The Total Customer Experience

With a wide range of cancer treatments coming to the market, oncology has become one of the fastest growing segments of the pharma/biopharma business. In order to better understand how pharma companies can reach doctors with these new products, Market Strategies International (MSI) conducted its third annual MSImage Oncology & Hematology Study, which identifies those pharmaceutical/biopharmaceutical companies that oncologists and hematologists perceive to have the best overall image. The study asked 465 physicians to evaluate which measures drive a pharma/biopharma company's image and performance.

Peter Carlin

Pharmaceutical Executive talked with Peter Carlin, senior vice president of Market Strategies International, about how pharma and biopharma companies can go about reaching this burgeoning market.

In terms of marketing, what specific needs of oncologists and hematologists did the study address?

The study looked at how oncologists and hematologists define company image, and how they evaluate performance in terms of services and other value-added programs offered by pharmaceutical and biopharmaceutical companies. We looked at 31 different performance measures ranging from customer satisfaction issues to how an oncologist or hematologist generally perceives a company's commitment to their practice or their patients. The performance measures are divided into three different areas: sales representative performance measures, corporate commitment performance measures, and R&D performance measures. The study ranks all the companies that deliver oncology products to physicians.

What were the results?

Genentech has been ranked number one by oncologists and hematologists for three straight years; this year, Novartis, Sanofi-Aventis, AstraZeneca, and Amgen round out the top five. Essentially, Genentech finished first in all three areas. What's interesting about 2008 is that Genentech had previously been number one by a very wide margin. This year that margin really started to narrow. Novartis is now a much closer second, implying that oncologists and hematologists are starting to see Novartis as the major threat to Genentech's leadership.

Over the last few years, Genentech has had four major products—Avastin, herceptin, torciba, and retuxin—that have been widely used by oncologists. In many respects, those products drove Genentech's leadership, as well as its profile among oncologists and hematologists. Those products have been around for a while, and they're still first in almost all their categories, but Novartis has come up with a number of different products, and has started to perform better on many of the measures we evaluated. Novartis is now second to Genentech in all the sales force attributes, as well as corporate commitment and R&D measures.

What kinds of sales force attributes create a positive image of a pharma company?

The most important sales force drivers among office-based oncologists were:

• Providing objective data

• Being knowledgeable about their products

• Being responsive to a physician's request

• Providing valuable information to physicians

• Respecting the time of physicians

• Respecting the physician's staff's time.

The last two of these key sales force drivers—that reps respect physicians' time and that they respect the time of physicians' staff—are very important in the industry right now. MSI recently looked at whether or not sales reps were being restricted in terms of their access to physicians. It's been going on now for a while in the mass market (the non-specialty areas like primary care physicians), where more and more sales reps are finding it difficult to get into a physician's office to see them.

We did a separate study with oncologists, and what we found was that a growing number of oncologists are restricting the access of sales representatives to their practice. And when they do see a physician, they're spending less time than they used to. It's a general trend throughout the industry.

In oncology, clearly one of the key reasons for this is the nature of the practice and the treatment of patients. Oncologists want to spend a lot of time with patients; what they're looking for from sales reps is not old data but new information that's going to help move the needle and treat their patients more effectively.

Oncology is the fastest growing area of the pharma/biopharma business. Still, a lot of the mass market products are finding it difficult to crack the market because of managed care restrictions and because of R&D issues that have been cropping up in clinical development. On the other hand, because of the focus on cancer, and the fact that cancer products are becoming much more widely used and certainly widely paid for by both Medicare and managed care, there are close to 25 major companies involved in oncology.

Why is oncology growing so rapidly? Are cancer rates shooting up?

There's clearly an unmet need. PhRMA [Pharmaceutical Research and Manufacturers of America] just released a new study that said there are around 700 drugs for oncology. And an area that's driven by unmet need becomes a very competitive part of the industry. Five years ago, Pfizer didn't have an oncology division. Now it has a major one. Bayer, Merck, as well as big biotechs like Amgen and Genentech—all major pharma companies now have oncology divisions.

Then why don't oncologists want to spend as much time with sales reps?

It's not that sales reps are becoming less important, it's that more pieces of a company are reaching the oncologist. In other words, a company has many different types of activities that focus on the oncologist, not just the rep, who is obviously interested in influencing prescribing behavior.

What we've been suggesting to our clients is that they need to go beyond relying solely on their sales reps, and look at what we call "the total customer experience." Companies need to look at what the total customer experience is. This might include everything from CME to patient assistance programs to help with reimbursement—all the areas that are most important to an oncologist's experience with a pharma company.

So the answer is a more holistic approach, rather than just focusing on the sales call.

That's correct. There are many services and activities being brought to the oncologist by pharmaceutical and biopharmaceutical companies—well beyond the sales force. In oncology, a physician's image of a [pharma] company ends up being important not just because they may or may not prescribe a product; they may also be willing to participate in other areas of the company's needs. For example, serving as a clinical investigator in a clinical trial. That's one of the key issues right now in oncology: There are simply not enough physicians and not enough patients for all the clinical trials. A company that provides a good experience in clinical trials is more likely to attract more physicians. If you deliver a good experience with CME, you're more likely to have physicians want to participate. If a physician has a strong image of and experience with your company, they're more likely to visit your company's booth at major medical meetings.

So that's one area that I think companies need to be looking at—that total customer experience, rather than simply that sales rep call. The second area that is becoming very important is healthcare reform. More patients are finding it difficult to pay for drugs or cover the cost of out-of-pocket expenditures, and many pharmaceutical and biopharmaceutical companies are turning to patient assistance programs to help physicians provide their product to patients. In oncology, it's very important, because the cost of treating cancer has risen tremendously, and so almost every oncology pharma has a strong patient assistance program. This year, MSI has created a division called Access to Care, and one of the topics we've been studying is these patient assistance programs, because it's a very important part of the customer experience to oncologists.

Peter Carlin is the senior vice president of Market Strategies International's Healthcare division, and brings more than 25 years of experience within healthcare and life sciences to the company. He specializes in oncology, nephrology, and hematology strategic market research and consulting, and has held senior level positions with companies including Novartis, Ciba and Pfizer.