How Indegene Uses “Hybrid” Go-To-Market Model to Help Orchestra Omnichannel Pharma Launches for Their Clients

Bozidar: Hello and welcome to the new episode of the Pharma Launch Secrets podcast. I have the pleasure today of being joined by Nancy Phelan. Nancy is a senior VP at Indigen, a digital-first life sciences commercialization company. They have clients, 19 out of the top 20 pharma are their clients. And she has over 25 years of experience in the biopharma industry, having been on both sides. And she was recently named by MM&M as a medical marketing media woman of distinction. Love that. She's in the DPC Hall of Fame. Wow. A recognized thought leader and expert in the field, as well as a corporate board member and a committee chair. Once again, pleasure to have you here today, and I'm excited to be chatting with you about all the advanced, innovative new ways to go to market for pharma, especially in the context of pharma launches. So to start us off, what are some of the major trends you really see when it comes to pharma marketing in the context of launches?

Nancy: So, first of all, thrilled to be here, Bozie. Thank you so much for the opportunity. I think it's a great topic to cover. And I think what we see in terms of some of the big trends, we just completed a couple of pretty significant market structure surveys. And what we're seeing is that, hands down, pharma marketers are really prioritizing successful launches. There's a lot of launches coming up, but we know that if you look at some of the more recent ones, they haven't all been successful. So what we're seeing is that people are really digging the next level down to say, what is it going to take for me to be successful? The market is changing, our customers are changing, our product mix is changing. So what do I need to do to be really, really successful in terms of being able to launch successfully? Cause that's what the future of the companies and their evaluation is really banking on.

Bozidar: Yeah, launches are such a big deal. I read some, I mean, last time I checked, I think it was one of the reports that, you know, about 60% have been not successful in the, yeah, it increased post-COVID. That's what I remember. 

Nancy: Yeah, significantly. The majority of launches, if you look over the past five years, have not been successful in achieving their year two forecast. That is problematic. So we really need to understand that and sort that. So a big trend that we're seeing is our clients and our customers, the industry as a whole, are really grappling with how do we become successful in this new world in launching these products. Our markets are more complex, our therapies are more complex. It takes new thinking and it takes a new go-to-market model.

Bozidar: And it's harder to reach the audiences. It's like every year. And so with that, I know you use a term called a hybrid model. So I'm very curious to understand how you guys think because you're staying at the forefront, being digital-first commercialization company with multiple capabilities. You have a distinct viewpoint. So what is a hybrid model in the context of pharma launches?

Nancy: So a hybrid model, we call it a hybrid omnichannel model, and it's really about taking the best of face-to-face as well as digital and bringing it together in an integrated way, so that if you understand an HCP's preferences and if you're able to reach them in face-to-face, that's the way that you should lead. But if you also know that they prefer digital, you should lead with digital. And hybrid omni-channel is bringing together all of these channels in service of ultimately an improved HCP experience. So we really believe that the old days, if you will, of making a choice of should we prioritize this HCP to be reached through the face-to-face channel or should we deprioritize and then they get digital channels, that's gone. A hybrid omnichannel model means that you are thinking, how do I take the best of face-to-face and power it augment with digital so that ultimately you're able to reach the HCP, get them the information they need, the content that is absolutely critical, especially at a launch, help them with the time of day, the access to the information in a relevant and simple way so that ultimately they are well prepared to treat patients and to bring new treatments to market effectively.

Bozidar: Yeah, I understand. I think it used to be like, oh, this is digital, this is non-digital. No, it just has to be both. Yeah.

Nancy: Yes, right. You've got to bring it together. And I think that's the harder thing, right? It was so simple when it was face-to-face and or digital and they were kind of kept separate. The challenge right now is how do we bring these things together and really work across all of the different teams internally or all of the partners? And that's what our data is saying is that this is requiring new ways of working. It's not just going out into the market and finding new ways of leading with digital, leading with face-to-face in an integrated way to reach your customers, but also requires a different way of working internally. It requires a lot more cross-functional collaboration.

Bozidar: Yeah, so let's say I'm a brand director launching a product and I know I have to have all channels. I know it's more complex and I know that I have a high chance of failing. The high level, where would I start? Do I start first with the strategy and think of segmentation and then realize how my kind of segments in the funnel work and then see which channel or first get my data together in one place, make sure I can have a 360 view of the doctor. Where do I high-level start thinking about this?

Nancy: Great question. I like the approach that you said. So, you know, first of all, you really need to understand what your product opportunity is and what's happening out in the market. You need to understand your customer. And from there, then you can look at augmenting the data you already have. So I think a more traditional approach is you look at the potential, you look at the prescribing, and that's how you organize your segments. In a hybrid omnichannel world, you really need to augment your data with understanding digital affinity, understanding preferences, types of practices that they're in, so that you get a much more rich, much more actionable set of data on which you can do segmentation and targeting. So it's really, really important. Once you've got your segments and your targets, it allows you to make sure that those are best aligned to how you're positioning your product in the market. It's the STP, Segmentation, Targeting and Positioning Framework. These three things really have to co-travel. And then from there, once you've got that nailed down, you really need to understand what type of content, wherever you can gain insights into content affinity, content preferences. And I'm talking about something not just from a brand. Of course, a manufacturer is gonna really understand their brand, but you need to take the knowledge and the data that you have for your brand and infuse it with an external view. So understanding are your segments of physicians, are they most likely to react and respond well to clinical data? Or maybe they're more interested in understanding patient quality of life data or access data. So really being able to understand not just the channel preferences, but also the content preferences and using that insight to tell your brand narrative, your brand story or your medical story in a more compelling way so that it connects to your customer, your HCP in a meaningful, relevant way. So you take your segments, you do your targets, you position your product, you understand your content, you understand the core messages, and then you need to really find a way to orchestrate the execution of this plan. And you can orchestrate this in multiple, multitude of channels, but you really need to be able to make sure that you have visibility when you are going live and when you are orchestrating in terms of what is actually happening. So the ability to get data back in and importantly to optimize, all companies are able to figure out a great plan. Where we see things fall down and launch is there is a gap between what you plan and what you actually are executing. And getting visibility very, very quickly into what you're actually executing is absolutely critical. That is the chasm that needs to be solved. So you might have planned a certain level of call frequency against your highest HCP targets. You absolutely should be checking your call completion file to say, am I actually getting that done? What we see with our analysis is north of 50% of the time, for your most important segments and tiers, reps aren't able to get the call frequency that companies are expecting them to. So you really need to be able to have the ability to execute and then be able to understand at a very detailed level, what you're actually delivering, and very, very quickly be able to dial up in a very agile way where you need to put more emphasis and dial back where maybe you're not executing as you thought you could and figure out an alternative way.

Bozidar: I love it. I mean, there's a lot to unpack here. It probably takes two hours to unpack each of the pieces. But I like the high level. Okay, it starts with segmentation, targeting, positioning, including barriers towards adopting a prescribing habit. And then all of that requires data and understanding of doctors. And you mentioned digital affinity, which I know Indegene has also developed. You guys developed that as a tool to help understand at an individual level, like how much this doctor requires the click digital support to digital channels in terms of preferences, also content. So I think that channel preferences, content preferences, and their segmentation means you actually have a lot of data about doctors before the launch. So how do we get as a brand director all these data and how do you typically, would you say that there is a gap in execution? Where does the gap come from? Is it the lack of data? Is it the lack of the right partner? Is it the lack of competence and skills within the company? So two questions.

Nancy: Yeah. Oh, that's only two questions. I love the way that we're going back and forth on this. So the data piece is really, really important. In an omnichannel world, you have more data than you've ever had before. And so one of the things that we know working with our clients, it's really critical, is to be able to use machine learning and artificial intelligence models to help simplify and organize these complex data sets so that they're actionable. And that is absolutely something that leading companies, leading providers are doing it. At Indegene, we've created and launched Invisage, which is our proprietary platform grounded in machine learning and AI that allows us, gives us an ability to organize this complex data into actionable approaches. So that's absolutely critical. To your second question, I believe, in terms of what is the gap between what you plan and what you execute, there isn't one simple answer to say that this is the one area of of gap. I can tell you, at Indegene, we have commissioned a fairly significant, robust piece of work on what it takes for launch success. We're just publishing it. And what we saw is that there were five areas where companies come up short in terms of their execution, the gap between what they plan and what they actually deliver. One is around payer activation and reimbursement. So what you plan versus what you actually are able to achieve, there can be some gaps. There are also challenges or gaps, if you will, in terms of the type of label that you may plan to get versus what you might actually get. And if you don't go back and continuously update your assumptions and understand what it is you're taking into market and how it's different from what you planned, you may come up short. We also see significant gaps in terms of market adoption by HCPs. So when you think about that, the HCP, we used to know the reach and frequency model, really simple, right? We all knew it. You need to get this number of calls and this amount of time to reach this threshold. And then you can get the critical awareness and HCPs are gonna adopt it. That reach and frequency model simply doesn't apply today. Reps aren't able to reach HCPs at the same pace. And so you have to think very differently about that. And so if we don't yet fully have the next recipe, if you will, for the reach and frequency model, but absolutely there are gaps in execution in terms of what you plan to do and what you're actually able to do. There are also challenges in terms of patient engagement and adoption. Really, really critical to engage patients well in advance before you are launching a product to really understand from their perspective what their critical needs are and not wait until you have a label in hand to start having those conversations. So what we know in terms of execution is that there are big gaps across multiple areas. And I think importantly, when you think about the challenges of getting all of these materials through at the time of launch. You can have a perfectly planned journey and sequence of messages, but at the end of the day, if you don't get them through MedLegal review in that same exact way you planned it and you wind up executing, you might execute patient before you have payer before you have HCP, that's problematic. And so the criticality of understanding how you're executing versus what you're strategically planning to do is very, very vital for launch success. And that's where we see that clients do need some help in that space because there's a lot more data. There's a lot more complexity. And so bringing it all together and being able to organize it, being able to orchestrate and importantly get data back in so you can make changes near lifetime that makes or breaks company success in launch.

Bozidar: Now, looking forward to see that research. And when it comes to channels, do you notice any trends of channel, especially on the digital side, channels that are becoming more and more popular among doctors? And I'm talking about the HCP and something that's working well, working better, working worse in your data set.

Nancy: So channels are really, really critical, but so is content. And so what we see is that you can't really separate channels from content, right? You can have a great channel, but if the content needs to be refreshed, it may not work as hard. What we do see is that things like long-form video, like what you have on Evermed, where you can really engage, you can get a more rich experience is really powerful with HCPs. Whether it is long-form video content that they go find on their own, or it's long-form video content that happens with a virtual rep, or a virtual engagement with a face-to-face rep that they may have scheduled virtually. So content is just as important as channels. Absolutely. We also are seeing from a use case perspective that different channels work differently based off of the use case. So being able to build awareness can be very, very effective with things like programmatic. But once there's awareness and you're really trying to get a specific patient type or drive a change in behavior, EHR can be very, very effective. At the end of the day, though, all channels can be effective. What's critical and the approach we take at Indegene is test, learn, and optimize. TLO, it's one of our favorite frameworks. And so we will go into all of our engagements with built-in hypotheses that we're going to test, we're going to learn, we're going to optimize. And what we find is whether we're working in diabetes. We're working in overactive bladder. We're working in oncology. Channels and content work together and they deliver and they work well, but there are nuances. And unless you're operating in a test, learn and optimize framework, you won't pick up on those. And so I would say to anybody that's listening to this, if somebody tells you, here's exactly what you have to do, I would say you should be very, very wary because customers are changing, markets are changing. So what you really need to do is embark on a journey with a partner, whether it's an internal partner or it's a third party partner that will help you with a test, learn and optimize approach. So that way you have your finger on the pulse and you understand what your customers are reacting to and not reacting to importantly.

Bozidar: Is there a way to do reach and frequency model using digital channels? Google has been every year publishing an update on how many touchpoints are required in order for someone to buy something, right? In this case, in order to start prescribing the product. So is there anything that can be applied there, like 10 touch points, 12 touch points, three short form, two long form, things like that?

Nancy: Absolutely there is definitely. So one of the reasons why I'm at Indegene is that early in my career had some experience when I was working at a large pharma. And what we figured out was that eight emails was able to get us a level of engagement for a no-see physician comparable to one rep call. And we were like, wow, this is really interesting. And so, you know, I've been on a journey to try and figure out a smart way to evolve the model. And beyond just face-to-face, beyond just a traditional reach and frequency model. And so at Indegene, we've actually developed something. It's a proprietary model called a digital rep equivalent. What it allows us to do is to predict the shortest path to getting an HCP to change their prescribing behavior. And it allows us to account for and attribute digital touches. And not just a touch, not just an engagement, but there is a very different value if someone were to look at an email and read the content versus look at an email click all the links and follow the videos all the way through to completion. So you can give a much more sensitive weighting to the different activities than you can for just the face-to-face. And so we're able to build models and it's early days in the maturity of our understanding of digital and how it works with face-to-face. But at Indegene, we've been doing this for many, many years. We've been a pioneer in this space. And so I can absolutely tell you with a lot of confidence that yes, you can build those models. And I think that very strong understanding of reach and frequency, very strong understanding of PDE as a currency, if you will, for a rep impact, you can do the same thing with digital. We call it a digital rep equivalent, or in the case of medical, a digital medical equivalent.

Bozidar: That's also like in conversations with Indegene executives like yourself, that you know, digital, rapid equivalent, digital affinity, those terms have been in the making for years at Indegene. And if you think about all the plans that you highlighted from start to end at launch, those are nowadays a must. They are not nice to have. They are a must have. If someone reads and engages deeper with a certain piece of content that has a different weight, as you said, and getting closer to being equivalent to an extent to a rep visit. So once you have that data, then planning becomes much easier because it becomes more predictable. Are there any examples of that? I know you guys publish a lot of case studies on your website. Are there any examples that you'd like to share without or with naming of the client that's up to you as something that worked really well?

Nancy: Thank you for the question. I appreciate it. I think that we have a lot of examples and we do publish a lot of case studies, both on LinkedIn and also on our website. I would say that one of the top case study that I would cite is where we're able to apply digital affinity and we were able to find a different go-to-market model, one that blended the best where an HCP preferred a rep, we led with a rep model. Where an HCP preferred digital, we led with digital. And there's this whole messy middle, if you will, where physicians don't really feel strongly about either one, they want all. And in fact, Viva's most recent data, I think, said that 84% of HCPs prefer an integrated hybrid model. So we were able to partner with our client in a really competitive category and help them think differently about this model. And what this model allowed us to do was improve the HCP experience by about five to 10%. We were able to take cost down and we were able to expand their coverage and reach from across their HCPs. So these models aren't just about improving the experience or playing up to preferences. It's not just about being more efficient and more effective or taking out costs, but it's also about expanding your coverage and your reach. And that's really the message that we're trying to send. I think in the old model you really had some simple choices, right? You had a constrained set of resources and you would have to put your reps against the highest priority HCPs and everybody else, especially like if you're out in the rural areas, you just simply couldn't put a resource against them. But in today's world with a hybrid omnichannel model, you don't have that false choice to make anymore. You actually can reach a lot more physicians. You can provide on-demand resources, just like you do with Evermed, on-demand resources, so that when a physician needs something, it's available and it's gotta be high quality, high content and easy to access. And so we see with all of our customers that we're able to move across multiple dimensions and that these models are proving effective.

Bozidar: That's really powerful. Good to hear that it's happening. In terms of content, you mentioned MLR review as one of the reasons from the new report. How far do you think is pharma from the reality of being able to produce content consistently and in a timely manner as well?

Nancy: That's a great question, a really thoughtful question, and it's one that I find hard to answer. And the reason why is, from my experience, if you think about the MLR processes, if you are working, if you're at a company that has a lot of products that are getting launched and having a lot of label updates, unfortunately, label updates can take a significant amount of time and they've got to be prioritized. And so that can limit the amount of content that can go through a system. What we've seen, what we've created at Indegene are these boosters, these accelerants, so that if you have periods of fairly significantly intense content coming through, you can give a booster to try and get more capacity. But I don't think that we're there yet. And so I think that there are some companies that are definitely more advanced on the content front than others. And I think if you look at our industry, there are also startup companies that are their ability to create content, they may have really, really strong connections to the advocacy group, to the thought leaders, but they don't yet have the maturity to scale up the content sufficiently. And that's where partners can come in. So I would say across industry, what I've noticed in the last year, year and a half is a significant focus on content and a strong intent to get there. And they're great partners to help them, but no one I think has solved it yet. I think content is the next area that people are gonna really need to start to focus on to get that right. Because channels with outdated content don't work as well as channels with strong content. And it's time we got both working together.

Bozidar: Content has to be fresh and I just read a report today and a report says fresh and trusted top two. I think that when it comes to it, then it comes short form on demand, etc. But it has fresh and trusted, so if it takes six months for MLR review to happen, then it starts being fresh. I mean, they heard it somewhere else and then you don't control the message and things like that. And another, just comment on what you think. Sometimes when I say content, depending on whom I'm talking to from the farm side. Sometimes people think visually, and it's very interesting that in 2023, people still think their content, and then I have to clarify, oh, I meant on-demand content, video, audio, text, but that's very interesting. Also another comment is, because we have two sides of business and we work with medical associations as well, and more and more, and it's interesting thinking how creating a lot of custom content, sometimes I talk to associations, I see that they're in a fantastic position to actually produce a lot of content and derivative content because they do have thousands of hours of videos of fresh content from their conferences which is great and once you repurpose it can work really well through personalization, Netflix delivery, but then from that content you can create a ton of text-based, video-based, audio-based, custom content especially with the you know advance of technologies nowadays. With that said, of course, requiring new capabilities, competences, and we are helping out as well. With that said, AI, hottest topic these days, where do you see the biggest applications of AI in the context of everything we've discovered on the channel, from STP to channels to content?

Nancy: That's a great question. And I reserve the right to come back to you with an answer. And the reason why I say that is I think it's very early days. I know at Indegene, we have 36 different active experiments underway where we are actively applying GenAI in a variety of ways. And we're doing it to create content. We're doing it to deliver content. And I think it's still early days. What I do believe is that with GenAI, we are going to have a for companies that are able to get comfortable with it, we are going to be able to personalize content unlike anything we've ever seen before. And I think that there will be potentially new content distribution modalities. It has profound implications for global rights in terms of like, you know, we used to think about your image rights. Well, now there's a whole different way to think about your image rights. So I think it's really, really early days. If I had to flash forward five to 10 years, I believe that the industry will have sorted this out like we have for programmatic, and that we'll be able to have very, as you said, fresh, trusted, and I would also argue simple. Our data tells us that content that's simple to use is also very important. I think sometimes we don't make it as simple. So stay tuned, but I'd say next three to five years, I don't think it's gonna be fully sorted, and I don't think we're gonna be able to yet take the full advantage of it in industry. So stay tuned.

Bozidar: I used to play chess professionally, and chess and AI, that's been, you know, 20 years in the making right now. So AI became better than human beings in 97 when Kasparov lost the match. So, because chess is like a closed system with a lot of predefined rules, so it's much easier for AI to work with something like that. And I think of the MLR, for example, review versus content creation. I feel like content creation will take time to get to the point to be able to do what you just outlined. Things like MLR, my hope at least is that because there are predefined rules and one rule is a label, you have to be on label. Another thing has to be font logos, have to be on brand and then many other things. But many of those things can be done with AI much faster, more efficiently, and I'm sure there are companies that are helping with that. I remember the other day I was playing with GPT just took one pharma product and I asked, do you have access to the FBA label for this product? Like, yes. And then I wanted to test it out. I'm like, is this claim on-label or off-label? And I said, and it gave me perfect answers for everything I was asking. I'm like, well, if I'm a marketer submitting or an agency submitting something for an MLR review, I will probably get 90% done by a well-trained custom model with LLM so that at least my content gets out faster out. Then I can solve the other problem which is how can I create various types of content formats etc. That's where my hope at least is there.

Nancy: Yes, I agree with you. I absolutely agree with you. But I think that the likelihood of wide adoption so that it becomes a standard way of operating, I think, is not going to be done overnight. And so I would say that, yes, it's absolutely possible. But I think we work in an industry that is risk-averse. And I think it's, it's going to take a while for even something simple like that in MLR. I think it's going to take a little while for it to get adopted. I know that we use a lot of pre-trained models and a lot of our work. It helps us speed through contracts. It helps us be much more efficient, helps us take on a lot more, freeze up significant capacity. So I'm a huge proponent, but I don't think we are not gonna wake up January 1st, 2024 and have that be the way that it is at Pharma. I think we still need to temper our expectations. Even though it's possible, I don't think it's gonna be widely adopted.

Bozidar: And I was just about to ask you what you think will be the trend, because I hear words from AI to personalization to many other things. So it's always an interesting and fun question. Great, for the very end, you've been in the industry; you work for Big Pharma, you work now, digital commercialization, first company with multiple capabilities. Someone just entering the world, the complex, intricate world of pharma launches, what would be your advice for them?

Nancy: I would say that I think success follows a really careful understanding of customers and markets. And don't get tripped up in, you know, the Gartner hype cycle and everything. I always love to look at like what's high and what's low. Don't get tripped up on buzzwords. Roll up your sleeves, do the work, understand what's happening with your customers, understand what's happening with your markets, and find really smart ways to make sure that whatever you're planning to do out into the market, you have a finger on the pulse and you are able to make changes as your customers and as your markets change. The companies that do that, and I believe the hybrid omnichannel model is one of those many, many triggers, many levers that you have to do that, marketers that are able to do that will be successful. Marketers that are not able to have their finger on the pulse of customers and markets will not be successful because they're changing so very rapidly.

Bozidar: Sounds great. Well, thank you for being a guest today and sharing with us all the, you know, modern ways of thinking about omnichannel, what works, what doesn't, how to think about the future, and most importantly, how to help someone who is right now planning the launch, how to think something that's becoming much more complex.

Nancy: Bozi, it was a total pleasure. Thank you so much. All the best to all of you watching this on your upcoming launches.

Bozidar: Once again, thank you.