Optimizing Product Commercializationin Today’s IDN Environment
Authors:
Greg Skalicky, President, EVERSANA
Krista Pinto, President, Deployment Solutions, EVERSANA
Faruk Abdullah, President, Professional Services & Chief Business Officer, EVERSANAIn recent years, Integrated Delivery Networks (IDNs)
have risen in prominence across the healthcare
landscape, and today, nearly 70% of all physicians inthe U.S. are employed by a hospital, health system orother corporate entity – a significant increase fromless than 50% a decade ago.1 IDNs bring several
inherent advantages to healthcare, including theopportunity for:As a result, reliance on traditional field teams to callon prescribers or television to influence patients is
no longer an effective launch strategy. While theseelements are still relevant in the overall launch andcommercialization strategy, today’s commercialization
strategies require a multifaceted approach, onethat acknowledges the various opportunities andchallenges associated with the IDN model.

•Improved collaboration among physicians
across different therapeutic specialties•

Improved operational efficiencies througheconomies of scale and reduced administrativecosts•

Stronger purchasing power and contractnegotiation clout•

Improved patient care and clinical outcomes•

Streamlined data integration related to healthinformation technology (HIT) and electronic
health records (EHRs)•Reduced overall healthcare expenditures due
to streamlined care coordination

Today, thanks to the IDN’s direct role in establishing
formularies and treatment protocols, the decisionmaking process is more complex and involves
stakeholders beyond prescribers and the pointof care. Field deployment teams must engage
with not only prescribers, but also a diverse rangeof stakeholders within the IDN systems. This
engagement requires a comprehensive approachthat goes beyond brand promotion. Prescribers
still need to be aware of the full safety and efficacy
profile of nearly 50 new medications that are being
introduced every year, as well as understand how
existing therapies compare to competitor therapies
within the same therapeutic space. Field teams mustalso assist stakeholders in navigating their own IDN
health systems to support informed decisions andimprovements in care. By connecting with prescribers
and other stakeholders through all available channels,field teams can ensure confidence in their knowledgeof the full range of therapy options and provide datadriven insights to advocate for particular therapies
considered by IDN formulary decision-makers.

Meanwhile, IDNs often develop and control
their own drug formularies and centralize theirpurchasing efforts, guided by not only efficacy
and safety data, but also considerations related
to cost-effectiveness, population health priorities
and contractual agreements. Similarly, IDNs often
develop and implement standardized clinicalpathways and treatment protocols that incorporaterecommendations for therapies based on establishedclinical guidelines, efficacy data andcost considerations.

These factors have created more challenges forpharma brand teams in terms of what they must doto formulate and execute the most effective strategy.

1 | © Copyright 2024 EVERSANA | EVERSANA.COM | 1612

Combine a top-down and bottom-up approach
In addition to a top-down and bottom-up approach,manufacturers must first understand which IDNs toprioritize and characterize how they operate and whois involved in decision-making. Manufacturers alsoneed to design a bespoke customer engagement
model (e.g., new roles, different approaches toengagement, different initiatives to focus on foreach IDN).
Today, the path to success for pharma brand teams
must involve a synchronized two-pronged approach:••Top-down outreach — Deliver data-driven
information that showcases the full value
proposition of the therapy to key executive
decision-makers and disease-specific key
opinion leaders (KOLs) within the IDN
Bottom-up outreach — Deploy a right-sized
field team that delivers targeted, value-added
messaging directly to physicians and otherprescribers; such messaging should clearly
showcase the full range of clinical and financial
attributes (and competitive advantages) of
the therapy to address the needs of both thephysician and the institution

Several actionable recommendations are discussed
below for how brand teams can expand their strategy
to reach these two essential stakeholder groups.
Outreach to IDN decision-makers: For certain
disease states, IDNs have more influence on decisionmaking than independent physician practices, thereby
shaping which therapies physicians can prescribe
at the point of care. While one-to-one engagement
between sales reps and physicians is still essential,
the newer launch and commercialization strategy
must incorporate efforts to engage meaningfully
with key IDN decision-makers as well.
While decision-makers within the IDN are – of course– focused on patient care and clinical outcomes,
the IDN is also committed to initiatives that canhelp to reduce overall healthcare expenditures. As
such, outreach aimed at clinical and administrativedecision-makers within the IDN must provide datadriven information that illustrates how access andadherence to the therapy can provide overall
cost savings for the institution.

2 | © Copyright 2024 EVERSANA | EVERSANA.COM

Keep in mind that the goal is not to merely promote
the drug; rather, it’s to educate the pivotal IDN
decision-makers and KOLs on the demonstrable
advantages the therapy can provide – for boththe patient and the healthcare system overall.
Real-world evidence (RWE) that is developed overtime from studies of real-world data (RWD) plays
an important role. Wherever possible, the IDN
engagement team should use RWE studies todemonstrate to IDN stakeholders how the drug:•Optimizes patient care and improvesclinical outcomes•

Affects healthcare expenditures•Stacks up against other therapy options in thesame therapeutic space (using comparative
effectiveness studies, where available)

The effort to build trusted relationships within
the IDN framework should begin at least one year
prior to launch. The initial effort should focus onunderstanding the following:•The internal process for evaluating and approving
drugs with within the formulary system•

The specific strategic objectives designated forthe health system•

The patient populations they serve•

The specific diseases they manage•

The patient outcomes they are trying to achieve
at lower costs

Additionally, the IDN engagement team should seek
to identify the KOLs within each therapeutic area.
Laying the groundwork early will help the brandteam to deliver targeted insights that will be mosteffective. The goal is to create and deliver a datadriven narrative that will resonate across the IDN.
For instance, when RWE insights demonstrate how
improved outcomes associated with a given therapy
can reduce hospitalizations and medical interventions,the IDN will be more compelled to ensure access tothat medication.
Outreach to prescribers: For field deployment
teams, gaining access to prescribers is alreadychallenging, as physicians are busier than ever andhave less bandwidth for meeting with pharma sales
reps. However, as the underlying science associatedwith today’s sophisticated and costly therapies –such as novel treatments for oncology, cell and genetherapies, and other complex biologic specialty
therapies – continues to advance, the role of fieldteams and related multichannel outreach from thebrand are more important than ever. The underlying
goals are to educate physicians about the therapy
and to help them to understand which ones provide
a comparative advantage (through data-driven RWE
studies) over other options in the therapeutic space.
Meanwhile, it is incumbent on the field sales reps
to know which physicians in their territory operate
within each IDN and to understand how those IDNs
function. The ability for field reps to inform andeducate individual physicians about the full clinical andeconomic value proposition of the drug has an added
benefit: It puts that physician in a better position to
help advocate for inclusion of the breakthrough orlifesaving medication on the IDN’s formulary so thatpatients are not denied access to it.

Getting Started
Today, as brand teams plan their multifaceted launchand commercialization strategies, they should:

Closing Thoughts
As the IDN model has drastically reshaped thehealthcare landscape in recent years, pharma/lifesciences brand teams must continue to evolve in termsof how they develop the best engagement strategy toensure access to their lifesaving medications, using thetop-down, bottom-up strategy discussed here.
One hidden upside of the IDN model is that it canprovide economies of scale to the brand team. Oncea drug has been approved on an IDN formulary,
hundreds of prescribers operating under the same
IDN umbrella can be educated in a systematic way,
and patients under their care will have access to themedication at the point of care.
Pursuing an impactful IDN engagement strategy
that yields results requires a team of experts acrossthe entire commercialization spectrum. Brandteams should engage with knowledgeable partners
that have demonstrated experience, infrastructureand established relationships with IDNs. Consider
selecting a partner that has launched complex
pharma/life sciences products and has a vested
interest in maintaining those relationships. The goal
is to effectively communicate how a new treatment
should fit within the IDN formulary and what value itbrings to patients and to the institution. Otherwise,
it will be costly and time-consuming to build yourown team from scratch.

•Synchronize a two-pronged approach with
top-down, bottom-up outreach to align withthe product’s compelling value proposition•

Understand the unique buying process of each
IDN and independent physician practices•

Understand who the key stakeholders are in any
given IDN and the hierarchy of decision-making
related to formulary development•

Structure the data-driven messaging in ways that
directly address the IDN’s key clinical and businessobjectives

At EVERSANA, our end-to-end commercialization
model seamlessly integrates Market Researchand Insights, Field Deployment, HEOR, Value andEvidence, and Professional Services, creating arobust and comprehensive IDN engagement strategy.
This unique and cohesive approach empowers drug
manufacturers to navigate the complexities of themarket with precision, ensuring a successful
product launch and sustained impact on thehealthcare industry.

•Design a field deployment model that can be
adjusted for different IDN structures

1 https://www.fiercehealthcare.com/providers/more-and-morephysicians-are-working-under-hospitals-corporate-entitiesreport-finds

In short, pharma needs to find a way to stand out andbring unique collaboration that goes above brand toalign to the IDN’s most strategic priorities.

EVERSANA is the leading provider of global commercialization services to the life sciences industry. The company’s integrated solutions
are rooted in the patient experience and span all stages of the product life cycle to deliver long-term, sustainable value for patients,providers, channel partners and payers. The company serves more than 650 organizations, including innovative start-ups and establishedpharmaceutical companies, to advance life sciences services for a healthier world. To learn more about EVERSANA, visit EVERSANA.COM
3 | © Copyright2024 EVERSANA| EVERSANA.COMor connect
through LinkedIn
and X.