The volume of non-personal promotion laser-targeted at healthcare providers has been growing for years, but nothing has magnified its clout like COVID-19. When most pharma companies yanked their salespeople out of the field, the number of meetings between reps and HCPs sank 65%, according to Sermo. While some plucky reps have resumed in-person visitations, two-thirds of providers say they hope reps will stay away until the crisis eases.
It’s not that face-to-face promotion is off the table, as many companies have found that providers remain quite open to one-on-one video conversations. But it does mean that an even larger percentage of promotional activity has become non-personal, and it will likely stay that way for the foreseeable future.
As marketers scurry to modulate their messages, they’re learning more than they imagined they might. The big surprise is that, despite its profound toll on everyone and everything tangentially related to healthcare, the pandemic has been good news for NPP.
It has given the industry a much-needed shove toward greater digital innovation. And the enormous upheaval in providers’ lives — whether they’re on the front lines or sidelined at home — has prompted marketers to reassess the tone of their non-personal messaging.
Take Esperion, an Ann Arbor, Michigan-based company that had enormous hopes for the introduction of Nexletol. The oral treatment to lower cholesterol was the first daily non-statin to debut in almost 20 years. “It had been more than 10 years in the making,” says Esperion executive director of marketing Renée Marotta, whose team worked alongside FCB Health New York for a scheduled March 23 launch.
The buildup included the training of around 300 reps and an elaborate launch event in Phoenix. But as days ticked off the calendar and COVID-19 began to overwhelm the country, Esperion made the only call it could. The company pivoted to a virtual event a week before the government declared a national emergency.
A disaster? Hardly. The virtual event — which transpired on Zoom, naturally — was “amazing,” Marotta recalls. “The chat function just kept lighting up with engaging questions and observations. This format was more productive than a live meeting would have been.”
The Nexletol brand team also scrapped its existing marketing plan, replacing it with one relying heavily on NPP. “We are now in an environment where virtual is the name of the game, so we started asking, ‘How can we personalize non-personal promotion?’” Marotta continues. “We knew our reps were going to be put in a unique situation.”
At the same time, the HCP zeitgeist was a fast-moving target. An Esperion meeting with its ad board at the end of March, for instance, found that providers were downplaying a potential shift toward telemedicine. Within two weeks, of course, that changed dramatically.
“It’s so important that we are not using our gut all the time, that we don’t assume we know what HCPs want,” Marotta says. “There is a lot of enthusiasm for this product. But we needed to be more empathetic, especially with providers based in hard-hit areas such as New York City.”
To make it easier for reps to interact with providers, Esperion leaned deeper into platforms such as Salesforce, Veeva Engage and Zoom. “We reined ourselves in and made sure we were addressing HCPs directly,” she adds. “It forced us to be smarter marketers and think of HCPs more as regular consumers. They want information that’s helpful and succinct.”
Marotta hails Skipta, a provider-only social media platform, as particularly effective for the tasks at hand. Esperion created a micro-community, Lipid Management Connect for Esperion, that featured in-stream banners and an iFrame of the brand site, which afforded site connectivity without leaving Skipta.
It’s worth noting — for roughly the 60 millionth time, that digital dexterity has not come easy to pharma marketers. “Our industry has been such a laggard in terms of digital adoption, especially when it comes to reaching providers,” notes Keli Walbert, VP and general manager of Horizon Therapeutics’ ophthalmology business unit.
But given that some 70% of HCPs are digital natives, the slow adoption can’t be pinned on them. “It’s not that our target customers aren’t comfortable with digital. NPP is finally going to catch up with our target demographic,” Walbert adds.
Like Esperion, Horizon saw a high-profile launch program disrupted by COVID-19. Tepezza, which treats thyroid eye disease, had been on the market just five weeks before the Chicago-based company sent its reps home.
Against all odds, this sparked the brand team to rethink its notions about the role of email — yes, plain, vanilla email — within a concerted NPP effort. “In 2019, we kind of dabbled in it, but it was more of an adjacency to our other marketing efforts,” Walbert says. “But with COVID, we significantly increased our email marketing.” The returns, she notes, have been “remarkable.”
Walbert points to Veeva research revealing that email is the preferred form of communication for 66% of physicians, dwarfing face-to-face encounters (17%) and direct mail (6%). “As good marketers, we want to communicate with customers in the way they want to be communicated with,” she says.
Such realizations and learnings kick-started a series of hard internal conversations at Horizon. Walbert stresses that HCPs value rep interactions, but “only for certain things, and our industry has typically used reps for everything. What we’re saying is, ‘Let’s use email more, and save those precious face-to-face interactions for the things that matter most, such as clinical interactions and launches.’”
Horizon now employs virtual communications for less complex messages around patient education. It reserves face-to-face meetings (or, more accurately, screen-to-screen) for messaging with clinical implications.
The challenge is to keep things fresh, and to put content in a form that HCPs already understand. We don’t need them to change. We need to change.Keli Walbert, Horizon Pharmaceuticals
But Walbert cautions that NPP must be bigger than email. That could be a challenging mindset to instill in a business where, all too often, “going digital” has meant creating a PDF of a print brochure and calling it an afternoon.
Horizon has high hopes for a virtual booth experience it initially created for non-virtual conferences and trade shows. Working with Area 23, the company quickly reinvented that half-and-half experience as one that is genuinely virtual. “We will put a fair amount of NPP behind it so attendees can check it out,” Walbert says. “The challenge is to keep things fresh and new, and to put content in a form that HCPs already understand.”
She pauses for an instant, then adds, “We don’t need them to change. We need to change.”
However, all of this requires marketers to truly comprehend the extent to which COVID-19 has upended healthcare. Some HCPs and systems were stretched to their breaking points. Then there were the specialists who sat idly for big chunks of the last half-year, watching income evaporate as they wrestled with everything that comes with reopening.
Ophthalmology has been among the hardest-hit specialties. “People often see eye health as maintenance, and anything that’s not urgent is easy for patients to kick down the road,” Walbert says. At the same time, all the shelter-in-place orders meant that ophthalmologists and their support staffs “had more time to engage with us.”
Kowa Pharmaceuticals similarly recognized that it faced a changing market for Livalo, its cholesterol medication. To better support HCPs, it shifted its messaging.
“People want to see brands that offer support without being overly focused on COVID-19,” says executive director of marketing Rusty Nolen via email.
To that end, Kowa offered information about cost-saving opportunities and longer-term prescriptions for those who couldn’t get to a doctor during lockdown. The company also strived to block negative COVID-19 content and run ads adjacent to positive news, such as work-from-home tips and survival stories.
“We shifted all in-office print to launch only in markets less impacted by COVID-19, where offices are seeing normal traffic. We have a health guide program that will now be sent directly to patient’s homes, instead of distributed by their HCP in office,” Nolen says.
Before the pandemic, Kowa and its agency partners at W2O focused on reaching list-matched HCPs. “The goal was to leverage multiple channels — display, video, email, social, EHR, search — to provide surround sound messaging for HCPs via efficient, effective and impactful non-personal promotion,” Nolen explains.
But amid sweeping economic concerns, Kowa stepped up its mentions of Livalo’s price. “All electronic health record vendors have seen HCPs having a higher receptivity to financial messaging while they are in their workflows, which increases the HCP’s propensity to write the script by improving cost perception,” Nolen adds, noting that the approach is working. He reports the company has generated “a steady and strong increase in script lift from our EHR partners.”
Will NPP programs such as the ones engineered by Esperion, Horizon and Kowa become the new normal? Marotta thinks they might.
“The pandemic has pushed NPP to be thoughtful in new ways,” she says. “We’re looking to make communication more meaningful, in terms of what we say, when we say it and the channel we say it in.”