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Go Smart to avoid a bleak future of oncology sales force after Coronavirus in US?

Being a Sales representative is not an easy task; right from identifying potential prospects to lead generation, the role is demanding, physically tiring and full of uncertainty, failures and rejections not knowing if the goals would be met at the end of quarter.

And now Coronavirus lockdown may create a turmoil for the frontline sales reps of this $200B1 oncology drug market which will double in size by 2026. As other businesses have shed 700k2 jobs in March 2020 to reduce cost, should pharma companies stop oncology sales force expansion plans?

Oncology sales reps are hard to hire as cancer is no longer a single disease with a massive patient population, but 16 cancer types with 50+ sub types4 and with smaller patient pools and smaller prescriber populations.

Detailing a prescriber about the specific disease cancer therapy requires knowledge of the disease, drug, competitor drugs, reimbursement details, state & national legislations, along with negotiation and persuasion skills. Also developing a relationship with prescribers takes months or persuasion skills as almost 2/3rd of the 7,000-oncology advanced practice providers3, have having “moderate to severe” rules governing rep visits.

Given the above indispensability of the oncology reps, there is a dilemma to expand the sales force so to meet the business growth objectives or keep the cost low since oncology reps are one of the highest paid job and it costs almost $300k per annum per rep to companies.

The above dilemma can be resolved if there is way to further boost productivity of this costly resource.

Sales reps size is calculated based on the hours required per week for target physicians or accounts divided by maximum numbers of hours a sales FTE (Full Time Equivalent) can spend in a week. Rep size will be lower if lower number of hours are required to cover target accounts. And even better is to time rep visit when prescriber is about to write the relevant drug.

Oncology drugs are primarily targeted towards the metastatic phase and are approved by Lines of therapy (LOT). Drugs are typically approved by FDA (Food and Drug Administration) for a specific line of therapy, based on evidence from clinical trials. The label may also be restricted to patient segments that have a specific biomarker (ALK, EGFR, PD-L1, etc). This makes treatable patient populations increasingly narrow and reduces the market potential of the drugs.

Claims data analytics can alert sales team before a patient becomes eligible for a specific drug. This way, reps can plan visit to prescribers at the right time. And it can be achieved by an integral promotional plan where in the medical, marketing, analytics, and sales force team work integrally.

Smart analytics to predict movement of patient from one line to next line can be achieved using therapy knowledge combined with patient journey tracking and algorithm to predict the movement. Claims and EHR (Electronic Health Records) data is complex, voluminous and each incremental refresh adds to the complexity of data processing and analytics. Tech cum pharma experts can process ETL pipelines (refers to a set of processes extracting data from one system, transforming it, and loading into some database or data-warehouse) as per “Lines of Therapy”, defined by business users.

Rep can make a call to prescriber to sensitize about the drug based on the patient condition or treatment condition. It is achieved in the following way:

  • Identify patients who are on 1L specific regimen of drugs, therapy (eligible patients pool)
  • Calculate the median DOT (Duration of Therapy) time for specific therapy in first line
  • Flag those physicians who are treating patients on specific therapy drugs and about to cross the DOT time
  • Send message / email reminding for better treatment option for next LOT

For example, NSCLC (Non-Small Cell Lung Cancer) is a type of lung cancer where Durvalumab is an IO (Immuno-Oncology) therapy recommended for stage III C for patients with unresectable patients with stable on CCRT (Concurrent chemoradiation therapy). Likewise, Pembrolizumab + chemotherapy is the standard of care in 1st line of stage IV (refer below image). Algorithm based on the above steps can help calculate the DOT for Durvalumab, or Pembrolizumab and predict the movement to first line or second line where chemotherapy or Nivolumab is prescribed.

Smart alert based on claims data can provide an integral approach towards sales force targeting and calls to ensure increase in productivity and target the prescriber at the right time. Do you think, this will lead to lesser hours and more probability of prescription thereby ensuring sales force size is optimized but the sales are doubled for Oncology by 2026?

Go Smart to avoid a bleak future of oncology sales force after Coronavirus in US?


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