnson & Johnson Healthcare Systems Inc., Ethicon, Inc. and OrthoMcNeil Pharmaceuticals, Inc. Sebby received his B.A. in Public Administration from St. John’s University in ‘81, and received his M.S. in Organizational Dynamics from the University of Pennsylvania in 2001.

Maria Finlay, MBA Associate Director of Oncology Marketing, Teva Oncology Maria has over 20 years of commercial marketing, sales leadership and operations experience. She has led multiple sales, women’s leadership, and cross-functional teams at Johnson and Johnson, AstraZeneca, and Teva Oncology. Maria has experience collaborating to launch and grow small and large molecule products across seven different specialty therapeutic areas.

Bob Roda

Editorial Board

President and CEO, Menarini Silicon Biosystems Bob Roda is a senior commercial executive with extensive experience in delivering business growth and profit in the medtech and diagnostics sectors of healthcare. He currently serves as the President and CEO of Menarini Silicon Biosystems, where he is responsible for driving the commercialization of novel cancer diagnostics. Previously, Bob held a variety of roles of increasing commercial responsibility at Becton Dickinson. Most recently, he was VP and General Manager of the MPS business unit as well as leading the commercial integration of the CareFusion acquisition. Bob also had a successful career within the MD&D sector at Johnson & Johnson. His diverse background includes positions in business development and senior leadership roles in sales and marketing at Johnson & Johnson Medical, Inc., Ethicon, Inc. and Ortho-Clinical Diagnostics. While at J&J, Bob also served as the executive sponsor of the Commercial Leadership Development Program as well as the chair of the VP Marketing Council for all of MD&D. Bob is a highly respected, successful global leader with proven abilities in diverse disciplines. He holds a Bachelor of Arts degree from The College of Business Administration at the University of Rhode Island.

Lewis Chapman Vice President, Global Commercial Operations, AllCells, LLC Lewis Chapman is currently the Vice President, Global Operations at AllCells, LLC.Â He has spent over thirty years in health care management. He served as VP of Global Strategic Marketing at BioMarin Pharmaceutical from 2007 to 2012, where he was responsible for strategic marketing and product portfolio analyses, and implemented medical education, brand enhancement and sales support programs on a worldwide basis. He oversaw the global launch of Kuvan, which in the U.S. was 112% to budget in 2008, the first year on the market.Â Previously, he worked with Alpha Inntech Corporation as Vice President Global Sales and Marketing, where global sales grew 26% in 2004 and 22% in 2005 under his leadership. Lewis started his career with Eli Lilly & Company, with roles at Syntex and Genentech, where he was responsible for the global commercial launch of Activase (t-PA), the largest biopharm product launch in the history of the industry up to that time (first year sales $187 million).

Nick Gurreri Vice President New Products, Alexion Pharmaceuticals, Inc. Nick Gurreri is a business leader and General Manager with over 25 years of consistently achievinghigh performance and profitability through strong leadership and cohesive team building in the biopharmaceutical and medical device industries. Nick has held executive positions at Medgenics, Insmed, Pfizer, Pharmacia and Bristol-Myers Squibb. Nick received a BS in Mechanical Engineeringfrom the University of Delaware, and also acquired a Master of Science in Information Assurance at Carnegie Mellon University.

Kristen Sharron-Albright Head of Marketing, Noven Pharmaceuticals Kristen Sharron-Albright, the current Head of Marketing at Noven Pharmaceuticals, was until recently VP Sales and Marketing, Anti-Infective Marketing and Institutional Sales Specialty Care Business Unit at Pfizer. She is an experienced business leader with 20 years of experience in the pharmaceutical and biotechnology industries. She has a strong track record of delivering results in highly competitive and complex markets. Starting her career in sales at Eli Lilly, she then held positions of increasing responsibility at Lilly, Neurogen, and Pfizer, where she was responsible for sales and marketing in a franchise business model. In her spare time she volunteers, serves on the leadership committee for her church, and enjoys hiking.

HS&M AUGUST/SEPTEMBER 2018 | 8

Pharma & Biotech

Executive Spotlight: Otsuka and Spark Therapeutics CEOs on Marketing Firsts in Digital and Gene Therapy Dr. William H. Carson President and CEO, Otsuka Pharmaceutical Development & Commercialization, Inc.

Jeff Marrazzo CEO and co-founder, Spark Therapeutics 9 | HS&M AUGUST/SEPTEMBER 2018

The healthcare industry has undergone a technological revolution in the use of digital devices to communicate, provide apps, offer education to doctors and patients, make therapy more efficient, enhance adherence and much more.

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MAIN CONFERENCE CHAIRS Ritesh Patel, Chief Digital Officer, OGILVY

Danielle Halstrom Vice President and Head, R&D and Commercial Communications BRISTOL-MYERS SQUIBB

Shwen Gwee, GM, Digital Accelerator, Global Drug Development NOVARTIS

A SNAPSHOT OF THE LARGEST EVER EXPERT SPEAKER FACULTY GLOBALLY FOR 2018: KEYNOTE SPEAKER Tom Cannell, Chief Operating Officer and President, Global Commercial Products, OREXIGEN THERAPEUTICS Elena Alikhachkina Worldwide Head Analytics Technology, Strategic Insights and Data Solutions JOHNSON & JOHNSON

Amir Lerman Professor of Medicine MAYO CLINIC

James Musick Vice President, Head of Neurology Patient Technology U.S. UCB PHARMACEUTICALS

Lisa Deschamps Worldwide Business Head, Neuroscience NOVARTIS

Tim Moore US Commercial Excellence Lead EMD SERONO

Angela Horstmann Head of Consumer Digital Experience and Innovation, US Pharma Customer Capabilities and Operations GLAXOSMITHKLINE

Sai Punjabi Global Head – Digital Marketing Capabilities and Operations ALLERGAN

Bozidar Jovicevic Vice President, Global Head of Digital Medicines SANOFI

Saskia Steinacker Vice President and Global Lead Digital Transformation BAYER

NEW TOPICS FOR 2018: _

Digital transformation as an enterprise-wide commitment to your evolved customer

Aligning innovation with business objectives

Connecting the disconnect between Marketing and Sales: Using Cross-Channel, Content and Data to Inform the Customer Experience

From Digital Analytics to the Digital ROIs AND Linking Digital Analytics with traditional non-Digital Analytics

Digital Therapeutics/Beyond the Pill/Investing in the space vs. designing new models to make that work at a practical level

Multichannel engagement and the new model that combines online and offline channels in a way that generates real results

Are ‘patient solutions’ really that? Addressing whether physicians are more likely prescribe your drug if you are providing a patient support tool or network

VISIT WWW.DIGITALPHARMASERIES.COM/EAST FOR MORE INFO

Pharma & Biotech But there’s another kind of tech revolution happening, and that’s in the development of the medications themselves. In digital health and gene therapy, miraculous advances are emerging that will further change the nature of healthcare. This past May, at the Veeva Commercial and a Medical Summit in Philadelphia, in an interview with Veeva Co-founder and President Matt Wallach, two prominent CEOs outlined the recent breakthroughs their companies have had. Dr. William Carson of Otsuka Pharmaceutical Development & Commercialization, Inc. spoke about the very first digital therapy ever approved by the FDA, and Jeff Marrazzo of Spark Therapeutics gave some background on the first gene therapy ever approved by the FDA.

These advances will affect everyone in healthcare: patients, providers, payers and of course the manufacturers and marketers themselves. Digital Abilify As President and Chief Executive Officer of Otsuka, Dr. Carson has worked to establish new alliances,develop new compounds and introduce innovative ideas that secure approvals. Abilify is Otsuka’s product approved for treatment of schizophrenia, manic episodes associated

with bipolar disorder and as an add-on treatment for depression. Last November the FDA approved Abilify MyCite, which has a digital ingestion tracking system. A sensor embedded in the pill records when it was taken and sends that information to a digital patch, which transmits the data to a mobile app. Patients can allow caregivers and physicians access to this data, potentially improving compliance. The sensor and patch were developed by Proteus Digital Health. Nonadherence is, of course, a growing concern, estimated at costing about $100 billion a year due to the need for additional treatment or hospitalization when patients don’t follow dosing advice. Dr. Carson described the sensor as being “about the size of a grain of sand.” He said that a major challenge was how to start the process with the FDA. Both Abilify and the the Proteus product had independently been approved. But they were concerned that the FDA would ask for a major trial that would take five years. That didn’t happen. But the agency’s concern was whether the patients could use the system. “[It] comes in a box which is very similar to all of your tech things, and the FDA in these human factor usability studies, wanted to know could the patients themselves turn on the phone? Turn on the app? Put on the patch? All of the things that go with the system there. Especially their concern was around [patients who have] a mental illness and could they actually figure that out. It turns out in human factor studies that these patients are as capable as

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all patients and all of society in being able to do that. Once we went through that hurdle I think the path to approval really was much more about an understanding that digital medicine was upon us, and FDA really wanted to be very clear and very measured about moving ahead. “ Once the approval was granted, another issue was how to launch. Dr. Carson said “We didn’t want to move ahead with this full scale because part of the challenge is not understanding how payers, providers, patients, families and us as a company…would use the data? We brought in a whole group of bioethicists to help us address a lot of the issues that were happening around privacy, data, how it was going to be managed, and the most interesting concern that was raised with the bio-ethicists was the fact that doctors feel that they have data overload.” He explained that they already have data on about 500 patients. “The data that we collect—positional data, urography, vital signs as well as measuring the ingestion—are continuous down to the minute. So, in those 500 patients we have more data collected than all of the clinical trials ever conducted by Otsuka. Think about what that might look like going forward. You could have in these systems lots of patients, maybe not 500 a day but 500 a week, 500 a month. Think of the data that would be generated. I have been calling it a data tsunami, because it is overwhelming and addresses the question that the bio-ethicists were describing around data. What it leads to is the concept or the need

At the Veeva Summit, l. to r.: Matt Wallach, Jeff Marrazzo, Dr. William Carson for data visualization, so you’re going to have to be able to make sure that the doctors get the information they need and that they’re able to take action on it.” Of course, the patient has access to the data as well. Dr. Carson explained that they don’t have a way of interacting directly with patients or finding out what they want—what they’re looking at on their phone, what they’d like to know, who they want to share data with. Then the doctors and payers get access when the patients give permission. This, he explained, will help them learn quite a bit during the limited launch phase. “The information to the company and to the payer is all anonymized, so we will be seeing group data anonymized. However, because of GDPR and privacy concerns, we have to be able to go in and pull out patients’ data if they request to opt out. So, you have to be able to

take the data out completely and change the data set. Next month, they can opt back in. Part of the challenge is how do you manage the opting in, opting out data sets, those types of things?” Luxturna and Gene Therapy Jeff Marrazzo is CEO and cofounder of Spark Therapeutics, a late clinical-stage gene therapy company established in 2013 as a result of the technology and knowhow accumulated at Children’s Hospital of Philadelphia (CHOP). Initially focused on orphan diseases, they are working toward helping patients with conditions for whom no, or only palliative, therapies exist. Jeff said that “the human genome project was this incredible breakthrough where frankly we learned the actual specific codes of what the blueprint is for biology of the

human being. The question was could you actually turn that data into a medicine? “Luxturna, which is our first approved gene therapy, the first of its kind in the United States, in essence took information about a particular gene that, when it’s defective in a patient, causes blindness. We put that information into a disarmed virus. We actually used the power of the virus to infect cells, but we used a disarmed version of the virus and one that’s not pathogenic, to basically drop that biological blueprint and information into the cells.” The virus with the DNA inside of it infects the cells, which then have the machinery to make normal copies of a protein that otherwise was missing. “So, in fact what we’re doing is a one-time therapy that has the potential to have longlasting, if not lifelong, effects.” The question, he said, is about transiHS&M AUGUST/SEPTEMBER 2018 | 12

Pharma & Biotech tioning from a 20th century policy about volume and fee-for-service to a world in which we are more about better health outcomes in patients “regardless of the amount of interventions that you have.” He explained that there are about 200 different genes that can cause blindness as a result of your retina deteriorating. “Luxturna is indicated for one of those, so it tells you actually how far we still have left to go as a scientific community and medicine. There are no approved products of pharmacologic agents at all for any of those 200 types, so not only was Luxturna a big deal for people rooting for gene therapy as a technology, it was a big deal for an entire blinding community that was looking forward to any treatment that could help their disease.” As with Abilfy, this is a patient population that, until recently, had been told there was nothing medical science could do for them, that they would eventually go blind. “What we saw in the 41 participants in our clinical program was that with a single dose of Luxturna we could restore functional vision in these patients in a way that they were now able to open up activities of daily living and do independently what they hadn’t done before. It’s incredibly exciting, and [what] patients and families say about what it means for them in the context of their schooling or their work life is really powerful to hear.” Jeff discussed the commercial model for Luxturna, and how they determined to present the proposition to payers. The wholesale acquisition cost is $425,000 per eye, so the total is $850,000 per treatment. “That’s a one-time

charge, but the treatment is indicated to be used [just] once, and the data that we have generated to date, including the latest data we’ve presented at the American Academy of Ophthalmology, suggests that that one dose at three years and counting is still showing a sustained effect, and we believe based on all the pre-clinical data that it has the chance to be long-lasting if not lifelong. That’s the value proposition…There are certainly a large number of orphan drugs that are on the market that cost quite a large amount of money per annum for the rest of a patient’s life. “Instead of…trying to price in reference to what is an annual cost for existing type of modalities like enzyme replacement, we took a step back and said we’re really being asked to somehow evaluate what is the value of sight in a patient -- what it was worth to a young child or a young adult to have an intervention that would enable them to have restoration of aspects of their functional vision for potentially the rest of their life. When you do the modeling, a pharma-economic modeling exercise, what we saw in evaluating it was that the worth of that was in excess of a million dollars, when you actually put together the cost of educating a blind child, the cost of loss in productivity for someone who has to care for a blind child.” There was also independent data that helped them make the case. There have been more than 25 state court cases that have ruled on the cost of people losing their sight. These cases determined that on a compensatory basis plaintiffs should be awarded more than a

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million dollars on average for losing their sight in an acute event that was not their fault. That gave them a basis for what had been determined as the worth of someone’s sight. “We felt that we were now entering a new age where we might be the first of what I hope is many different treatments that are one-time treatments that aspire to produce better health, not more healthcare. I think that’s an important distinction. Traditionally what we’ve done in 20th century medicine is to try to produce pills that people have to take on a reoccurring basis for the rest of their life in many instances. What we’re trying to move towards is these one-time treatments that introduce better health. “We said why don’t we start to introduce a set of discussions with the payers, with policy makers about how we might go about doing that. So, in launching Luxturna we also introduced three unique payment and distribution models that haven’t been introduced before. One of them was a way in which we could actually reduce some of the costs related to the middle men and the middle parties that were involved with getting a drug from manufacture all the way to a patient. The first three patients we were treated with Luxturna in the first quarter of 2018, less than three months after we launched, which is a great accomplishment. Those first three patients were all treated under this direct payment model where we sold the product directly to the payer. We didn’t have middle men involved in the process. That’s one innovation.

“The second innovation was that we said we are going to stand behind our product and are offering outcomes-based rebates. So if the drug doesn’t work initially or is not sustained in its effect, we give rebates back for part of the cost of that therapy. The third thing we’re doing is [talking to the] Centers for Medicare and Medicaid services where we are looking to actually take and decouple the intensity of service from the value and time in which it occurs. What we’re offering in that discussion is a way that that $850,000 could be paid in installments over time and your outperiod payments would actually be linked to continued effect or to outcomes. So, the idea is we pay for better outcomes, better health, not for more healthcare and we don’t pay for the intensity of the service. We pay for better health.” Finally, there were considerations about the physicians. Spark estimated that there were about 1000-2000 people with this specific genetic subtype—a very rare condition. “Since Luxturna is delivered through a surgical procedure, we decided that we actually wanted to have a model in which we use Centers of Excellence. So we actually have nine treatment centers geographically dispersed around the United States that are able to deliver the product. “This is an under-diagnosed disease. So we’ve looked to a specific portion of the physician community, about 1800 ophthalmologists, to partner with in driving diagnosis. We’re offering a free genetic test to facilitate the genetic diagnosis of these patients. So those 1800 really are our partners, if you will, in the diagnostic process. Ultimately, they’re referring patients into one

of these nine centers. You can only accomplish this with a very limited distribution, not just because it’s a rare disease but because it’s a onetime treatment.

Asked for final thoughts, Dr. Carson offered that, being at the beginning of digital medicine, we have to consider whether we are prepared for what comes next.

“When it starts to open up, I think there are some really important questions about the supply chain generally for bio-pharmaceutical products. When you only have to deliver something one time to a patient you can organize a whole bunch of resources to frankly move that patient from one place in the country to another to get that right procedure done at the right place with the right expertise. It really starts to [answer] what are all the needs for those various different elements of the supply chain.”

“In 2010 the CEO of Google shocked the audience by saying that every two days we gather as much data as was gathered from the beginning of time to 2003. Every two days. So, the question is, how much data and how fast is that now? That’s the challenge when we start moving into these spaces with each individual patient and how do we take all of that data and make sure that we can turn those insights into action.”

Not only is the genetic test free, but patients may not even have a co-pay, depending on the payer they’re with. “We are really pleased with these first three patients because we were able to provide this to them through what is this innovative and alternative contracting model where we are selling it directly to the payer. It’s not actually being sold to the hospital, so it’s not going through a traditional buyand-bill. Our pact with the payer was we’ll only do that if you ensure that, one, the coverage is consistent with our FDA label; two, that you rapidly produce their prior authorization; and three, that you cap their out of pocket exposure as a patient to in-network maximums. Then the Affordable Care Act has some caps on what that is on an annual basis, and we have patient assistance programs along with travel and accommodation assistance programs that then help pick up, if not all the cost, the lion’s share of that cost for patients.”

Jeff Marrazzo said that “We have a simple saying at Spark. We don’t follow footsteps, we create the path. That creation of the path begins in the lab but it does not end in the lab, and I would encourage all of you who are in roles that are not necessarily in the lab, that there is as much innovation that is required and needed to bring these types of new medicines to patients as there is the work that’s done at the bench. And that’s what we strive to do every day at Spark.” This article was excerpted from the keynote at the annual Veeva Commercial & Medical Summit, which brings together leading life sciences professionals and experts to learn about innovations advancing the industry’s digital transformation. This year’s event drew nearly 1,500 attendees from the world’s most innovative companies, including Alkermes, Amgen, AstraZeneca, Insmed, Merck, Novo Nordisk, Otsuka, Roche, and Spark Therapeutics. •

COMMENT

HS&M AUGUST/SEPTEMBER 2018 | 14

Roundtable

Sales Strategy: Viewpoints from MDcentRx, Sunovion PTC Therapeutics and Wipro Execs Our panel of experts: ERIK DALTON Executive Vice President MDcentRx

CHRIS GISH Former VP US Sales Sunovion

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JOE MANSFIELD VP, US Sales & Market Development PTC Therapeutics

SHALINI SHARAD Partner, Commercial Launch Excellence & Patient Centricity Wipro

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Roundtable You could get whiplash from trying to follow and respond to the changes in the healthcare sales landscape these days. More expertise is required, from more sources, leading to more pressure on training, plus the focus on more platforms where communication is happening, and the tweaking of messaging across those platforms. How do long-term sales professionals adapt, and what are companies looking for in bringing on new hires for their sales forces? We called on people with experience in this end of the industry to share their insights. If you have additional wisdom to offer, we’re always eager to hear from our readers. What are the major challenges to sales organizations in pharma, bio and device these days? ERIC DALTON: The biggest challenge we’re seeing is access to HCP offices, but the most addressable challenge is what to do once a rep is inside of that office, other than fulfilling sample requests. The other major challenge is how to connect NPP marketing efforts with the sales force in order to achieve leveraged success from the combined effort. CHRIS GISH: First, in today’s environment the pharma sales organization needs to make sense of a growing body of data that is being created as the companies interact with customers in more

ways. With digital interactions, telehealth, customer service reps, MSLs, and traditional face-to-face encounters, everything is part of a mix of activity and preferences that are unique to each customer. The challenge to the sales organization is to merge all this valuable customer data into a single view or data base that can be used to make the conversation efficient and effective. Second key challenge is operational efficiency. Younger employees have less patience for systems that don’t work, numbers that don’t make sense, and old school command and control. Third is that the “customer” is changing. Physicians are still important but more and more there

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is a need for key account managers to coordinate a single large account or customer after a contract for access is signed. SHALINI SHARAD: The changing healthcare needs to require companies to redirect their efforts, budgets and focus on disease management rather than their drugs/devices ONLY. The healthcare market is asking for a treatment package as a “pharma/device product” instead of the traditional product that has been selling over years. This is a result of the constant price pressures, bundle payment models, healthcare cost savings and the need of increased patient life-expectancy/quality of life. Additionally, this change has led to more professional procurement practices in the healthcare ecosystem. Sales organizations in pharma and device companies have to meet the needs of diverse purchasing groups like hospital, IDN, procurement department, HCP and indirectly the patient & payers. JOE MANSFIELD: The biggest challenge for all organizations is to be relevant and provide value to all members of the respective treatment team. Healthcare professionals have incredible demands on their time and often sales professionals are seen as a distraction and not part of the solution that can bring value. How are companies addressing these challenges? JOE MANSFIELD: Top organizations provide their teams with the training and resources to be of value to HCP’s. The sales professionals need to have information

that is crucial to treatment decisions and facilitate access to treatment, where the burden created by the insurers can be daunting. ERIC DALTON: The companies that are tackling these challenges successfully are accessing truly unique data sets that are more behavioral and less Rx specific to help drive customization at the individual HCP level. It’s one thing to know that an HCP wrote a new script, but it’s a completely different challenge to know why. This is especially true with claims data that can take months to process. We’ve found success in going to the source (i.e. the HCP directly) to find out how each of them would prefer to interact with sales reps. CHRIS GISH: Companies are making strides to integrate all of their customer data into a single place and draw insights from that. Some new approaches using machine learning systems can harvest amazing insights from the data once it is integrated. Artificial intelligence can uncover customers more likely to respond and act, as well as ones that are less likely. This can then be operationalized by the sales force. To boost operational efficiency, companies in pharma are beginning to streamline activity data and focus only on very high value actions. Also, front line reps are being enabled to make more independent plans focused on results versus activity, and this makes efficiency easier to achieve. Companies are using less user-driven, customizable views for sales data and creating more efficient dashboards and views with the items

ACCESS

EXPERTISE DEMANDS

COST AND SAVINGS CONSIDERATIONS

OPERATIONAL INEFFICIENCY

people most view. This also creates efficiency. Finally, companies are moving to more hybrid models for field deployment and moving beyond the traditional sales/managed markets/field-based medical separate teams of the past. Key account managers are becoming more common and enabling better focus on customer need and value versus internal silos competing to talk to that customer. SHALINI SHARAD: These companies are transforming sales into high quality interactions through digitally transformed channels and effective content based on “product package.” Companies are training sales organizations on solutions to complex reimbursement models along with the drug prescription. This is one significant problem to solve to boost sales. Sales organizations is also changing the sales model to a digital sales and marketing model. This kind of hybrid approach that encompasses both traditional face to face sales interactions and digital

interactions is increasing the reach and face time with HCPs, who are themselves on digital/social media. How has the demand for increased expertise changed the sales staff makeup? CHRIS GISH: Companies have begun to adjust job descriptions and begin to require more experience in coordination, B2B selling, and negotiation. Local customer-facing members of the sales team and their leaders must be more flexible, able to act in ambiguity, and make rapid decisions. Some awareness of marketing science as well is more and more needed in order to integrate all promotional channels and give feedback to HQ. ERIC DALTON: The current rep is much more experienced and specialized, with their knowledge of a specific drug class being closer to that of a Medical Science Liaison (MSL). Niche reps within a key area that focus on selling with clinical conviction have a better chance of changing an HCP’s habits than reps focused only

HS&M AUGUST/SEPTEMBER 2018 | 18

Roundtable on relationships. HCPs demand specific knowledge and expect new updates versus regurgitating the same information shared during previous meetings. SHALINI SHARAD: Sales staff are becoming more clinical educators who can focus on specialties like Alzheimer’s or oncology reimbursement, treatment that includes biologics/biosimilar. There is a need to have in-depth knowledge of various disease types and treatments possible for financial access. Sales reps should be able to have high quality interactions with the right messages per stakeholder like procurement organizations, HCPs, purchasing organizations, mostly through multi-channels like social and digital media, video interactions etc. It is a package of strengths that include reimbursement understanding, account management, clinical education & treatment options in the market. What resources are necessary to address the questions posed by a value analysis committee? ERIC DALTON: Detailed data on cost versus benefit to patients. You have to address why the treatment is needed, the true costs, what the treatment replaces within the current regime, and how it will help the committee prove improved outcomes. Recent deals showcase that “risk shares” based on proving outcomes can lead to more effective deal structures for both sides. CHRIS GISH: Companies will need to begin to design studies and collect data that reflects realworld use cases. Too often patients in trials are not “real” patients. A second area that requires attention

is data collection. In many cases customers are unprepared to collect and report the data needed for value-based contracting. Companies will need to find a way to “meet customers where they are” technically, versus insisting on a complicated need for data. This is what will drive new thinking in the value-based contracting space. What kinds of supports are helping reps conduct more effective conversations on disease states, practice problems and other issues that are not brand-related? ERIC DALTON: From my experience, personal research outside of pharma helps sales reps the most with these conversations. Discussing the key therapeutic area and specific patient challenges with family/friends/colleagues/other physicians, along with independent research, is the most valuable, as it provides a similar context to that of an HCP versus what pharma might otherwise produce within training sessions. CHRIS GISH: The best way to deliver information, whether that is product-related or disease state only, is with effective technology in the hands of the person with the customer. Of course, this means and iPad or tablet, but also means augmented video experiences via VR goggles and headsets. Content also has to be not just digitized but changed to make it more relevant for the technology. This can be done by including gamification and interactive touchpoint. JOE MANSFIELD: I’m a huge proponent of training the sales professionals as if they are in an MSL role, with the added development

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of being experts in access. This way they can provide value from beginning to end. Not all sales professionals have these skills nor the aptitude to develop them. How important is it that reps assist in the doctor/patient conversation, given the limited time HCPs have with patients? What tools are available to help with that? SHALINI SHARAD: The doctorpatient conversation is the real place where a sale is made. This fact-based conversation between these stakeholders should be most effective in order for the patient to start and stay on the treatment. It needs to include issues like reimbursement, access, side effect management, expected complications, lifestyle etc. Hence, a sales rep should be enabled to offer the “treatment package” that a doctor can prescribe along with the core drug/device. This includes customized care plan for a patient using digital tools, counseling services, financial access & quick onboarding applications for the patient. CHRIS GISH: Reps can make all the difference in some cases, and in others very little. This is driven by customer preference. Knowing which customer is which is key and enables efficiency. Tools such as ZS’s Access Monitor have become very good crowd source tools to make sure we send reps to doctors looking for F2F contact versus ones that see no reps. Likewise, we do the same for MSLs, etc. The best tool for short situations is effective training. This has to start with educating on what is vital in the customer’s eyes, and what is

interesting to the rep, which aren’t always the same things. Also, the pressure for quick details is also helped again by good technology platforms that engage and work smoothly. JOE MANSFIELD: This is an everincreasing issue where you need to understand the HCPs dialogue with their patients on treatment options and access. Companies need to provide resources for the HCPs that they can provide to the patients for additional support. For ultra-rare diseases we have extensive patient service support allowing engagement with patients. ERIC DALTON: It’s crucial in my opinion and is one of the key ways that reps can provide true value to the HCP and their office. An independent study from earlier this year showcased that the top two reasons HCPs meet with reps are for samples and new product information. However, the number one way in which HCPs believe that sales reps can improve is by providing more patient education and information. In the new age of specialized medicine, providing handouts, customized websites and follow-up services for patients are paramount for an improved doctor/patient conversation, especially for more complex treatments. How can reps best prepare prior to a call with respect to the patient makeup of a practice, the territory, or the competition? JOE MANSFIELD: Successful sales professionals in today’s world need to be expert in all things related to the therapeutic area they work: treatment options, nuances

Moving Forward BEHAVIORAL VS. Rx FOCUS

CUSTOMIZED MESSAGING

RAPID DECISION CAPABILITY

of the practice/institution/department they engage with, payor position on their product and competitors, if one exists. The time an HCP spends with a sales professional needs to be of value and not a one-sided conversation focused on the benefits of their product. ERIC DALTON: From our perspective, proprietary data sets that focus on insights into specific HCP behaviors and interests are key to having a better discussion with an HCP. The relationship has to get back to neutral where the rep provides a real value to the HCP versus simply promoting a message from pharma during that call. Simply asking “How can I help you and your patients today?” is a good start. SHALINI SHARAD: It’s is critical to understand unmet patient needs and the diseases that they are suffering from. Factors like state laws, social determinants, county benefits, health plans and others impact a patient’s life and

MSL COORDINATION

have a direct impact on their buying behavior. Sales reps should be enabled with behavior-science based personalized packages per patient segment that further help them in managing their diseases. HCPs want to prescribe these patient-centric packages that keep patients on treatment, help them with behavior-based services and ultimately reduce healthcare costs and improve outcomes. CHRIS GISH: Veeva is the king of data presentation and the most effective at enabling views on actionable data. When combined with a search engine tool such as Aktana, they become even more effective. These types of tools scan the larger data base looking for activity and trends that have been pre-identified as requiring action or serving as potential change points for a customer. Things like writing a competitor or searching the company website for information. Where do you see the sales strat-

HS&M AUGUST/SEPTEMBER 2018 | 20

Roundtable egy landscape headed in the next few years? ERIC DALTON: I think sales will operate more like that of a white glove/exclusive/ concierge type service, where reps cater to as many needs as med/ legal will allow regarding a specific drug based on the unique insights that are becoming more readily available. I think sample fulfillment will become more automated, which will force sales to think about how to collaborate with an HCP based on different factors, including syncing up with NPP efforts for the brand. JOE MANSFIELD: The demands on HCP’s will continue to grow, payors will increase their focus on cost containment thru restrictions on access, patients will have increasing levels of frustration accessing specific meds and expanded out of pocket costs. All of which will be the foundation to what core areas the sales professional’s prep needs to be focused. CHRIS GISH: Sales strategy will be evolving from a traditional marketing/sales dynamic to one more aptly described as marketing & promotion. Promotion will encompass all the ways we can convey the sales message—integrated digital campaigns, telereps, customer service reps, and traditional detail teams. Sales leadership will need to become more fully expert in all ways a product can be promoted and how these levers are best used, as well as when you’re just throwing money away on expensive tactics. Tomorrow’s sales leader will develop key strategies in concert with marketing and then design a multi-channel campaign to promote that strategy. SHALINI SHARAD: We are already witnessing commercial launch and clinical trial strategies changing in a patient-centric direction. The sales strategy landscape in the future would require a combination of digital medicine, digital health, digital marketing, behavioral science and real world data-based sales strategies. It can be a brilliant combination of market access, digital innovation, brand/ franchise units and marketing coming together. The access to markets and patients, patients’ health outcomes, and healthcare costs will be positively impacted by an organization that no more sells only a drug/device, but a service oriented product working towards improved quality of life. •

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MEET OUR panel of experts ERIK DALTON Executive Vice President MDcentRx

Erik has helped spearhead the evolution of the business for over 10 years, driving market growth and product innovation for the company. edalton@mdcentrx.com

MDcentRx’s core expertise is maximizing NPP and sales rep marketing efforts by leveraging our expansive physician community along with proprietary data and analytics. CHRIS GISH Former VP US Sales Sunovion

Chris has 27 years’ experience in the biopharmaceutical industry in sales and commercial leadership roles. At Sunovion, he grew their marquee asset, Latuda, into a blockbuster billion-dollar brand. Chris also worked at Pfizer for 21 years with roles in sales, marketing, and training, culminating in his role leading all promotion assets (digital and personal) for Established Products US Brands Group. cgishnj@gmail.com

JOE MANSFIELD

SHALINI SHARAD

VP, US Sales and Market Development PTC Therapeutics

Partner, Commercial Launch Excellence & Patient Centricity Wipro

Joe has held leadership roles with several companies in a plethora of therapeutic areas. At PTC he leads the build-out of support functions and hires the U.S. sales team for the launch of novel treatments for Duchenne Muscular Dystrophy. Prior to PTC, Joe held key roles at AstraZeneca as a sales professional, eventually progressing to Regional Oncology Business Director. He subsequently moved to MedImmune as the Northeast Oncology Sales Director, served at UCB as the Eastern Director for Sales, and was National Director of Sales for NPS Pharmaceuticals. joemansfield63@yahoo.com

PTC Therapeutics is committed to finding treatment options for patients living with lifethreatening diseases. It has two commercially approved products for the treatment of Duchenne Muscular Dystrophy. Its mission is to build an integrated biopharmaceutical company based on expertise in RNA biology. Its lead product candidate is ataluren for the treatment of patients with genetic disorders due to a nonsense mutation.

Shalini is a thought leader, author & speaker on patient centricity. Changing healthcare has motivated her to focus on newer ways to engage patients and drive better outcomes. She holds IPs on patient engagement solutions to help in innovative commercialization of drugs from Phase II to launch excellence, enhancing patient adherence, driving better patient-doctor relationships, and improving health outcomes/QOL/QALY solution sets in valuebased care/FDA digital health regulations. She has worked with many pharmaceutical organizations across clinical and commercial programs: CVM, oncology, CNS, respiratory, and specialty/rare disease. shalini.sharad@gmail.com

Wipro Limited is a leading global information technology, consulting and business process services company that harnesses the power of cognitive computing, hyper-automation, robotics, cloud, analytics and emerging technologies to help clients adapt to the digital world. Wipro is recognized globally for its comprehensive portfolio of services and strong commitment to sustainability and good corporate citizenship. It has over 160,000 dedicated employees serving clients across six continents. It offers IT, platforms & consulting solutions to the healthcare and life sciences industries.

COMMENT

HS&M AUGUST/SEPTEMBER 2018 | 22

sales

The Rep of the Future BMS, Daiichi Sankyo, Sunovion and Qstream Draw the Picture To complement our roundtable discussion on sales strategy and challenges, here are some further prognostications gathered by eyeforpharma Chairman Paul Simms from a webinar discussion with commercial leaders. Weâ&#x20AC;&#x2122;ve excerpted some of the wisdom provided by them. You can read more from Chris Gish in our roundtable here. Patrik Grandits Michael Connolly Enterprise Accounts Director, Pharma, Qstream

Managing Director, Head of Commercial Operations EMEA, Oncology, Daiichi Sankyo Oncology Europe

Ludovic Hacopian Chris Gish Formerâ&#x20AC;&#x201D;Vice President Sales US, Sunovion

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Head of Worldwide Field Medical & Medical Effectiveness, Bristol-Myers Squibb

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sales Paul challenged them to give their views on what the rep of the future will be like. He pointed out that reps are going to be the “trust creators, the data sources, the educators, the fonts of the patient’s insight that we’ve been able to generate as well as, obviously, being entrepreneurial in terms of their own management and keeping a keen eye on customer experience as well.” Michael Connolly kicked off the discussion by describing Qstream, a micro-learning platform that helps sales teams deliver to customer needs and meet quota by reinforcing key knowledge and shaping the behaviors they need to be successful in the field. He said “The solution was founded on the basis of 20 clinical studies that were carried out by the Harvard Medical School. The outcome of those clinical studies brought out two things. One is that it is possible to reinforce knowledge of key information that professionals need to have in their field so that they are credible in front of their customers. “More importantly, it also showed that you can actually change onthe-job behavior over time. Our customers have been telling us that they need to move their sales reps in a different direction. They want to move them away from the transactional model, the old model of ‘Buy three of these drugs and you can get the extra one free,’ to a more value-add model providing value to the customer with the patient in mind. The conversation that the new sales rep would have would go along the lines of ‘This

particular drug lowers glucose by this amount.’ So the sales rep is actually providing information about how the drug actually works, providing value to the HCP who can then share it with the patient.” Michael noted that it’s not necessary to change the sales force and bring in people with a new mindset, because you can change the behavior of current sales reps. He says the top 20% of sales reps get it, the bottom 20% don’t, and the middle 60% can be moved from the transactional model to the value-add model. He offered some feedback from Qstream customers, “The one constant is that unique relationship between the sales rep and, let’s say, the doctor. That is not going to go away.” But the nature of the relationship will change, because doctors today feel that they’re not learning from the reps. The Qstream training helped the reps increase their number of calls by orienting their message to value. Michael pointed out that medical science liaisons, MSLs, are also a critical bridge between the commercial model and the sales team, the marketing team, and the R&D side. “So, we have actually helped the MSLs retain key knowledge on the same side that they need to have to be able to share with the customer. Now medical affairs and the MSLs are actually getting more actively involved with the sales teams, either going on calls with them or helping the sales teams better understand the signs behind the products as well as the disease area.” Customers as partners Patrik Grandits noted that customers want to be seen as partners, people whose needs are under-

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stood and intrinsic to the value proposition that is presented. “What I try to do in Daiichi Sankyo is to connect all the dots with our customers, put them in the middle and then have not only sales reps or MSLs, but the entire organization focusing around those needs. The rep of the future will have to be not only an educator and a good listener but a partner of our different stakeholders. So payers, regulators become even more important for all of us in the industry.” He indicated that this would necessitate prolonging the selling cycle to make sure we are impactful by truly having the customer needs at the forefront of what we do. Ludovic Hacopian said that, in addition to investing in the right talent, the industry needs to work on talent retention and development. He said BMS is already thinking about what they’ll sell in 2050. “This is just a theoretical exercise but I found it quite exciting. I personally think that from more personalized medicines to commodities in 2050, companies will not be selling just a simple medicine. We are not just offering a therapy. I think that companies will be co-packaging diagnostic options, personalized medicine, and support program.” This model would put the patient at the center of everything. “We don’t have a crystal ball today. So those skills may be cognitive, different than what we know today.” “I think it comes all down to being very also open-minded and entrepreneurial in the approach that our customer-facing roles will have to take,” said Patrik. “I think having only true value-add medicines that will be reimbursed will also really drive the access

component.” He listed some attributes that Daiichi Sankyo looks for: entrepreneurship, scientifically educated people, those who can make fast decisions. “We also put down P&L responsibility even on a key account manager level so they can really make fast decisions for the customer, and understand the value chain.” What this also affects, added Patrik, is the rep-to-MSL ratio, which is shifting from one-tothree to one-to-four or even -five. He said “One key account manager (I would not even call them sales reps) will face probably six MSLs. They will be part of the value cycle, not the selling cycle, enabling top class science discussions and peerto-peer exchange. In the future, the scientific level of expertise will be much more critical. We will also need to be able to sell to new customers and the activities of the sales team no longer will focus on visiting doctors and on medical information. The focus is on addressing the needs of a broader network of buyers and influencers, and all the stakeholders will expect to be part of the conversation.” Superhuman reps? Paul asked the panel if we’re trying to put too much on the reps—to ask that they become superhuman, with an unrealistic array of knowledge. “If we’re expecting these people to be able to do so much, are we willing to actually make that investment in a smaller number of people perhaps, but more able?” Chris Gish suggested that there is a coming disruption in the nature of the reps, and it would likely come from the emerging companies rather than the established ones. “I think the disruption is also going

to come as you see devices become part of the package and the people who come from the device world, the tech world, the software world are going to demand a new different type of model. But it’s going to come from a company that we may not have heard of today. It’s going to come from a company that’s starting from scratch and it’s choosing to do things differently.” Ludovic responded that “We need to think about ourselves as IBM was 15 years ago. They were selling computers and they realized that it wasn’t working anymore. So they had to sell the services and the product was embedded into the services. I think this is really where it needs to be more ambitious than only thinking about the new rep, or the new MSL, or whatever we call it because I also truly believe that there may not be a clear separation. But we need to think about what type of business model we want to have and based on this business model then our world will evolve.”

one, the role of the frontline manager. They are a critical component in this. What our customers tell us is that they draw a definite correlation between the coaching of the frontline managers and the success of their team. So you need to have hands-on, proactive frontline managers. “The other thing you need to think about as well is your compensation model. You’re going to have to change it. It’s going to have to move away from the incentivebased model that was predicated upon how many prescriptions that the doctor writes. It’s just something that’s maybe based on value. Maybe that’s based on the feedback you get from the doctors themselves about the interaction they had with the rep.” De-siloization Paul addressed the issue of silos: can we affect the changes needed in a culture in which information is not seamlessly shared?

Patrik’s view was “We’ve been talking about individualized onboarding, personalized training for a long time. I think it’s really time that we take that seriously and make sure that the individual feels that they have a purpose, a clear understanding of what needs to happen, and then feels empowered, and feels well supported by the organization that focuses on the needs of the customers and employees. I think that this aspect of cultural shift will play a big role in the future. The culture will become innovative and entrepreneurial.”

Patrik spoke about Daiichi Sankyo’s culture. “I think what we have tried to do in our day-to-day work here was to enable constant and immediate inside sharing, not an information overload but really truly inside sharing. I think it is a fair comment that also you need to make sure that the infrastructure enables you as well. So we have built a CRM system across Europe in one language where all of our key account managers speak the same language. They can share information. They can share their account plans. They can share the insights and that can happen in real time.

Michael Connolly returned to his insights into customer experience. “Two things you have to consider that are very important. Number

“What we do is to identify customer needs, build tailor-made solutions, but we can only do that if this information flow goes into HS&M AUGUST/SEPTEMBER 2018 | 26

sales the system and out of the system at a constant level, constantly evolving, creating customer-type solutions instantly every week.” He added that the other elements that have to go along with this are appropriate incentives, away from sales and toward value. “They will be empowered and enabled to have a very different conversation with the customer in a compliant way.” Michael Connolly added a final item about the sales enablement professional. “We are seeing in our customer base that the sales enablement professional’s role is getting stronger and stronger. I met a lady who has moved from one of the big pharma companies to a mid-sized European pharma company because she was very successful in the sales enablement side of her previous employer. The company she has joined is very siloed and the CEO of that company recognizes that. That’s why she hired this particular individual. We talked about her challenges, breaking down these silos. But I think, again, if it comes from the top down and if there is a sense that this is the way of the future, you will break down those barriers. I see that the sales enablement professionals are going to be very critical making that happen.” •

Paul Simms Chairman, eyeforpharma Paul was General Manager of eyeforpharma from 2003 before moving into his current chairman role in 2009. Paul has a special interest in new projects, innovation, media and overseeing the general development and direction of the company. He is passionate about helping the pharmaceutical industry become more open and valued. In pursuit of that, eyeforpharma aims to find the best people doing the best work, and make that work normal—by first making it famous.

COMMENT

During the discussion, Paul conducted a survey of the 420 viewers of the webinar. Here are a few results from that survey, giving a picture of how the industry views its companies’ efforts:

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HS&M AUGUST/SEPTEMBER 2018 | 28

pharma Click here to get Top 50 pharma companies

PHARMA COMPANIES

Revenues Continue to Rise: The Top 50 Pharma Companies It was a year of continued good news as we saw increased growth last year with our Top 50 Pharma Companies’ revenue growing by $56.9B, up 7% from 2016 after 5% growth the year before. This is a strong trend given that we were only at 2% the prior year. The market is growing. Our Top 50 are growing faster than the total market. Worldwide total prescription drug sales growing at a rate of 2.6%. R&D spend is growing as well at $165B up 3.9% over 159B in 2016. And we saw a 104% increase in FDA approvals of NMEs & Biologicals for a total of 55, vs. 2016’s low of 27. Oncology drugs lead the share of the total market with $104B, Anti-rheumatics are next at $55.7B and Anti-diabetics at $46.1B. Drug prices continue to remain high with the average cost per patient per year for an orphan drug of $147,308 (up from 145,262) and a non-orphan drug of $30,708 (up from 28,904). Mergers and acquisitions slowed a little in 2017 (101 vs. 130 in 2016). Biggest deals included the $30B J&J acquisition of Actelion, Gilead’s $11.9B purchase of Kite Pharma, Thermo Fischer’s $7.2B

takeover of Patheon, Takeda’s $5.2B purchase of Ariad, Pamplona Capital Management’s $5B acquisition of Parexel, Bain and Cinven’s $4.36B purchase of Stada, Fresenius Kabi’s $4.3B purchase of Akorn, Novartis’ $3.9B takeover of Advanced Accelerator Applications, and BMS’s $2.3B acquisition of IMF Therapeutics. The thought is that the US tax reform will have a positive impact driving 2018 deals as the corporate tax rate drops below 20%. The first half of 2018 has shown the impact with over $100B spent on mergers and acquisitions to date. News of Obamacare has fallen off the radar and the industry is trending up. We continue to hope for the best as our markets seem fueled for growth. Here’s a snapshot of where the Top 50 (based on 2017 revenue) were

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at year’s end. We have tracked movement up and down the list with regard to both ranking and revenue changes as compared with 2016. Companies are ranked by their 2017 pharmaceutical revenue as furnished by their annual reports and publicly available sources, Edgar and Morningstar stock information websites (figures of non-U.S. companies were converted to U.S. dollars from various currencies using end of the year exchange rates for 2017 and 2015). Pharmaceutical revenues were extracted from reports to create an equal playing field. We also revised 2016 earnings to align “apples to apples” revenue reporting with 2017 figures. Companies that had revised 2016 revenues from our last year’s report include: Actavis (purchased by Teva), Bayer (restated report), and Sun Pharma (exchange rate conversion).

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Companies are ranked by their 2017 revenue as furnished by their annual reports and publicly available sources such as Edgar and Morningstar stock information websites. Figures of non-U.S. companies were converted to U.S. dollars from various currencies.

PHARMA COMPANIES

Click here to get Top 50 pharma companies

Ranking Company Location 2017 Revenue in US$B

Pfizer

New York, NY, USA

$52.55

Novartis

Basel, Switzerland

$43.09

Paris, France

$42.06

Basel, Switzerland

$40.16

5 Merck

Kenilworth, NJ, USA

$40.12

New Brunswick, NJ, USA

$36.26

Brentford, United Kingdom

$36.22

Sanofi

Roche

Johnson & Johnson

GlaxoSmithKline

AbbVie

North Chicago, IL, USA

$28.22

Abbott

Chicago, IL, USA

$27.39

10 Medipal Holdings

Tokyo, Japan

$27.27

Gilead Sciences

Foster City, CA, USA

$26.11

Boehringer Ingelheim

Ingelheim am Rhein, Germany

$26.06

Eli Lilly

Indianapolis, IN, USA

$22.87

14 Amgen

Thousand Oaks, CA, USA

$22.85

15 Alfresa Holdings

Tokyo, Japan

$22.71

16 AstraZeneca

Cambridge, United Kingdom

$22.47

Petach Tikva, Israel

$22.40

Bad Homburg, Germany

$21.34

Teva Pharmaceuticals

Fresenius

Bristol-Myers Squibb

New York, NY, USA

$20.78

Bayer

Leverkusen, Germany

$20.21

Darmstadt, Germany

$18.39

Merck KGaA

31 | HS&M AUGUST/SEPTEMBER 2018

Ranking Company Location 2017 Revenue in US$B

Novo Nordisk

BagsvĂŚrd, Denmark

$17.99

Takeda

Osaka, Japan

$15.76

Shire

Dublin, Ireland

$15.16

Celgene

Summit, NJ, USA

$13.00

Biogen

Cambridge, MA, USA

$12.27

27 Mylan

Canonsburg, PA USA

$11.91

Tokyo, Japan

$11.71

Astellas

Valeant Pharmaceuticals

Laval, Quebec, Canada

$ 8.72

Daiichi Sankyo

Tokyo, Japan

$ 8.55

Teijin

Osaka, Japan

$ 7.43

Otsuka

Tokyo, Japan

$ 6.90

CSL Behring

King of Prussia, PA, USA

$ 6.62

Slough, United Kingdom

$ 6.11

34 Reckitt Benckiser

35 Regeneron Pharmaceuticals Tarrytown, NY, USA

$ 5.87

UCB

Brussels, Belgium

$ 5.44

Eisai

Tokyo, Japan

$ 5.34

Zoetis

Parsippany, NJ, USA

$ 5.31

Grifols

Barcelona, Spain

$ 5.18

Perrigo

Dublin, Ireland

$ 4.95

Chugai Pharmaceutical

Tokyo, Japan

$ 4.75

Sun Pharmaceutical

Mumbai, India

$ 4.51

Sumitomo Dainippon Pharma Osaka, Japan

$ 4.25

44 Mitsubishi Tanabe Pharma

Osaka, Japan

$ 3.86

45 NEW Alexion

New Haven, CT, USA

$ 3.55

Dublin, Ireland

$ 3.47

47 Aspen Pharmacare

KwaZulo-Natal, South Africa

$ 3.35

48 Mallinckrodt

Dublin, Ireland

$ 3.22

Kyowa Hakko Kirin

Tokyo, Japan

$ 3.12

Shionogi

Osaka, Japan

$ 3.02

Endo Pharmaceuticals

HS&M AUGUST/SEPTEMBER 2018 | 32

patient focused

Accenture Advice and AstraZeneca Case History On the Power of Patient Services Most healthcare companies have invested in a variety of patient services to help educate both HCPs and patients, improve adherence, assist with cost, make information more accessible, and positively affect outcomes. But the problem is, even with a wealth of these services, many patients arenâ&#x20AC;&#x2122;t aware of them or fail to use them efficiently. Accenture recently looked into this trend and came up with some key findings and useful advice. In previous surveys, they had found that patients preferred to hear about these services from their doctors, and that healthcare companies were relying on the doctors to communicate about them. But Accenture recently found that just one in five patients is aware of the services.

33 | HS&M AUGUST/SEPTEMBER 2018

So in their 2017 survey, the company looked into where the disconnect might be occurring. They interviewed 362 healthcare professionals in the US, the UK , France and Germany, general practitioners and specialists, to monitor behaviors and understand what might be done to improve the use of patient services. Primarily, they wanted to find out not only about the awareness of patient services among physicians, but also whether the HCPs believed in their value to improve outcomes. What are the attitudes, barriers and remedies? Here are a few eye-opening snapshots from the report.

What do over of the top 20 pharmaceutical, biotech, and medical device companies have in common? They choose Jacobs Management Group as their recruiting partner.

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215-732-6400 • www.jacobsmgt.com • ckraft@jacobsmgt.com

patient focused KEY FINDING #1 MOST HEALTHCARE PROFESSIONALS ARE NOT VERY AWARE OF PATIENT SERVICES • Just 40% reported being very aware of patient services • 60% said they are only somewhat aware, or not aware at all • Professionals in oncology had the highest awareness, 52%, followed

by immunology at 44%. Brain specialists had the lowest, at 31% • Sales reps are the number one way HCPs hear about patient services • But nearly half of the HCPs said they hear about patient services less than 25% of the time from reps • Learning through conferences, email, websites, portals, etc. is happening even less [Figures 1 & 2]

35 | HS&M AUGUST/SEPTEMBER 2018

KEY FINDING #2 HCPs DON’T TALK ABOUT SERVICES FREQUENTLY WITH THEIR PATIENTS • 81% of pharmaceutical companies rely on HCPs as the primary way of communicating with patients about their services. • 63% of patients want HCPs to be their primary point of contact for those services

• But just 15% of HCPs reported that they always personally share information on pharma services with their patients • 85% said that they sometimes, rarely, or never personally share information on services with patients [Figure 3] • 42% reported that their primary reason for not discussing services

KEY FINDING #3

is that they lack a good understanding of what’s available [Figure 4] • HCPs who share information about services with patients do so most often when those patients are starting out with a new therapy/ drug/device, rather than at other points in their treatment [Figure 5]

HCPs SEE BETTER PATIENT OUTCOMES AS THE NUMBER ONE BENEFIT OF USING SERVICES • But most pharma companies aren’t presenting them that way: just three out of ten reps present the services in terms of their ability to improve patient outcomes.

HS&M AUGUST/SEPTEMBER 2018 | 36

patient focused

Most don’t present patient services as an integral part of their company’s offerings or part of a holistic solution to address unmet patient needs. • 21% of respondents cited patient services as an important contributor to patient care and support outside of the provider’s office, and a factor supporting patients’ ability to manage their conditions [Figures 6 & 7] • HCPs indicate that they would be far more likely to recommend patient services if sales representatives made a more compelling case for their use: 63% say that solid, published evidence of improved outcomes would increase their trust/belief in the value of patient services

• 42% said that evidence of services helping patients adhere to their treatment plans would increase their trust/belief [Figure 8] AstraZeneca: incorporating services into clinical trials In 2016, the company began using a mobile app in three clinical trials studying a therapy for women with certain recurring forms of ovarian cancer to gather information about two common side effects of the treatment. The goal: to help the patients report side effects more easily (and hopefully more quickly), and to help the doctors conducting the trial track side effects and respond more readily to patients suffering from them. The app was developed

37 | HS&M AUGUST/SEPTEMBER 2018

by Paris-based Voluntis in close clinical collaboration with AstraZeneca and the US National Cancer Institute (NCI). It uses a Bluetoothenabled blood pressure cuff to gather and send data to the patient’s smartphone and also to the patient’s doctors, including those conducting the trial, via a web portal. SO WHAT SHOULD PHARMACEUTICALCOMPANIES DO DIFFERENTLY? Fill the Communication Gaps Patient services will deliver better patient experiences and outcomes if HCPs: • Possess a comprehensive understanding of what’s available • Understand how services can help deliver a better patient outcome

• Feel confident when talking about services • Can easily inform and connect patients with the services best suited to their needs Fill the Product and Service Gap • Reorient commercial functions from developing and marketing brands to designing and marketing holistic patient solutions. Currently, if they market services at all, most patient services are

treated as an ancillary service vs. an integrated solution, which lessens perceived relevance to patients and HCP’s.

Fill the Engagement Gap

• Embedding patient-services talent into existing brand teams makes the process holistic

• Sales reps are still driven by incentives based on script volume— an approach that is not aligned with the HCP’s, patient’s or payer’s goal of improving patient health and outcomes

• Another successful tactic is to create “outcome” teams instead of brand teams

• Focus conversations with HCPs on outcomes—across all channels and with greater frequency • Ensure that every communication through every channel leads HS&M AUGUST/SEPTEMBER 2018 | 38

patient focused

with outcome—positioning it as “what” they are selling and “why” their offerings should matter to their target audience Fill the R&D and Commercial Gap • Rigorously generate evidence on the effect of patient services on out-

comes—starting with clinical trials • This calls for embedding services into the product-development process to generate the required data to prove impact on patient outcomes • This will also help prove the value of services internally to sales reps, medical affairs, and budget hold-

39 | HS&M AUGUST/SEPTEMBER 2018

ers, who will then advocate for or allocate resources so that service programs can be developed more effectively and marketed more purposefully •

Study authors and contributors: Whitney Baldwin whitney.baldwin@accenture.com Keena Patel keena.b.patel@accenture.com Anthony Romito anthony.r.romito@accenture.com Eva Wiedenhöft eva.wiedenhoeft@accenture.com Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations. Combining unmatched experience and specialized skills across more than 40 industries and all business functions— underpinned by the world’s largest delivery network—Accenture works at the intersection of business and technology to help clients improve their performance and create sustainable value for their stakeholders. With 449,000 people serving clients in more than 120 countries, Accenture drives innovation to improve the way the world works and lives. www.accenture.com

COMMENT HS&M AUGUST/SEPTEMBER 2018 | 40

industry trends: by the numbers Compiled by Cari Kraft, Jacobs Management Group, Inc.

$7.8B + % =

75%

Doctors who want to get info from reps Physicians continue to want to hear about patient services programs from pharma reps, according to a study by Accenture Life Sciences. 75% want this information from reps, followed by conferences (74%), colleagues (66%), websites (57%) and email (64%). Source: Lost In Translation: The Communication Gap in Patient Services, Accenture Life Sciences, 2017 (For more on this report, see our summary in this issue.)

Size of healthcare data analytics market by 2020 The data analytics market will grow by a CAGR of 15% and reach $7.8 billion in the next two years. Source: US Healthcare Data Analytics Market, Forecast to 2020, Frost & Sullivan, April 2017

31% of 91%

Estimated importance of delivering on patientfocused mission In a survey of over 1200 healthcare professionals, 91% said that it was vital for their companies to deliver on their patient-focused missions/visionsâ&#x20AC;&#x201D;but only 31% had confidence that this would happen soon. Source: Ipsos Healthcare Aurora Project Survey, February 2018

40%

40% of Millennials are digitally tracking their health information In a survey of over 1,000 consumers and 400 physicians, Aetna finds that consumers ages 18-34 rely on digital tools to navigate health with over 40% digitally tracking their health information, and 30% using a wearable tracker. Source: Aetna Aetnaâ&#x20AC;&#x2122;s inaugural Health Ambitions Study, December 2017 41 | HS&M AUGUST/SEPTEMBER 2018

80%

Nurses who say non-physicians play bigger role in care A survey of 512 full-time nurses and administrative staff by the University of Phoenix College of Health Professions showed that over 80% believe that nurse practitioners, RNs and other non-physician healthcare professionals continue to increase the importance of their role in patient care management. This includes completing tasks typically done by physicians, more involvement with information systems and regulations, and a greater responsibility to manage overall patient care planning. Source: Survey: 8 in 10 nurses believe nonphysician practitioners play larger role in managing patient care, Becker’s Hospital Review, May 2018

571

DIGITAL HEALTH EFFICACY

Number of Digital Health Efficacy Studies 2001-2017 Digital health technologies, a significantly growing part of our healthcare system, are clearly affecting treatment guidelines. IMS’ IQVIA showed that 571 studies of digital health initiatives – observational studies, randomized controlled trials, systematic reviews and meta-analyses – have been published in the last ten years. This is estimated to grow to an annual level of 1120 by 2022. Source: 2018 and Beyond: Outlook and Turning Points, IQVIA Institute For Human Data Science, March, 2018

82%

COMMENT

Employers who have installed Employee Assistance Programs for healthcare EAPs are the leading digital program used by employers to assist employees with their healthcare, followed by smoking cessation (77%), health risk assessment 72%), disease management (68%), diabetes management (66%), biometrics screening (62%) and others. Source: The State of Digital Health, Castlight 2018 Annual Report HS&M AUGUST/SEPTEMBER 2018 | 42

PHARMACEUTICAL

Great Advice From Great Minds: Takeda Head of Commercial Learning and Development: Breaking Down Silos Serina Fischer talks with Jill Donahue, Author EngageRx Despite the fact that our industry is drowning in data and more complex than ever beforeâ&#x20AC;&#x201D;or maybe because of that!â&#x20AC;&#x201D;we need help in making certain areas and tasks more streamlined and efficient, in order to get the job done with the proper speed and strategy. 43 | HS&M AUGUST/SEPTEMBER 2018

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hours of educational networking

PHARMACEUTICAL At the LTEN (Life Sciences Trainers and Educators Network) conference in Phoenix this June, I spoke to Serina Fischer, Head of Commercial Learning and Development at Takeda. While Serina herself is a fountain of knowledge, in her role at Takeda she has taken on the refreshing task of helping her colleagues understand goals, tell stories, and break down the messaging so that it can be communicated to all stakeholders in record time.

varied background in sales, sales leadership, operations, marketing, and more, as well as being a certified Six Sigma black belt—not a lightweight!

After more than 14 years at Lilly, Serina came to Takeda a little over a year ago. She is responsible for markets, marketing, sales and other departments, offering crossfunctional support for learning and development. She has a very

Part of this culture is a deep respect for breaking down silos and respecting the lenses through which each department sees their role. Serina noted that if you’re advocating an initiative, you’re going to have a better chance of getting

Takeda is supportive of interaction with other colleagues across healthcare, such as at LTEN, to learn about innovation and share ideas. Serina presented at the conference on their transformation journey, from a training culture to a learning culture—the steps taken and the measurable outcomes.

Serina Fischer interview

45 | HS&M AUGUST/SEPTEMBER 2018

support if you have a mutual understanding and communication across the organization. She appreciates Takeda’s internal structure, which supports stakeholder management at each level, making sure there’s sharing and connection. This helps achieve numerous ends: efficiency, alignment, buy-in, strategy. One of the lessons she teaches is how to tell a story in marketing, communicating the value of what you’re doing. People often get caught up in massive data and analysis paralysis about ROI and what it contributes to the bottom line. But that ultimately isn’t important to explaining the goals, because there are so many variables. More vital is being clear about the

knowledge and behavioral changes you want to see at the end, and getting alignment with stakeholders by demonstrating that. She says we often get entangled in an activity-based environment. Serina recommends going right to executionary centralism. When I pointed out that 85% of life sciences professionals believe in patient centricity as the path to better outcomes, but 69% are not sure that their organizations can clearly define this, she said that Takeda has a framework to achieve it. It’s called PTRB: Patients, Trust, Reputation and Business. All decisions have to start with the patient in mind. If you can determine what’s best for the patient first, all the rest will follow logically from that. All the leaders at Takeda take this very seriously, and insist on moving the process along in the proper order. Their global corporate training programs embed this philosophy as well. From the decision chain to the language they use, this is the motivating influence. It helps connect the concept from the field force through to the home office, and make it part of Takeda’s DNA.

Jill Donahue Principal, Excellerate Author, Engage Rx: The 3 Keys to Patientfocused Growth Co–founder, The Aurora Project Jill, HBa, MAdEd, is a keynote speaker, author and thought leader who has authored two books on Influencing in patient-focused ways and co-founded The Aurora Project, a global patient-centricity group. She also serves as Associate Editor of Healthcare Sales & Marketing. Jill.Donahue@excellerate.ca

COMMENT

I am really inspired when I meet people like Serina. Despite her youth, she has the knowledge, skills and wisdom of a leader. Our industry is in good hands! • HS&M AUGUST/SEPTEMBER 2018 | 46

motivation

MOTIVIDEOS By Cari Kraft, Jacobs Management Group Ah, that morning meeting—always a challenge to wake people up and get them excited about the day or week ahead. So here’s our usual kickstart for you—a few visual pieces that will provoke conversation and excite brain waves. Enhance Your Speaking—Learning About Language We all strive to use language so that others clearly understand what we’re talking about. But here cognitive scientist Lera Boroditsky shows us some of the subtleties we communicate—or miscommunicate -- across cultural lines. Helpful if your company is global. Tune Up Your Presentations—First Things First! Another lens to look at your sales and marketing presentations through. Ann Ricketts outlines the four steps to making a compelling presentation that people will really listen to! (Hint—it begins at the very beginning of what you say.)

How to Start Your Day This is the very essence of Motivideos—how to get yourself inspired at the beginning of the day. How to believe in what you can do. And how to get it done. Take notes! What’s the Next Idea? There’s always more than one way to solve a problem. Here is a short funny video to kick-off an idea session. When the first doesn’t work—don’t get defeated. Trust your ingenuity.

Submissions are welcome. If you have one you like, email a link to me at ckraft@jacobsmgt.com.

Cari Kraft leads a team of master level recruiters at Jacobs Management Group, celebrating 20+ years of executive recruiting in the healthcare (pharmaceutical, medical device, biotechnology) and high-tech industries, nationally. Prior to joining Jacobs Management Group, Ms. Kraft has held positions as a Senior Sales Executive, Director of Business Development and Director of Marketing. She also has deep knowledge of the technology/startup fields, having been in the industry through the rise of the Internet. Ms. Kraft is a University of Pennsylvania/Wharton alumnus holding a degree in economics and decision sciences. Cari can be reached at ckraft@jacobsmgt.com.

COMMENT 47 | HS&M AUGUST/SEPTEMBER 2018

TOP LISTS the publication for healthcare sales & marketing leadersâ&#x201E;˘

We are making HS&Mâ&#x20AC;&#x2122;s series of Top Company Lists available below.

medical device companies click here to receive your copy of the Top 50 medical device companies

healthcare Companies click here to receive your copy of the Top 100 health care companies

biotech Companies

pharma Companies

click here to receive your copy of the Top 50 biotech companies

click here to receive your copy of the Top 50 pharma companies

Enhance Your Speaking—Learning About Language

Tune Up Your Presentations—First Things First!

49 | HS&M AUGUST/SEPTEMBER 2018

How to Start Your Day

Whatâ&#x20AC;&#x2122;s the Next Idea?

HS&M AUGUST/SEPTEMBER 2018 | 50

INDUSTRY

Why I Work In Healthcare More answers to the most important question

For the last several issues, we have been traveling far and wide to capture the enthusiasm of industry people about why they chose to devote themselves to the life sciences. It’s been enlightening, inspiring and hopeful. So, we thought we’d take this opportunity to look inward and feature some of the people on our own staff, who also take joy in their work in this industry. We get to do it through you, by helping to build your teams, advance your careers, and get your words, and those of your top colleagues in the industry, on paper. Here are some of the faces of those who bring you top recruiting services, this magazine, our bi-weekly news brief—healthcare headlines, and more.

COMMENT 51 | HS&M AUGUST/SEPTEMBER 2018

NEW! Agency and Provider Spotlight! Profiles of Leaders: Healthcare Sales & Marketing’s New Feature As a value to the industry, we have initiated a project to profile the top agencies so that you have them at your fingertips. We are digitally compiling a searchable single source to give you access to the who’s who, their strengths, vision for the future, strategies and relevant white papers, so that you can get a better feel as to how they work. Our first spotlight is RxEdge. Founded in 2000, ahead of their time, RxEdge is a visionary com-

pany in providing access to patients through its extensive network of close to 30,000 pharmacies representing 70% of the retail prescription volume. Having worked with many of the pharma majors such as Merck, Astellas, Takeda, Allergan, Sanofi, Novo, AZ, GSK, Pfizer, Lilly and BMS, RxEdge puts brands front and center in America’s number one healthcare destination: the pharmacy. We are driven by the input of our readers so please let us know if you

have an agency or provider you would suggest we profile. Every agency we feature will be recommended by one of our readers. You will see some of the best with links to all their relevant data, their philosophy and history, as well as what makes them special. This is all in keeping with our goal of having the hottest industry companies and the top thought leaders in the pages of every issue of HS&M. Our goal is to constantly expand the value we bring to you.

If you have an agency or a provider to recommend, please reach out to me, Neil Greenberg at ngreenberg@hsandm.com so that we can evaluate them for consideration.

53 | HS&M AUGUST/SEPTEMBER 2018

Spotlight LEADERSHIP

Rx EDGE Media Network In 2000, when we formed Rx EDGE, little did we realize that we were ahead of our time. Our vision of helping consumers take more control over their healthcare by providing information about Rx brands through influence media is exactly where both healthcare and media would end up today. WE HELP CONSUMERS WHO HELP THEMSELVES

Jim O’Dea President and CEO

Mike Byrnes EVP, Sales

KEY STATS Rx EDGE was founded in 2000, and is a division of LeveragePoint Media LLC.

INSIGHT No matter where consumers are they are bombarded by unwanted ads for products that may or may not be relevant to them. And they have learned to ignore them. But we have a completely different relationship with consumers.

PHILOSOPHY These days, media is defined differently. It’s about fans and followers, and being where the action is. If you have the scale to influence, you’re media. Think of Rx EDGE Media Network as the most efficient and effective in-pharmacy influencer.

CONTACT Michael Byrnes, EVP, Sales michael.byrnes@rx-edge.com Office: 610.431.7606 Cell: 856.577.6388

These days, people spend less time with doctors and more time taking healthcare into their own hands. They’re mindful and resourceful. The pharmacy is the new healthcare hub and in-aisle is where consumers are actively searching for products and medicines to care for themselves, their ailments, conditions, and related needs. When consumers are in the pharmacy, Rx EDGE is the only targeted media that’s exactly where they’re looking. That’s why brands that use Rx EDGE average script lifts of 12.5% and ROI of $8.12. Visiting the pharmacy is not a one-time event. The average American lives within just two miles of a community pharmacy and over 275 million visit a pharmacy each week. Without over-the-counter medicines 60 million Americans would not seek treatment. Pharmacies are increasingly becoming a healthcare destination, with many offering on-site vaccinations and frequently hosting wellness events and health screenings.

AS CONSUMERS APPROACH HEALTHCARE DIFFERENTLY, BRANDS NEED TO APPROACH THINGS DIFFERENTLY, TOO. Rx EDGE media network is different for all the right reasons. No other media delivers like Rx EDGE. • Our displays get noticed and motivate action through takeone booklets that deliver product information, doctor-patient discussion guides, savings offers, and disease education.

Read our white paper to learn more about the emergence of the pharmacy as a healthcare hub and trusted patient resource. Participating in the media opportunities created in the new, diverse pharmacy is an ideal way to support brand goals to deliver more targeted and more effective messages to patients.

HS&M AUGUST/SEPTEMBER 2018 | 54

Spotlight:

Rx EDGE Media Network

• Our experience encompasses a breadth of Rx brands and categories, including: 75 Categories, 85 Manufacturers, 155 Brands, 3.5 million+ displays, 4.8 million incremental Rxs generated • Our expansive reach delivers more than 750 million impressions in a 12-week period across our network, representing over 70% of U.S. Rx volume. • Consumers go to the pharmacy for a specific reason, and the pharmacy is a constant in consumers’ lives. No other media has their attention the way we do when they’re searching for an-

swers about their health and most motivated to act. • Our Insight EDGE targeting platform insures that your brand is present in the optimal pharmacy section and geographic locations so your message matters to the consumers it reaches. • We use a matched-panel experimental design protocol, to measure our programs. It is considered the Gold Standard in marketing measurement because of its validated statistical design and level of accuracy. Unlike other media, consumers come to us…when they’re

55 | HS&M AUGUST/SEPTEMBER 2018

searching for the information we have about Rx brands. Across the country, across 29 of the 50 top Rx retailers, Rx EDGE puts brands front and center when consumers are most receptive and motivated to act.

Today alone 2.9 Million consumers stood in front of one of our displays. If your brand was there you could’ve met them. All of them. •

the publication for healthcare sales & marketing leaders™

...and we’ll let you know when each new issue is published.

it’S free! CLICK HERE FOR YOUR CAREER Healthcare Sales & Marketing was created specifically to help people like you learn and grow in the life sciences. Our articles are written by professionals for professionals, and we get great feedback on the benefits they derive from HS&M. Click the subscription button to sign up for a free subscription, so you don’t miss any of the insightful, expert articles we provide all year long.

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Marketing

What if Dr. House Used Twitter? A talk with Dr. Bertalan Mesco, the Medical Futurist Bertalan Mesco is an MD and PhD who has established a global reputation as a medical futurist. His mission is to fill the gap between healthcare and digital technologies. He is also very much a proponent of treating the patient as a customer. We were intrigued by his focus and the things he expects for healthcare, and asked him some questions about—what else?—the near future. He made some anticipated points—the effects of which we are already seeing—and some surprising predictions as well. HS&M: What medications—or treatment areas—would have advanced the most, and why (current areas of discovery, profit potential, etc.) BERTALAN MESCO: It seems that those medication areas that are supported by highly engaged, empowered patients could advance the most as patients can significantly contribute to that. Examples include diabetes management with continuous glucose monitoring systems or spotting atrial fibrillation as a risk for stroke with smartphone-connected ECG devices.

57 | HS&M AUGUST/SEPTEMBER 2018

HS&M: What will a patient’s—sorry, customer’s—life be like: what will wearables measure, how much will we depend on telemedicine, how much will we monitor our own health?

I, as a patient, want to be the point-ofcare. Wherever I am or whenever I need them, I want diagnostic and treatment options.

CONNECTING MARKETING & SALES IN THE DIGITAL AGE September 26-28, 2018 | The Westin Copley Place, Boston, MA

FP18HSM Visit pharmaforce.wbresearch.com for more information.

Marketing MESCO: What patients today can (or worse, are allowed to) do about managing their health and disease is ridiculously far from what technologies can provide them with. The patient life must change dramatically. First, I as a patient, want to be the point-ofcare. Wherever I am or whenever I need them, I want diagnostic and treatment options. Second, I want to get engaged, as my life is at stake. The era of hero physicians is over. No physician can be upto-date when there are 30 million studies out there. We need disruptive technologies that take care of repetitive tasks that do not require the attention of a person but let us

talk to each other to nourish the human touch. HS&M: How will pharma/bio/device companies change, in terms of how they market or sell?

Markets will become less essential and patients will go through different types of healthcare systems (of different countries) to get the help they need

Bertalan Mesko at TEDxNijmegen 2013

59 | HS&M AUGUST/SEPTEMBER 2018

MESCO: I think they will have to shift their focus from treatments to prevention. Prevention requires at least as many innovations, technologies and products as treatment does but preventing diseases is much more cost-effective for healthcare in general than treating what is already out there. As the ivory tower of medicine is breaking down, and access to anything from treatments and technologies to information and second opinion becomes global and digital, markets will become less essential and patients will go through different types of healthcare systems (of different countries) to get the help they need.

HS&M: What will the HCP’s day be like: mostly in virtual contact with patients, less or more time spent online and filling out forms, sources of information? MESCO: If we cannot remove 100% of administration from the physicians’ life, we are doomed. Medical students will leave after the first glimpse they get of their future job that involves 60% of their time spent on administration that could be aided or replaced by a few not even futuristic technologies. If digital health can reach its full potential, physicians will have a very creative job that involves all their unique skills from problem solving to empathy. They will have the time and focus to deal with a few cases that really require their attention in person. The rest can be dealt with through digital channels. This way their reim-

bursement and performance both become transparent. HS&M: Will the team approach— between various physicians, companies, payers, etc.—be enhanced so that the patient is better served? MESCO: This has been a main theme of improving healthcare for decades. What the multi-disciplinary approach misses, I think, is involving the team of the patient, too. Patients have a team including their pharmacists, patient advisors, advocates, online communities, peer support and of course, family. We will experience no change in practicing medicine as long as patients are not equal members of the medical team. HS&M: Will we be able to improve on such things as cost containment, adherence, risk prevention? MESCO: Health sensors and smart

apps patients can use at home can help a lot with risk prevention from stroke to diabetes complications. Digital pills that add a microchip to the medication* can help a lot with adherence in certain mental health conditions. In others, empowered patients don’t have an issue with adherence (I think the term is even offensive to them) as they perfectly understand why they need that treatment. Regarding costs, disruptive technologies are only disruptive if they are cheaper than any technology before them. Related to more complicated issues such as personalized medicine, it’s the responsibility of policy makers to realize that customization of treatments is more expensive today, but more cost-effective in the long-term as those help avoid side effects and re-hospitalization. • *See our coverage of Otsuka’s digital breakthrough in this issue.

Bertalan Mesco The Medical Futurist Bertalan is a self-described geek physician with a PhD in genomics and an Amazon Top 100 author. He envisions the impact of digital health technologies on the future of healthcare, and helps patients, doctors, government regulators and companies make it a reality.With 500+ presentations under his belt, including courses at Harvard, Stanford and Yale Universities, Singularity University, and organizations including the 10 biggest pharmaceutical companies, he is one of the top voices globally in healthcare technology. He has been featured on CNN and the BBC, in WIRED, National Geographic, Forbes, TIME magazine, and the New York Times, and was on the Healthspottr.com Future Health Top 100 list. His blog has more than 3 million readers, and he is one of LinkedIn’s Top Voices. He is the founder of Webicina.com, the first service that curates the medical and health-related social media resources free of charge for patients and medical professionals. berci.mesko@gmail.com

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AARP on older adults’ digital habits and attitudes on healthcare companies Recently, AARP did a major study on how people in their 50s, 60s and 70s use digital devices, what they search for, and who they trust. Some of the interesting findings were around healthcare—what devices they used most, and for what purposes. Called “Technology Use and Attitudes among Mid-Life and Older Americans,” it was led by G. Oscar Anderson, Senior Research Communications Advisor for AARP. It surveyed 1520 adults 50 and older, and was weighted by age within gender, education, race/ethnicity, household income, language preferences and census division to fairly represent the U.S. population over 50. The margin of error is estimated at 2.71% at the 95% confidence level.

Some of the key findings overall: • Mobile and traditional computing devices are now the primary technology used by Americans over 50 • 9/10 own a desktop or laptop computer, 7/10 a smartphone, and 4/10 a tablet • Not surprisingly, those over 70 tend to use desktops and feature phones more than those in their 50s or 60s

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• Very few use wearables or home assistants, or are familiar with virtual reality or augmented reality • A sizable minority use their devices to manage medical care or learn online • 42% get health and fitness info on their computer • 32% manage or receive medical care on their computer

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A deeper dive into the study reveals some facts of interest to marketers in healthcare. For instance, among online learning activities, health and fitness info comes in first:

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Even on tablets—a lesser-used technology among older Americans—33% search health and fitness info, and 17% are already managing or receiving medical care, possibly through their doctors’ web portals.

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Healthcare also comes up on phones for a sizable minority of users. Around three in ten smartphone users do these activities on their phones: where getting health and fitness info and managing medical care come in third and fourth

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As with most digital transactions, older Americans join the rest of the country in being skeptical about how their information is used and how much they trust the companies they contact. Yet, despite the recent downturn in the image of our industry, healthcare companies come in second, after banks and financial institutions, in inspiring trust.

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August / September 2018

Articles inside

What if Dr. House Used Twitter?

Industry Trends: By The Numbers

Editorial Board

R ep of the Future: BMS, Daiichi Sankyo, Sunovion Predictions

Executive Spotlight: Otsuka and Spark—Firsts in Digital and Gene Therapy

Takeda Head of Commercial Learning on Breaking Down Silos

Editor’s Letter