IQVIA Holdings Inc. (IQV) Earnings Call Transcript & Summary

Good afternoon, everyone. My name is Matthew Smith. I'm a Senior Principal within IQVIA strategy consulting group, and I focus on new commercial models and digital engagement. And I'm very pleased to welcome you to today's panel discussion, where we'll be talking around agile deployment for modern HCP engagement. Before we get started, I'd like to point out that we do have a couple of pieces of relevant content for you, an e-book, a white paper and a fact sheet that are all available for download within the Resources section of your on24 console. So today, we're going to be talking about agile deployment and the continued importance of field and in-person resources in driving optimal HCP engagement in the modern health care ecosystem. We do have a few slides that we want to quickly go through before we'll be transitioning to our panel discussion. So as we continue to transition out of the pandemic, we're seeing a new normal of increased digital engagement. But within that, it's critical to realize that in-person interactions remain a primary channel and critically important. Whilst HCPs have demonstrated a new respect for digital engagement and are looking to provide input on their promotional mix and how they might tailor their channel messages and mix. There is still a belief that in-person engagement is critical within that. And whilst they may be looking for more digital engagement, they're still looking for in-person engagement as a primary channel. So 50% of HCPs are preferring that in-person engagement across all channels. And looking across all therapeutic areas, more than half have returned back to 70% of their relative values prior to COVID. So we really are seeing an emergence of a much more integrated and omnichannel model where in-person, digital and virtual engagement all work in harmony with one another. What's that leading to is life sciences and biopharma organizations are obviously responding as a result. And they're looking to work much more diligently and much more and disciplined [indiscernible] around identifying and defining that optimal mix for digital remote and face-to-face channels and how they can best engage and meet with customers when and where they want to be engaged with. They're also focusing on engaging in a much more dynamic and real-time manner so that they can meet customers when they want to be engaged and offer the flexibility and agility to respond and react and even predict and preempt when and how to drive engagement. And obviously, they're looking for flexibility and agility in terms of how they deploy resources. So moving away from the more annualized or static deployment models of old and looking to drive data-driven and insight-based models that allow in-person and nonpersonal resources to be deployed in a much more flexible manner. So the way IQVIA likes to think about all of these concepts is through a framework that hopefully is familiar to a number of you, which is our agile brand promotion framework. With this, we're trying to go beyond the buzzwords of just by customer, right cadence, right channel, right content and put a little bit more depth and granularity into what that means in an innovative but practical way. So as you can see from the materials on the slide, the core pillars of this framework are grounded in comprehensive and customer data, diverse and differentiated customer-facing roles, a truly omnichannel model where sales, accounts and marketing resources interact seamlessly with one another and the notion of a much more adaptive allocation and deployment model where everything is personalized, not just by channel, but also by content and cadence. And at the heart of this model, we have advanced analytic decision-making, both monitoring and optimizing every facet. I'm not going to go through all of those in detail, but the intent of today's conversation is to focus on just 2 core pillars, the first being those diverse differentiated field roles, so how can organizations best develop the suite of customer-facing roles that are tailored to specific customer, portfolio and therapeutic dynamics. And then in the bottom left-hand corner, how can they monitor local market, customer and territory needs to offer much more flexible resource allocation across the different channels and resources. And how can we bring in both in-person but also virtual and hybrid roles and that concept of agility and flexibility to better engage with HCPs in marketplace. So if we do a little bit of a double click into that before we transition to the panel discussion, I think it's important to realize, we recognize there isn't a one-size-fits-all approach here. As market dynamics shift, there's a need for a much more scalable and flexible approach. But what that looks and feel like will vary whether you're an emerging biopharma or a large biopharma, your therapeutic area and portfolio dynamics, the customers and geographies that you're looking to engage with. And you can see on the left-hand side, the visual here is just simply meant to demonstrate that as we think about the health care ecosystem, there's a variety of integrated stakeholders from the provider, the physician, patient and payer side all coming together. And they're potentially surrounded by a growing variety and volume of different roles and role types, whether that's the traditional reps but also account managers, field reimbursement managers, medical specialists, policy experts, [ and then ] of course, our contract and inside sales resource as well. So today, we'll touch on kind of some of the dynamics that come into both selecting and designing the right roles to engage with your organization as well as how they come together and the associated enablers to drive a much more optimal engagement model. What we will touch on during the conversation really is thinking about some of those opportunities for modernizing HCP engagement. So how can we balance sales teams with differentiators, nonpromotional team members to increase customer engagement satisfaction? How can we think about deploying resources dynamically and crucially at scale, not just one-off, onetime, but really driving that across the business unit or enterprise scale and to allow for a much more optimized and real-time response to changes in business and market dynamics and thinking about some of those enabling factors, whether it's the necessary skills and capabilities or the underlying processes and ways of working to drive engagement and to drive engagement with HCPs. We're now looking for a much more solution-based and digitally savvy engagement model. So with that, I'd like to introduce you to my fellow panelists. Again, I'm Matthew Smith, Senior Principal focused on new commercial models and digital engagement. And I'll be your host and moderator for the discussion around agile deployment for modern HCP engagement. I'd like to introduce you to 3 of my esteemed IQVIA colleagues who will be joining me today: Christie Conn, who is the Vice President for Brand and Commercial Strategy; Jave Castillo, our Vice President for CSO Strategic Solutions; and Kirk Harmon, Vice President, Contract Sales. Welcome, Christie, Jave and Kirk.

So let's get the discussion started, if we can. There does seem to be a degree of diversification emerging amongst customer-facing roles with a growing volume and variety of role type, whether that's customer engagement managers, rep, orchestrators, local ecosystem roles, just to name a few. I'm curious what the panel sees as being important when we're thinking about the design of these customer-facing roles in the current climate? And what are some of the newly emerging and critical factors that you need to build into your design? So Christie, perhaps I can start with you first.

Sure thing, Matt, and welcome to everybody on the line. I'm happy to be here and speaking to you all with Kirk and Jave. We've worked for a number of years together, so this, I'm sure, will be likely debate. First and foremost, let me take us really wide actually. The macroeconomic situation is something that the industry is facing along with so many of the other industries, but there's an acute difference within life sciences that's creating a convergence of pressure points for the industry. First and foremost, we're looking at a new inflection point on innovation. Life sciences are in this new paradigm of balancing the risk associated with the economic pressures but also trying to build new assets to address diseases that we haven't been able to treat before. So that's a converging subdynamics. Add to it the big squeeze for anybody that's heard from my colleague, [ Luke Greenwald ], the big squeeze that's going on between gross to net also puts additional pressure on budgets, especially on the SG&A side. And so this makes it really challenging for brand leaders, especially sales leaders as their colleagues to consider where to invest. How do they make confident decisions when some of the analogs that they had are really about the pre-pandemic pre-norm? And they don't really apply now. The third big factor is that we have a facing and growing consideration as it relates to access and differentiation for product launches. Launches are getting harder and harder, right? We have specialized medicine, personalized therapies, the complexity of the health care system itself that's demanded the industry to consider how to bring a broader set of roles to the table. So we're in this shift now of beyond the rep. Add to it all of the other critical resources of engagement, HCP, provider, network and payer, it makes for an additional level of complexity that we haven't seen before. And then, oh, yes, we've got all these new digital channels that HCPs are raising their hands saying, don't forget about the way that I like to be spoken to or engaged with. So that's 5 major forces that we've just talked about. It begs the question then for brand leaders like how do I incorporate these new channels? How much do I put towards them in investments? How do I look at them on an affordability scale when I'm also trying to balance across our most valuable resources with the field? And what's the best mechanism to communicate the value of the product and differentiate? Honestly, it's a really tricky question, Matt. It's -- you and I have been with many clients lately. We're fielding it in across the board. And if I had to go away with just like one answer to that is what matters most in today's climate is that personalized message and making sure that we have the right channel for the HCPs, for the accounts, for the IDNs to be able to deliver that message. And so you'll hear my perspective throughout this afternoon being one of an analytics background, speaking about that need for strong and current set of analytics. It helps the field with the next best action that many large pharma is working through, but it also helps on the home office side in determining how do we take that strategic planning and the right channels to then diffuse that appropriately with the right mix and knowing where and how to shift and therefore be agile. So being agile is really about the analytics piece. That's my short answer to my long dialogue.

Thanks, Christie. Definitely made it sound very easy. Jave, I wonder if you can sort of build on that wide overview that Christie gave and maybe kind of hone in on what you're seeing from the sales side of things.

Sure. Thank you, Matt. And Christie, you bring up a lot of the important dynamics that I think everybody is facing, right? The big squeeze, the convergence of all these pressures and everybody really looking at reevaluating the engagement and how they're resourcing the engagement models. As you mentioned, despite all of the economic pressures, everybody is converging on growth engines that are driven by therapeutic areas with unmet needs, rare disease. Oncology was, is and continues to be a big growth area. But even within oncology, in many cases, we're looking at more rare oncology diseases. So some of the things that all of these have in common is that we're looking at smaller patient populations, smaller HCP specialist targets, which had less time and now have even less time. And these are complex therapies with complex diagnosis, treatment, complex reimbursement journeys. And they all require additional support from pharma, something that you're not going to accomplish just simply through digital engagement. But at the same time, post-COVID, everybody is kind of over-indexed a bit on digital. And I'm not saying digital doesn't have its place, but again, maybe, like you said, a little biased to be looking at this through a CSO lens. It's indeed an effective channel, but it has to be delivered with precision, and it needs to be integrated across models. So I'm not saying that just from my perspective. But IQVIA conducted a survey of HCPs, and they too are feeling the shift. 63% of HCPs have noticed a significant shift to digital. And 3 in 5 of those HCPs basically pointed out that manufacturers are not providing the right content. And they're feeling, frankly, oversaturated with digital. They're being overwhelmed and content that's not necessarily a value to their practice. So we have this convergence of -- into smaller HCP targets with increased needs that can't be met solely by traditional omnichannel. And so we need to balance those channels and the promotional investments in the face of the economic pressures that you highlighted and the rapidly evolving market. So go-to-market planning really needs to evolve to be more nimble. Traditionally, we've established launch plans, secure budgets, make sure we identify what's the number of resources, how much headcount do we need and deploy them. And that model has limited flexibility really to adapt rapidly. Maybe there's some evolution of the messaging. But from a staffing perspective, it's a bit rigid. So we really need to rethink the staffing model and introduce more agility with a more variable model. And that's something that we successfully partnered with pharma through outsourced teams. Complex therapies and the fierce market competition with everybody converging on similar TAs, they require a lot more planning, not only upfront, but also, as Matt mentioned, more frequent evaluation in order to optimize that strategy and the roles that are required to deliver on them. I never thought I'd be quoting Mike Tyson in a pharma discussion, but I do love his quote. Everyone has a plan until they get punched in the mouth. And right now, there's a lot of punching going on. It's really a matter of how quickly you can pivot to seize the opportunity and capitalize on it or respond to a challenge. In my time at IQVIA, I've spent a lot of time building patient support programs. And we spent -- invested a lot of time understanding the journey for the patient, from before diagnosis all the way through to ongoing retention and adherence. And we need to look at it through that lens and making sure that we have thought through that journey from prior diagnosis to post-treatment decision as we're thinking about what that HCP engagement model looks like, what are the barriers? What are the opportunities along that care pathway, and what are the optimal resources and channels to address that. So we mentioned about the payer landscape, the financial pressures, but adding even more complexity to the environment today is the ongoing consolidation of hospitals, IDNs. And so we've seen a growth of key account managers, and what Matt has around the wheel there has -- is basically a key account manager. It's the quarterback, but they need those multiple roles to support them, whether that's sales roles, clinical roles and clinical nurse educators, reimbursement and access roles. And with IDNs, we're seeing a growing role for health information technology specialists. So it really needs to be customized and nimble. But you need to constantly ask yourself if you have the correct resources and think beyond the boundaries of the IDN. Just to layer in kind of some roles outside of the IDN, you need to think how dependent are my brands on referrals into specialists, and how are you driving referrals? So are you focusing on the referring physicians to drive education, awareness and leveraging a mix of digital inside sales or therapy awareness teams to drive those referrals in. So while we talk about design being important to the industry, it's still determining -- everybody is still trying to figure out what that ideal mix is. And you need to keep in mind that the market is continuing to evolve. So planning needs to include room for that agility and that ability to evolve and flex to meet not only from a national scope, but making sure that you have the lens for the local market needs.

Thanks for that, Jave. You've got me picturing both Mike Tyson and also Ross from Friends screaming pivot with his sofa. We touched on an awful lot of roles there and the design factor, but obviously, you were kind of mentioning that ability to be flexible. Wondering if we transition away from the design, but actually start to think about as these new roles evolves, organizations need to think about how they can assure any new resource has the best chance for success within that role. What should organizations be looking towards in terms of developing, recruiting, retaining and enabling the necessary skills and capabilities to succeed in this evolving health care landscape? Jave, I wonder if I can turn to you first, and then we'll bring our fellow panelists in shortly thereafter.

Sure. Traditionally, we've always built teams and looked for individuals that had umpteen years of experience within the specialty that we're launching into and that they had the relationship with those providers. And I'm not saying that's not a consideration that we still need to look at today. We still include that. But sometimes, those umpteen years of experience doesn't always equal performance. And oftentimes, it comes with individuals that have -- are limited or perhaps less flexible to adaptability that's required in today's environment. So look, much of pharma experienced this during COVID that simply taking a rep from the field and moving them home and providing them with Zoom or Teams does not make a great hybrid or remote sales representative. And the same goes for the management oversight. It's all a bit different when operating remotely. We've been at the forefront of hybrid teams even before COVID made it a thing. And we've cut our teeth along the way. Marketing was already accelerating digital engagement, but the need to integrate both was important. So when we think about developing a team today, you asked about retention. And I really believe that retention starts even before the recruiting process begins. So let me just dive into that. What I mean is that it's important to match the profile of the hiring requirements and the expectations with the role to make sure that they're built for purpose. And it's critical not only for attracting the right folks and to drive performance but also for the retention about it. So when we think about the rep today, they're all in some way hybrid, both face-to-face and remote. Regardless of whether you're giving them that title or not, every rep has some element of hybrid. And so they need to have that -- not only the ability to engage remotely, but also manage their evolving territory by interpreting and acting upon the data and insights that are provided to them. And we're getting more and more sophisticated in what we're able to provide to make sure that the old adage of the right message at the right time but also the relevance and the right resource. So again, look, it's a highly competitive marketplace, fierce competition, everybody really converging on similar TAs. So you better make the most of your engagement and make sure that what's being delivered is of value and relevance to the HCP. So anyway, a long way to get to kind of what we're looking for is through that lens, we're not only looking for, yes, the clinical acumen and the experience, but we also have identified some specific competencies that we've identified of top performers in this space. So one is the ability to collaborate. It's really becoming more of a cross-functional team, as you've kind of got highlighted on the slide that you covered, but also ability to kind of shift with channels. So there are some things that we look at that you might think about from an inside sales rep as far as active listening skills. This is no longer about reach and frequency and just delivering a message, but you need to be able to adapt your communication based on your physicians' needs or the office practice needs and be able to shift that from face-to-face to remote. And so that -- there's competencies that we're looking for that we'll look through the interviewing process and purposely do it virtually to make sure that they're able to adapt to that but also that they -- are they able to function or are they digitally savvy. The one thing that I don't want to lose sight of beyond just product promotion is that they have a high sense of urgency and customer-centricity. And I know everybody overuses customer-centricity. But in looking at complex diseases with complex needs, it does come down to problem solving. So those problem-solving skills and the sense of urgency with which to deliver it is what builds that trust with the audience that you're working for. So it's a crowded market. These competencies really need to be there and continually developed if you're going to make an impact.

That's really, really helpful, the active listening, the problem solving. Kirk, I wonder if we can now bring you into the conversation at this point, and perhaps you can shine a light on what you're seeing in the marketplace around some of those skills and enabling factors that can drive success of some of these newly emerging roles?

Yes, absolutely. Thanks, Matt, and thanks, Jave, for laying the table down here. In addition, critical performance -- a critical component of performance and retention is the ongoing and continued development of the representatives. Each representative is going to come to the table with their own strengths and their own weakness. Some development areas are going to be identified easily upfront and can be coached from day 1. Other developmental opportunities will be identified through the ongoing field rides and coaching sessions. To add further complexity to what Jave kind of outlined upfront to the representative role is the ongoing evolution of health care decision makers, the evolving patient landscape and the ability to understand the growing amount of clinical data that is needed to support these complex therapies. Representatives must be developed and nurtured to be able to simplify and distill the information into what's the most important and relevant for their individual HCPs. Ongoing training and coaching not only helps secure retention but will also develop individuals to provide high-value HCP engagements, which, in turn, will increase access and add value to future discussions. Lastly, data and analytics provide just one piece of the puzzle. But the insights and feedback collected from the field are also very critical to continue to inform your go-to-market strategies. In this evolving and competitive marketplace, encouraging your team to share best practices and insights not only with the internal team but also with the cross-functional team members. This action will unify and create a one-team approach, which will ultimately help with retention, help with growth and ultimately accelerate results.

That's really helpful. I'll let that segue from the retention side but also that the ongoing development. I think Jave mentioned earlier this notion that there's -- throughout the pandemic, there's been something of an over-indexing towards the investments in remote and digital channels. And I guess what I'm curious now is as we transition out of the pandemic, how can companies best balance the realities of their own business maturity, their portfolio and life cycle dynamics and the different local market and customer needs to try to establish which role should be in-person versus hybrid versus virtual? Clearly, there's not going to be a singular answer but perhaps shining a light on where there's flexibility versus where there isn't. Kirk, if I can stick with you for a moment, perhaps you can offer some perspectives on what you feel is important on this sort of in-person versus hybrid versus virtual mix?

Yes. First of all, thanks, Matt, for the question. It's a very complex question, and it's certainly not one size fits all, right? You just brought up a few of the variables that must be considered when determining how to effectively and efficiently drive promotions and sales for your brands. As sales mature, they don't always require the same level of promotional effort, but it also doesn't mean that every territory should go digital or remote. First, we need to consider what are we solving for here? Are we still growing sales? Are we maintaining sales and market share? Or are we trying to manage the slowly declining aspect of our brand as it reaches maturity? Are we maintaining and maximizing our ROI through management of operational expenses? What's our current resource promotional mix? And what are the suggested ways to change that? Is the product sample sensitive? What does that look like? We also need to rethink the traditional business rules regarding personal promotion design, regarding HCP decile, number of targets and the driving radius of what a territory would be. The interesting thing is as we move into today, go-to-market strategies never stop evolving. And we need to continue to adapt to local market dynamics. As that brand matures, the market access investment may change. This could impact the level of favorability within that individual market. Conversely, the level of investment or other payer factors may negatively impact gross-to-net value of a prescriber. Although the prescriber might be ranked very high in a decile perspective, the actual gross-to-net value is lower, which may inform you to move to a different level of personal promotion. We also need to consider your organizational needs beyond just this mature brand. In other words, are there other launch brands or growth portfolios where their sales team might be transitioning into? In this scenario, we may see more tenured resources transition and move to support to those growth brands. This would allow for a stepwise kind of transition of the engagement model as you evaluate the local market needs and resource requirements. We've worked with a lot of our clients to proactively transition promotional plans and mix of field force resources. Field force vacancies provide such that opportunity to implement new promotional models, allowing our clients to resource in a very seamless and cost-effective manner. With each vacancy, the territory is evaluated when that vacancy happens to determine the level of personal promotion required, whether it be face-to-face, remote, inside sales rep, hybrid or a more multichannel digital approach. This helps manage the operational expenses while maximizing the client's return on investment. And it's completely based on local and territory needs as those continually evolve and adjust.

Thanks for that. Very, very insightful. Christie, I know you're spending a lot of time trying to crack the nut of this sort of in-person, virtual and hybrid question. I wonder if we can come to you perhaps to build on what Kirk was alluding to.

Sure. I'm not sure I can be quite as eloquent as Kirk was. I was just going to say, it's not a peanut butter approach anymore. And going back to my old analytics roots, where we would just decile, look at reach, frequency and writing behavior of scripts, that doesn't work anymore. And so it does really play into with a complex problem demands a highly integrated, multivariate solution. The simple answer is the adoption curve is real, right? And how we go about evaluating that adoption curve, be it where you are at launch to echo Kirk's point or where Jave was speaking to the points of following the patient pathways, that's that need for the adaptability of where we put resources, be it in-person or hybrid or virtual and how we communicate to them. And that includes the digital component as well. So let's use an example for the sake of getting real for a second. I mean, we see a lot of assets right now launching in the obesity market, Alzheimer's market. Those aren't the same equivalent go-to-market strategies. And it does demand doing a very bottoms-up approach from the local level as Kirk was speaking to. What does that mean at the local level? Well, it's not just how many HCPs are out there that may be in the endo or neuro specialty or practices. It's looking at patient opportunity. It's looking at, first and foremost, the managed care influences. And that gets really complex at launch because not every single contract is in place yet. So thinking about who's carrying that message is almost always best when it's in person and driving home that new differentiated strategy. So if there was a peanut butter answer, I'd say that is in-person, we see a lot more in-person investment when it comes to launch and then backing away from that as managed care contracts come on, as digital wrap around or direct messaging comes in. And then on the other end of the spectrum is what happens with LOE. I mean, we no longer just set it and forget it when it comes to the other side of the top of the growth curve. And it's no longer just going to a complete CSO either, looking to see in those local markets where there might still be opportunity to continue patients on therapy. Adherence and persistency is a really big deal right now, and that plays through to how we're messaging with physicians. So being able to shift those messages in the digital format to say, physician or practice, don't forget to remind your patients to stay on therapy is a trend that we're seeing. But it's also this opportunity where we're seeing a lot of the orchestration around what is the best resource that's needed at the office for that specific office. So maybe it's field reimbursement specialists that they need to just help patients in a more complex disease state. That might work in one, but we potentially don't need that and some of the -- all we're doing is hitting a refill button. The cool part is that as an industry, we're finally at a maturity point where we can provide those data-driven analytics. We're able to link up not just the investment planning or brand planning within the year but the tweaks that are needed on a day-to-day basis to evaluate who goes where and with what message and in what order. And that provides us a really great feedback loop to not only just have the analytics at our fingertips, but really to direct brands, the sales leadership and the regional or local leaders to understand why their NBA algorithms coming out the way that it is. So ultimately, it's providing us confidence both within the brand space as well as a financial basis, which we're all looking at acutely right now of when to pivot at the local level.