Pharmaceutical Market Europe • November 2021 • 27
THOUGHT LEADER
By Richard White
Look at many ‘integrated’ cross-functional plans produced by pharma companies, and the chances are you’ll find they were actually developed in the style of a potluck party. Each person (each function) is asked to bring a dish of food of their own choice (their own individual plan) – without conferring with any of the other partygoers – and then the ‘integration’ involves putting it all in the middle of a large table (combining each individual plan into one final document).
The problems associated with this approach to developing a cross-functional plan are the same as the problems anyone who has ever attended a potluck party will be aware of. Perhaps three or four people come with sausage rolls (the same activity is repeated multiple times by different functions) and nobody brings the salad (there are gaps in the overall plan that none of the functions has addressed).
Of course, anyone who works with large pharma companies knows that a major barrier to success is their siloed approach. Long-standing functions have been following established playbooks for their own stakeholders for many years and do not readily embrace change. The situation is somewhat different for smaller pharma and biotech companies. On the one hand, they are often less afflicted by a silo mentality because multitasking is essential in organisations with limited infrastructure. On the other hand, these organisations must rely heavily on outsourced agency support because the external demands are invariably too much for a lean in-house team – and a roster of disconnected specialist agencies can introduce silos of its own.
For many years, the response of pharma companies to the de-siloing challenge has been to set up cross-functional teams and working groups. The recent growth in medical affairs as a function is bringing together, under one umbrella, areas such as clinical development, health economics and outcomes research (HEOR), market access, field medical, learning and development and patient engagement. Activities such as scientific communications platforms and integrated evidence generation aim to bring functions together and work to meet the needs of all the key external decision-makers.
Whatever we call these activities, if fundamentally they end up putting together disparate individual silo plans into one ‘final’ plan, then they are not reaping the benefits of genuine integration. That requires individual functions to collaborate and co-create throughout the planning process. A much-repeated quote from Dwight D Eisenhower says that ‘… plans are worthless, but planning is indispensable’. One interpretation of these wise words is that the journey is often as important as the destination. In sharing their own stakeholder insights and planning together, different functions gain an appreciation of the commonalities and divergences in each other’s goals and challenges, and so benefit from a better understanding of the wider issues. Such discussions often uncover duplication of effort and critical gaps common to collections of disparate individual plans.
For agencies supporting pharma companies, therefore, a critical success factor is that the way we work helps our clients to de-silo and to integrate. Not only does this require us to bring genuine expertise in functional areas across medical affairs, R&D and commercial, but also to employ an operational framework that enables us to deliver an integrated approach ourselves. Expertise means understanding, respecting and representing a range of functions that each have different mindsets, different ways of working and even different vocabularies. The operational aspect is also not always straightforward, particularly in larger, networked agencies where the different subject matter experts may themselves be siloed in separate companies. Before helping pharma clients achieve integration, many agencies must first de-silo themselves.
And much work on integration remains to be done in order to adapt to a fast-changing external environment. For example, how can customer-facing roles – field teams, medical science liaisons, medical information, public affairs – be joined up with specialist functions to deal with questions from healthcare professionals and other stakeholders that increasingly go well beyond the clinical data and address issues such as value, affordability and the patient perspective? And how are these customer insights fed back to inform future planning? How can we ensure that patient engagement activities, increasingly happening across multiple functions, are aligned in approach and terminology, and that learnings obtained in one area are shared with others? How can we integrate data disclosure activities across clinical trial transparency, publications and medical education functions, so that there is a ‘single source of truth’ and an aligned end-to-end communications framework? And how can we also integrate with legal and compliance to ensure requests for clinical data sharing – by regulatory bodies, academic collaborators, scientific societies and journal publishers – are met without infringing data privacy laws?
These challenges can only be addressed by genuine integration. De-siloing and enabling experts to work together in planning ensures that the whole is greater than the sum of its parts – which may determine how effectively and quickly pharma companies can bring the right treatments to the right people in areas of true unmet medical need. And that’s far too important to be left to pot luck.
‘For agencies supporting pharma companies, a critical success factor is that the way we work helps our clients to de-silo and to integrate’