Oncology treatment breakthroughs provide patients and oncologists with an increased array of innovative treatment options and are fueling growth in today’s pharmaceutical market. However, as personalized cancer treatments become available, access to individual physicians to educate and convey required messaging related to this personalization is becoming more difficult. Relying on traditional broad treatment-centric marketing messages and sales approaches to oncologists is proving less and less effective. A key player in this development is the corporate provider network or integrated delivery network (IDN). Just as pharma no longer relies solely on a traditional sales force, it must evolve marketing and value messaging to broaden the focus beyond the individual physician to the IDN.
Nearly 70% of all oncologists are affiliated to an IDN. As the recent rollout of the Oncology Care Model (OCM) reflects, oncologists—increasingly involved in coordinating higher quality patient care—continue to evolve the ways in which they evaluate treatment value. But doing so within the IDN environment means that the balance of treatment quality, patient experience, and cost will be evaluated not just by oncologists but also by multiple stakeholders. Given the multi-stakeholder focus, the U.S. healthcare system is creating different treatment environments and influencers beyond the individual oncologist and account. For pharma, messaging objectives need to align treatment value to these broader stakeholder influences to increase its relevance and maintain, if not enhance access.
In surveying the perspectives of both oncologists and IDNs holistically, a few key principles can help to improve access to oncologists within IDNs:
1. Access is measured by relevance.
When pharma engages an individual oncologist as the single decision maker, as it traditionally has, it loses relevance to the other stakeholders who have an evolving role influencing treatment and patient care decisions. IDN-based physicians and their practices are exposed to broader health system financial influencers and a larger volume of colleagues and patient experiences with which to base their prospective decision-making. As pharma adapts its messaging to this holistic environment, and develops its messaging that addresses these constituents, access within an account will increase due to the relevance of the message.
2. Expand and change messages to stakeholders beyond oncologists.
In order to increase relevance with IDNs, and thus certain oncologists by extension, pharma can reframe its approach from specifically on oncologists to a broader focus on the framework of quality, patient, and treatment goals that can have input on a treatment approach for an oncology patient. When pharma thinks about targeting decision-makers who are prescribing therapy for patients, there are a broader array of influencers in the treatment decision that need to be taken into consideration.
3. Adopt a next-generation approach to targeting.
Traditionally, the exercise of focusing on customers has been defined specifically to the targeting of oncologists to receive messaging regarding oncology therapy. However, the need to expand targeting attributes to include the IDN affiliation or delivery model participation of the physician suggests a new, next-generation approach to targeting. This broadened approach should recognize that oncologists frequently collaborate together, consult with existing guidelines, may be influenced by payment models, and often employ a consensus approach that reflects the collective experience and practices of the IDN or delivery model in which they work.
A variety of factors need to be considered when redefining an approach to targeting:
- Recognition of IDN or facility guidelines to treatment
- Recognition of indirect IDN environment attributes that influence prescribing
- Recognition of leading facilities within IDNs and experiences/approaches to treatment
- Recognition of payment models, including both CMS and commercial payers
As a consequence of these factors, pharma needs to target differently. It should consider traditional metrics of patient volume and physician behavior. However it needs to account for multiple physicians in an IDN, guidelines that may determine physician behavior, and payment models that impact patient experience and cost.
4. Introduce aligned value messaging.
Identifying oncology treatment influence and un-blinding marketing to stakeholder influence is critical. This helps to leverage and align messaging to favorable influence where and as it exists within oncology practices today. By continuing to deepen its understanding of the number and relationships of stakeholders in the treatment environment surrounding the oncologist and patient, pharma can better interpret the needs and concerns of these stakeholders. This expands the definition of an “account,” increasing the breadth of an account from one or more physicians to an IDN-based definition that would include several physicians as well as multiple facilities, in addition to one or more committees with input to determining treatment guidelines.
However, in broadening the definition of an account to include more stakeholders, then the messages delivered need to be refined to address these stakeholders. In recognition of the above stakeholders, these messages should address a variety of concerns, including:
- Coordination of care across stakeholders
- Quality of care—determining treatment that is most appropriate to a patient’s specific condition
- Access to holistic care that may span providers and facilities
- Coordination of insurance coverage and payment
- Emphasis on outcomes to confirm alignment among stakeholders
As a result, access to an account can improve when messaging is aligned to the multiple stakeholders in the account. There are several steps the pharmaceutical industry can take right now to improve messaging relevance.
Key recommendations for pharma:
- Activate the capability to identify health system and payment model treatment influence. Where it exists and where it is currently favorable or unfavorable.
- Adapt targeting approaches to focus on those stakeholders with whom the oncologist interacts and consults with to determine patient treatment choices.
- Develop messaging that addresses questions from stakeholders beyond traditional topics of efficacy, tolerability, and dosing.
- Accelerate the push to build relationships based on relevance to those stakeholders in the broader IDN environment. This can involve clinical support staff, guidelines committees, pharmacy and therapeutics committees, and those involved in payer relations.
- Adapt approaches to IDNs and IDN-based oncologists. Just as messages need to expanded and refined, so does the approach to the IDN and its various stakeholders.