FORWARD

Welcome to the Autumn 2021 edition of Pharmafile. 2021. What began a year of great hope for us all has seen plenty of challenges, not least the pharmaceutical and healthcare industries.

They’ve faced a rapidly changing and evolving virus, a rise in antimicrobial resistance across infectious diseases, and the necessity of engaging increasingly via remote channels, with all the associated limitations. All the while, rare, chronic, and infectious diseases have needed addressing through innovative treatments and therapies. Kate Pain, Associate Director of Digital Strategy and Capabilities at Astellas, and Sebastien Noel, Director of Multichannel Strategy at Veeva, gave us insight into healthcare professional (HCP) engagement at a time when our relationship with health is constantly changing, and the needs of patients are both precarious and increasing.

Nine out of ten HCPs are claiming they would prefer either all virtual, or a mix of virtual and in-person meetings. Sebastien Noel, Veeva, shares: “The long-term implications for the industry with the dramatic shift to virtual, or hybrid, engagement are huge. I believe that the quality of relationships between reps and HCPs is the one big positive that has come out of this enforced shift to virtual. The ability to have more one-on-one facetime with HCPs is now enabling reps to present more content in a more streamlined way, in a way that works and is convenient for both parties.”

Kate Pain, Astellas, shared that the shift “requires an exponential revision in the way that pharma companies deliver their services. We need to ensure that our field colleagues have the tools and capabilities to be equally confident in hosting virtual or in-person meetings.”

It is not always easy to meet these demands, however: “We need to be proactive, not just reactive, so that we are primed for change and can pivot in accordance with environmental shifts and/ or customer preferences. One size won’t fit all, which will add further complexity, but it also adds colour and opportunity for pharma companies to differentiate themselves from the maelstrom, and shine.”

“In 2021, almost 70% of HCPs are digital natives,” Sebastien elaborated, “so providing a personalised, hybrid engagement model is needed to support meaningful interactions. With 87% of HCPs now wanting either a fully virtual or a hybrid meeting experience post-COVID-19, it is important that life sciences companies personalise their engagement channels to meet different HCP needs.”

But how might a company do this? Kate gave us some insight into how Astellas addressed the challenge of a rapid change in HCP needs: “When the pandemic hit, we jumped from first to fifth gear in terms of our digital deployment. We prioritised our focus on three core channels – Veeva Engage, our HCP portal Astellas-Pro, and rep-triggered e-mail. Stripping these three must-have channels out from the niceto-haves enabled us to narrow our focus and maximise our impact. We were able to preserve a line of communication with our customers, and ultimately with our patients.” So, organising communication is key: “Between March and April 2020, Astellas deployed Veeva Engage to 44 countries in just six weeks. Segmentation was key to the speed of the roll-out. We separated the 44 countries into 4 waves, split by their size and digital maturity, so that we were rarely managing more than 10-11 affiliates at one time.

“For our first release, we set our sights on mastering the basics. We enabled only the basic functionality within Veeva Engage. Now, on our fifth release, our offering has evolved into something significantly more sophisticated. As a business, we were able to differentiate between the immediate need versus a longer-term aspiration.

We also adopted standardised modular templates, a single source playbook, and maintained strong communication among project teams and affiliates throughout.

This activity, paired with our deployment of the other musthave channels, kickstarted a progressive digital mindset that was to continue for the next 18 months, and has left an indelible imprint on our commercial model moving forward, with a commitment to delivering omnichannel excellence.”

There are significant benefits to remote engagement, Kate argues: “One of the greatest advantages of remote engagement is that meetings are typically longer than in-person calls. The average face-to-face call is 6 minutes and the Astellas average for a virtual call is 26 minutes. It’s essential to provide soft skills training to support these longer interactions and to increase confidence levels with the technology also.” These benefits exist alongside hurdles, however: “we experienced access issues in select healthcare organisations, which deterred customers from connecting with us via Veeva Engage. This was experienced in Germany, Spain, and the Adriatics and Baltics. In this case, personalising our invites to include Zoom meeting links overcame the issue, and since then more than 8,000 HCPs have connected using these links.”

Further difficulties do seem to arise in relation to geography: “Challenges may also arise when operating across different countries, as the adoption of remote technology and response to COVID-19 has not been consistent around the world. Some reps and medical scientific liaisons have viewed it as a temporary fix until face-to-face interaction resumes, while others have been quicker to welcome it as a long-term solution.”

So, what is the future of HCP engagement, in such an uncertain landscape? Is the virtual solution temporary, or the new way of liaising with healthcare professionals? “It’s too early to predict what the pattern will be post-pandemic,” Kate told us. “From April 2021 onwards, we’ve seen in-person interactions increasing, however the numbers fluctuate monthly, and the face-to-face/virtual frequency has yet to find its balance.” With the emergence of the Omicron variant, and winter approaching, the status of face-toface meeting is again looking uncertain. “The critical point is that we need to deliver according to our customers’ preferences,” says Kate. “We need to get better at listening to them while also learning from early adopters outside our sector to provide effective solutions.”

Sebastien believes it likely that “over the next five years, face-to-face meetings will undergo a gradual resurgence across Europe, but virtual meetings will stay. This is because virtual meetings facilitate longer, more meaningful HCP interactions and deliver greater flexibility when scheduling several appointments in the same day. They also provide an alternative means to interact when face-to-face meetings are cancelled or disrupted last minute.

“With the life sciences industry now acutely aware of these benefits, I predict that an omnichannel approach to HCP engagement will become increasingly popular over the next five years.”

The pandemic has highlighted the growing need for DNA vaccines, in multiple areas including infectious diseases and cancer. Looking ahead to the future of healthcare during the precariousness of a pandemic, we spoke to Professor Lindy Durrant, CEO of Scancell, which develops immunotherapies simulating the body’s own immune system response. Scancell believe that DNA vaccines are one component of tackling diseases, believing the vaccines “give more sustained production of antigen which should lead to longer term protection than RNA vaccines.” This vaccination form is significant for the increasing demands and needs of global healthcare: “Dendritic cell-targeting DNA vaccines are cheap and easy to manufacture, and have long term stability at -20°C. They can be rapidly adapted to give protection against both infectious disease and cancer. They can be used for repeated injections or for injections for other viruses, whereas viral vector-based vaccines can only be used twice before the immunity to the vector overwhelms the response to the inserted virus.” For the many and varied needs presented by patients of infectious disease, this is significant.

Scancell uses a human monoclonal antibody to target cells that stimulate immune system response. This vaccine can be customised against a specific disease – a promising feature considering the changing nature of disease we have witnessed over the past year, and even the past month. This has the potential to change the current impact of vaccination. “A vaccine encoding both nucleocapsid protein linked to a modified Fc and receptor-binding domain should stimulate long-term memory B and T cells, and should give sustained protection over several years. This will give less opportunities for variants to arise and prevent people from having to be vaccinated every six months.

Scancell shared that its vaccine “targets antigens to dendritic cells to give more potent T cell responses that lead to long-term memory, and still give high titre neutralising antibody responses. The nucleocapsid protein is more highly conserved, giving better protection against variants.”

As for the future, Professor Durrant looks forward to “simpler delivery systems for DNA vaccines. Currently we use a mechanical needle free device which is acceptable, but a simple injection would be more reasonable”. Durrant also hopes for “better investment in vaccines that give broad protection (i.e. all coronaviruses – not just COVID-19), and sustained protection for 5-10 years should be developed now so they can be rapidly adapted when the next pandemic hits.”

With thanks to Veeva, Astellas, and Scancell for their contributions.