Navigating a New Reality: Pharmaceutical Detailing in a Digital World

April 24, 2020 Leah Hoffmann

The COVID-19 pandemic has left many executives scrambling to figure out how to work from home. It’s also sidelined the field reps that pharma and biopharma sales organizations typically rely on to conduct in-person pharmaceutical detailing and promotion with healthcare providers.

In the latest episode of our podcast, BTG Insights on Demand, independent healthcare marketing strategist Martine Taylor—who’s held senior leadership roles both at agencies and in industry—joins Business Talent Group’s Leah Hoffmann to discuss how companies can use a digital version of pharmaceutical detailing, known as eDetailing, to pull through the immediate crisis and rethink long-term strategies for engaging with physicians.

Martine has also generously offered to provide pro bono marketing and strategy consulting services for healthcare and life science companies working on COVID-19 related projects. Learn More

Listen to the podcast to hear Martine’s advice for building effective pharmaceutical detailing programs in our increasingly digital world. You can also read our lightly edited transcript of the chat below.

eDetailing is not new, but it’s taken on new relevance in the COVID-19 pandemic because, with social distancing in place, pharmaceutical sales reps can’t make in-person visits.

The topic is very timely. Pharma reps, now grounded by the pandemic, turn to their digital toolbox to reach their doctors—and this of course includes eDetailing, which is one of the most important components today within the marketing toolbox. Taking advantage of eDetailing can not only save time and money, it can help the reps establish a stronger, more trusting bond with physicians. That is, when it’s done right.

A lot of pharma marketers might say, "Sure, we do eDetailing," but it’s not just about taking ordinary pharmaceutical detailing materials and delivering them on an iPad, is it?

In the literal sense of the word, eDetailing is really any digitized sales content uploaded on a mobile device, whether it be an iPad, tablet, or smartphone. In its most basic form, it could include simply a PDF of a paper detail aid uploaded to an iPad. But this is far from the most effective type of eDetail. Done properly, eDetailing shouldn’t be a passive presentation. It should be interactive, providing ample opportunity for HCPs or other stakeholders to actively engage with contact.

What are some of the different eDetailing formats that are available and what are they best suited for?

I’ll try to cover a high-level range, from the most basic to the more sophisticated. That includes, as I mentioned at earlier, a static PDF of a physical detail aid uploaded to a mobile electronic device. And that actually is still sometimes done and will still be referred to as eDetailing. It’s not wrong, but it’s the most basic form.

Then there’s an interactive eDetail that’s delivered in office by a rep. It still allows the physician to lean forward and get engaged, but the rep is in control.

Then there’s an interactive eDetail that’s actually told to an HCP, often by email. That’s known as remote eDetailing, and it’s considered part of what we call the NPP mix, the non-personal promotion mix. HCPs are invited to join a link at their convenience and on a device of their choosing, and they simply join that link when they want, and contact is broadcast versus shared by a screen, and all the data is captured on views, clicks, and actions.

Finally, there is the most state-of-the-art type of eDetail, which is powered by artificial intelligence. These are algorithms based on individual physician needs, and the content is designed and tagged so that it reaches the right user in the right region and in the right way. As eDetailing evolves in the next five to ten years, it’s in AI systems that I think we’ll see the most interesting developments.

It’s not hard to see the limitations of traditional in-person pharmaceutical detailing—it’s expensive, and reps spend a lot of time waiting for relatively little face time. Healthcare providers have said they like eDetailing, especially since it enables them to access information on their own schedules. But the industry has been slow to adopt it. Why do you think that is?

I think there are a number of reasons. Highly regulated industries like pharma and banking are typically later adopters of newer technology. For financial institutions, it’s often issues related to security, but in the case of big pharma, it can bring inherent challenges for maintaining full control, particularly where content is tailored to individual physician needs. So you’ve got this push-pull scenario between marketing, who are trying to optimize the eDetail to make it flexible to individual physician needs, and a very stringent medical legal regulatory review process that really needs to control all of the content.

But it’s not all doom and gloom, and many companies are very successfully being able to overcome these issues and have been able to become early adopters of what really is the optimized eDetail.

For companies that are trying to use this as an opportunity to get smarter about eDetailing in the long run, how should they get started? In ordinary circumstances, when is eDetailing a complement to traditional in-person pharmaceutical detailing, and when might it actually replace those in-person visits?

My recommendation would ultimately be to have the two working in tandem, both remote eDetailing and in-person eDetailing. In-person rep relationships with doctors are absolutely paramount, because a trusted and loyal relationship with a local representative is really the number one influencer of prescribing behavior among physicians. And there’s actually a hot-off-the-presses poll that was conducted post-COVID with about 245 physicians by FirstWord; over half of the respondents said they prefer a face-to-face meeting with pharmaceutical industry reps. I think that tells you about the power of a rep.

But we need to be cognizant that the cost of putting reps on the road, training them, providing ongoing training, and maintaining the ideal call frequency is a huge investment. Furthermore, there are rural areas where it would likely not be cost-effective to have dedicated rep coverage because travel costs are going to be huge. So in this case, remote eDetailing can be an invaluable tool and perhaps may become complemented by some tele-detailing, because it’s always nice to hear a voice. And then of course it’s all overlaid by other important elements within the pharmaceutical marketing mix.

Another area where executives need to think more about remote eDetailing is with physicians who will just not accept in-person details. There are also an increasing number of large academic medical centers in the US that are restricting and even banning rep access.

How can companies start to formalize the decision-making process they use to make decisions about eDetailing across the product portfolio?

I think that’s an important question. As many companies are looking at streamlining the process and taking it to the next level, they should think about establishing a centralized digital taskforce. This team may be operating on a temporary basis, but it would work across all the brands, prioritizing upcoming launches, where you’re really starting from scratch and creating new content.

Once companies have done that, I’d suggest they pilot an eDetail prototype, initially with one or two brands or a portfolio of brands. Only once they’ve finessed the optimal eDetail format should they plan to roll it out across the board.

What are some of the benefits of working towards this centralized eDetailing process? It helps ensure consistency, I imagine.

It creates significant economies of scale. It frees up brand managers’ time to focus on what they do best, but it still enables them to have ownership over all the eDetail brand content, because what this digital task force were doing is creating the template for the types of eDetail that are implemented across the company’s brands.

And I would say that, as part of that process, the last priority for eDetailing should be brands nearing the end of their lifecycle, where there’s probably little or no new data to be detailed and the rep relationship is likely to be the key factor that’s influencing continued prescribing patterns. I’m not saying don’t implement it across those brands, but I wouldn’t make it the top priority.

You brought up engagement metrics earlier. Being able to understand how physicians are reacting to brand information is one of the more powerful things about eDetailing. In your view, would the task force be responsible for managing KPIs? What are some of the most revealing KPIs to track?

Yes, I think that really should fall under their mandate. I think it would be adapted by the brand managers, because obviously they know their brand the best, but I think there should be consistency in how the company develop their KPIs, rebuild their metrics, and collect their data because two things are absolutely paramount in developing smart KPIs.

First is technology. eDetailing programs should be supported with a technology platform that enables meaningful data collection, provides insightful analysis, and leads to actual metrics being put in place. That technology decision-making should really be under the rule of the digital task force. The second thing is a CRM system. Most companies have them, but the power and sophistication of the CRM system will be critical, and it’s always king in terms of data and in laying the foundation for establishing KPIs.

Let’s take a scenario where a company adopts an eDetail system that uses Artificial Intelligence that extracts the attributes of physicians who would react positively to specific messaging. What this means is that when a specific physician is selected in the CRM system, it will not only pull out the vital information on that individual physician, but it will also create a customized combination of pages or interactive content from the e-detail that would be most likely to engage and influence that specific physician. Hopefully that shows the power of an integrated CRM system working in tandem with an eDetail program and the vital role it plays in establishing smart and powerful KPIs.

Not every company may choose to adopt that, but even less sophisticated eDetail systems still enable metrics to be built, and that’s the beauty of the digital world. These metrics can ensure that the key messages of the brand will be continually communicated with the key data points to back it up because all of that can be measured in a way that was never possible with a physical detail.

Finally, whatever form of eDetailing is used, I think message testing to begin on the industry as ATU studies—Attitudinal and Usage studies—will always remain fundamental tool for marketers to measure the ultimate success of their eDetailing efforts and to build or tweak their KPIs accordingly.

You brought up regulatory concerns. Do you have any advice on getting buy-in from the departments that might be a little reluctant to go down this road? What best practices have you seen?

First of all, I want to say that the medical, legal, and regulatory review process always needs to be respected. The approvers on an MLR team must be assured that the content they have approved and the format with which it’s delivered cannot be tampered with. That’s their main concern. And as soon as you talk about adapting to individual physician needs or pulling content that’s most relevant or interactivity, that team tend to get very edgy and nervous.

So it’s often perceived as a challenge when there’s an ability to tailor interactive content to the explicit needs of the individual physician. And I use the word “perceived” because it’s not insurmountable. This is often where an experienced agency that fully understands the requirements and processes can really be invaluable. Typically, they’ve developed the tool with significant input from the company, but they’re often the ones making it happen. Also, given that they are the uploaders of the content, that they are an active participant in this process.

And as part of best practice, what I’ve also found very useful is to set up pre-review meetings. So before the official medical regulatory and legal review, you set up a pre-meeting with all the reviewers, the relevant people within the brand team, and your agency. The purpose of this meeting is to fully brief the team on how the tool is going to work in practice and reassure them of all the measures that have been put in place to ensure that approved content cannot be tampered with or adopted by the rep. Just because the rep is serving up content that’s very relevant, that content doesn’t change. It’s still the approved content.

But this is an evolving process, and it does take some work. And it does speak to your question earlier about why some companies would be slower to adopt the more state-of-the-art type technologies.

Face-to-face time with doctors is something that the industry has typically held near and dear. How do you think the COVID pandemic will impact that?

In terms of where we are now, the days when physicians are willing and able to schedule dedicated time to meet with sales reps are really becoming a distant memory. I believe that the post-COVID era will accelerate that trend. This is the time for change for sure. And in reality, many of the conversations that occurred between reps and physicians already took place on the fly. You’ll see these conversations happening in the hospital corridor. Sometimes they’re very rushed, and sometimes, in the case of medical devices, they’re actually taking place in the O.R.

So physicians could be very put off when they see a rep walking in with a tablet, because they know they’re ready to launch into an extensive eDetail. If we look back to what happened historically, in a time where physical detail aids were used, adoption was often very rushed. Often a doctor would say to the rep, “Okay, just tell me in 30 seconds about your product. Give me a leave-behind and a clinical paper, and I will go away and look at my leisure.” But, of course, with an eDetail they can’t do that unless the detailing is done remotely. And companies have to be willing to allow that to happen.

With all of that said, it becomes even more important to optimize digital capabilities for eDetailing so that content can be delivered to busy physicians when they need it, at a place where it’s needed—and that might be in their home office, after dinner—and in the format that it’s needed, because it may not be a linear 15-minute presentation. Physicians may just want to go to information that’s relevant to them. So that really is the future, and I think that’s where companies need to adapt, particularly in the post-COVID era.

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About the Author

Leah Hoffmann

Leah Hoffmann is a former journalist who has worked for and The Economist. She is passionate about clear thinking, sharp writing, and strong points of view.

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