Understanding IDNs and What They Mean to the Pharmaceutical Industry–Q&A with Greg Skalicky

Greg Skalicky
President and chief revenue officer
EVERSANA

Integrated Delivery Networks have changed the healthcare landscape over the past decade. Greg Skalicky, president and chief revenue officer at EVERSANA, spoke with Pharmaceutical Executive about the ways that commercialization teams are working with these networks to bring drugs to markets.

Pharmaceutical Executive: How are IDNs being utilized by the pharmaceutical industry?
Greg Skalicky: Integrated Delivery Networks, or IDNs, have risen in popularity across the healthcare landscape in recent years. According to data, 70% of all physicians in the US are employed by an IDN – meaning a hospital, a system or other corporate entity. This wasn’t the case a decade ago, when less than half of clinicians had the same employment agreements. The growth of IDNs means pharmaceutical companies must have strategies to reach physicians in these groups to encourage them to know about and prescribe their medications while also having strong knowledge of the buyers and other influencers.

Ten years ago, if you were bringing a new drug to market, you could have a sales rep visit a physician, educate he or she on the benefit of the drug, and the doctor could then decide to prescribe the therapy. That’s all changed with IDNs. Clinicians have fewer available hours in a day. They also, in many instances, may not have the buying power.

That said, if a sales representative, for example, has strong relationships with a clinician inside an IDN and that clinician has influence, the representative may have the opportunity to work hand-in-hand with the clinician to encourage his or her IDN to add the new therapy to formulary recommendations. This could dramatically increase access and help patients and is why a customized, IDN engagement strategy is critical for pharma to understand.

PE: So, with that in mind, what advantages do IDNs bring to healthcare
Skalicky: IDNs bring many benefits to both the overall healthcare system, to clinicians, and to patients. They provide greater opportunities for clinician collaboration across different therapeutic areas, improved operational efficiencies, better purchasing power, and improved patient and clinical outcomes through a better-connected system. Additionally, because all the data is under one roof, data integration is likely better in an IDN, which can help drive better health outcomes and even lower patient costs.

And for field sales representatives who have strong relationships with clinicians inside an IDN, opportunities are huge to create internal champions that can create support for new or breakthrough therapies. This influence can help impact decision-making at the point of care.

PE: What impact do IDNs have on drug launches?
Skalicky: The impact of an IDN on a future drug launch is about access. When the product comes to market, will the IDN have the medication available for prescription, and will doctors know about it? This is where an IDN engagement strategy must be developed early in the process.

For some disease states, IDNs have more influence on decision-making than independent physician practices. This influence can shape which therapies physicians can prescribe at the point of care. Direct engagement between sales reps and physicians is still essential, but inside an IDN, brands must truly optimize a more in-depth launch and commercialization strategy to engage all the decision makers.

And while decision-makers within the IDN are–of course–focused on patient care and clinical outcomes, IDNs are also committed to initiatives that can help to reduce overall healthcare expenditures. Data-driven insights that illustrate how access and adherence to the therapy can provide overall cost savings for the institution can help sway clinical and administrative decision-makers.

Real-world evidence (RWE) also can and should play a critical role in getting new therapies into an IDN. IDN engagement teams should use RWE to demonstrate to stakeholders how the drug optimizes patient care and improves clinical outcomes, stacks up against other therapeutic options, and, if possible, its impact on costs.

The effort to build trusted relationships within the IDN framework should begin at least one year prior to launch. It should focus on understanding the drug evaluation and approval process, strategic objectives of the health system, patient populations, disease state expertise and patient outcomes inside the IDN.

With these factors known and part of a brand’s commercial launch strategy, manufacturers will be in a better position to get their new product into market to help patients through an IDN.

PE: What role do you think IDNs will play in the future for life sciences and pharma companies?
Skalicky: Understanding the IDN model, its rapid growth and how it has and continues to reshape the healthcare landscape is paramount to future success for pharma and life sciences teams. To navigate it successfully, teams must continue to evolve in how they develop engagement strategies to ensure access to their lifesaving medications, using the top-down, bottom-up strategy.

From the top down, they must deliver data-driven information to highlight the full value proposition of the therapy to key executive decision-makers and disease-specific key opinion leaders within the IDN. And from the bottom up, it's about aright-sized field team delivering targeted, value-added messaging directly to physicians and other prescribers. This messaging must be clear and highlight the full range of clinical and financial attributes (and competitive advantages) of the therapy to address the needs of both the physician and the institution.

Building an engagement strategy that yields results requires a team of experts across the entire commercialization spectrum. Brand teams should engage with knowledgeable partners that have experience, infrastructure, and established relationships with IDNs. Those that do so will be poised to best navigate IDNs and effectively communicate how a new treatment should fit within the IDN formulary to demonstrate the value it brings to patients and to the institution. Create a win-win for everyone and you won’t be disappointed.