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Medical, marketing & sales: making cross-functional working work

Published on 21/09/10 at 07:00am
Karen Westaway
Pharma sales rep and doctor

A successful market access strategy requires the close collaboration of all functions within a pharmaceutical company. Most notably, the triumvirate of medical, marketing and sales departments must combine to form a cross-functional team with clearly defined and aligned objectives.

The theory is well understood, but in an environment of reducing healthcare budgets and diminishing field forces, the pressure to secure a commercial return is further driving the need for a clear and integrated operational focus. Simply understanding the philosophy of cross-functional working is not enough - making it happen requires a cultural mindset shift right across the business.

The primary goals of achieving market access begin right at the start of the product development process. In simple terms, this can be divided into three basic objectives:

1. Regulatory approval/product license

2. Market adoption

3. Reimbursement

Successfully navigating each of these hurdles requires collaborative thinking between the three key components of the commercial arm of every pharmaceutical organisation - sales, marketing and medical. Historically, medical departments have not been considered an essential part of the commercial operation - they have played more of a supporting role, allowing sales and marketing to focus on selling drugs. But, in an era driven by health economic imperatives and Health Technology Assessments (HTAs), medical departments must take more responsibility for the commercial performance and market access of drugs.

This may sound like a huge shift in roles, but realistically all it takes is a shift in mindset so that medical teams realise the central role they can have in building foundations for commercial success.

Marketers driving change

Marketers provide the glue that holds together a market access strategy, they need to be the architects of change, driving true cross-functional working and, in the process, giving brand teams a critical commercial edge. The most successful will consider all the tools they have at their disposal, not only looking to the field force as a route to market, but also maximising the interactions medical teams have with their customer base.

Medical departments need to be more aware of the impact they can have on the commercial success of a product. The effective communication of clinical data can deliver significant long term benefit for a product - but such communication begins long before sales teams start taking commercial messages to market. Medical teams can influence the speed at which a trial recruits through engaging in targeted interactions with key investigators. Many medics do this job already but how many are aware of the commercial gains that can be made if a trial completes recruitment ahead of schedule? Beyond this, medics also perform an invaluable role in talking to potential customers in the months between the completion of clinical trials and regulatory approval. Although these interactions can be neither promotional or solicited, the quality of this dialogue could be critical to the success of your product. The question is: do you, or your medical team, realise it? As a marketer seeking to give your brand competitive advantage, is your medical team clear about how its role is critical in laying the foundations for the future success of your product?

The ABPI Code does, of course, provide strict governance around this sensitive area.

Pre-license, companies cannot proactively seek customer engagement in their products - they can only engage reactively, following a customer request. But opportunities to raise awareness do exist - so long as the fine line between education and promotion is understood and respected. For example, if a medic is with a customer discussing a clinical trial, there is nothing to prevent them delivering information about other ongoing clinical trials, or having a broader discussion about their company’s current pipeline. This may help deliver faster patient recruitment to a trial, or possible compassionate use programmes.

The communication responsibilities for medical staff is perhaps most important in the interim period between the presentation of initial trial data and securing a license. This can often represent a considerable amount of time - dead time if you are not making the most of available data. For example, in cases where drugs are likely to achieve fast-track licensing, there can be a gap as long as twelve months between the original data presentation and the award of the license. This is a whole year in which companies can be leveraging the data that has been presented, and preparing potential customers to use the product once it becomes commercially available. Interaction must be reactive, but once in situ with a customer, field-based medical staff are well-placed to talk to clinicians about other opportunities.

To capitalise, medical and scientific staff must evolve beyond their traditional mindset.

They need to develop commercial competencies and become agile thinkers. Critically, field-based medics need a greater understanding of the impact that their dialogue with customers can have on the eventual uptake of a product. And marketers have a crucial part to play in driving progress.

Traditionally, medics do not want to be considered ‘commercially aware.’ Their comfort zone is in presenting scientific data and they thrive on the independence of their position. In some cases, they may not even feel that they have to present their data in a better light than other competitive data - as they regard themselves purely as an information source. This is a mindset that needs to change.

Today, markets are extremely competitive. Every interaction your brand team has with a customer will have an impact on the future uptake of your product. So, just as medics need to fully understand the longer term benefits of their customer interactions, marketers need to be more aware of the resources that they have at their disposal. Dialogue with clinicians is not simply the domain of the sales force. There is customer-facing resource within the organisation that may not have been fully maximised before now.

In fact, the stakes are getting higher, and the market is evolving in a way that heightens the need for more commercially agile medics. Companies across the industry are slimming down and sales forces are shrinking. Marketers need to be smarter with their available resources.

Practical steps

So how can marketers drive progress in this sensitive but key area? In the truest sense of cross-functional working, marketers need to work with the medics on the brand team to develop ways of improving their communication skills. Primarily, marketers should consider the following:

• How do you currently work with medical colleagues on your brand team?

• How are the objectives between the two functions different?

• Can you be more aligned in your objectives?

Ideally, the various departments within a cross-functional team will share the same objectives to ensure that a drug is commercially successful. However, it is most likely that the medical team will have objectives around information and clinical data. This isn’t going to help marketers unless they are answered with a commercial driver to make the drug a success. Cross-functional success will only come from having objectives that point towards a shared goal.

Other key considerations are:

• Are you getting the most out of the resources available to you across medical, marketing and sales to drive uptake of your product?

• How could you use that resource more effectively?

• What can be done to change your current approach?

There are, of course, numerous examples of brand teams across the industry that are leading the way in cross-functional team development. The sharpest medics are already thinking in this way and are working alongside proactive marketing teams who are well-accustomed to the integrated team approach - and reaping the rewards. However, some organisations may be lagging behind.So how do you establish which camp you’re in, and measure the size of the challenge ahead of you?

An interesting exercise to kick-start the process would be to call together a cross-functional brand team meeting and, at the appropriate time, ask each participant to explain how they can contribute to the commercial success of the drug. Commonly, most medics will remark that they don’t contribute to a drug’s commercial success, as ‘it’s not their responsibility’. They will explain that their job is to handle data and answer clinical questions. In instances such as these, it is the job of the marketer to underline the important role which medics can play in helping to win the clinical argument and secure funding in increasingly competitive markets. This, of course, will be achieved not through overtly commercial presentations, but simply by being more aware of the commercial environment and thinking much longer term about the information they reactively present to clinicians.

The bottom line is that although interactions must be reactive, advance preparation for them is not only possible, but critical. Marketers can do much to help medics improve their communication skills. The most proactive marketers will develop training programmes to help medics with objection handling. They may also develop engagement guides to provide medics with a framework for how they can communicate during a call. In the past, medics might have visited a clinician armed with a chunk of data, which they’ve presented, responded to queries about and then moved onto the next clinician. With the support of marketers, medical teams need to develop their thoughts so that when they visit a clinician, they understand which aspects of the clinical paper they are presenting might have the most positive impact on the commercial uptake of the drug in the future.

This is not about developing glossy materials and leave-pieces - which is prohibited - but simply about having a greater understanding of the brand’s commercial objectives and a call plan that helps support them. Moreover, it’s about building advocacy in the run-up to launch, rather than seeing visits as one-off opportunities.

The increasing demand for health economic data is creating a greater need for cross-functional communication throughout the entire product lifecycle - from clinical trial design right through to promotion. Therefore failure to develop more commercially agile medical teams represents a major risk for pharma. However, there is also a risk if you do embrace it. The ABPI Code provides stringent regulation on communication of this kind. There are some simple rules that must be followed to ensure that you stay on the right side of the road (see box above).

There is a very fine line to tread - but as long as visits follow a request, show clinical data and talk generically - the interaction should be considered to be within the limits of the Code. The evolution of a more ‘commercially aware’ medical team is now gathering apace. There are examples of European medical team meetings being held where medics talk about pipeline products and the projected market size if each is successful in achieving a licence. Within these presentations, emphasis is placed on the need to drive trial recruitment and thus speed up the time to market as much as possible; it is here that a medic must understand the need to focus on achieving outcomes and actions from every customer interaction.

The overriding rationale is to drive trial recruitment, quicker approval and faster uptake. Its purpose is not promotional, but is about improving efficiencies and ensuring patients gain quicker access to beneficial drugs.

In line with this, the role of the field-based medic is being given broader horizons. It is essentially the same medical role, but with additional competencies. There is an emergence of ‘Clinical Engagement Managers’ being deployed to talk about clinical data in an engaging and communicative way. Senior medical people are becoming far more commercially astute and are beginning to recognise the part they can play in the overall success of a company.

For the marketer, the challenge is to question what your medical team is currently delivering, and to identify how you can improve the way it works so it can contribute more to the long term commercial success of your drug.

What are the resources you have at your disposal, and are you using them to their maximum capabilities? Your medical team must never deliver promotional messages, but it can be incredibly powerful in getting the market prepared for your product once it becomes available.

The efficiencies that can be gained from more effective medical engagement are obvious - but marketers must be bold enough to drive things forward.


The field-based medical team can play a valuable role in helping recruit patients for clinical trials - promoting buy-in among clinicians, speedier patient recruitment and, ultimately, reducing time to market.

Medics are instrumental in communicating clinical data to customers prior to launch. Such information cannot be promotional, but if delivered properly, it can be a powerful means of raising awareness that will significantly help sales teams, once a product has been licensed for promotion.


 • Visits must be reactive - they cannot be solicited

• You must present a drug in a generic rather than a branded sense

• You must not use branded materials

 • You must use clinical papers and clinical data

Karen Westaway is joint chief executive at: WG Consulting. Tel: 01494 470760, email or visit

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