I spent three of the best years of my life as an inner-city middle school teacher in Los Angeles. Cue all the movie cliches, including armed LA County Sheriffs on campus. The students were quite possibly The Best Kids on Earth.* I love eighth-graders; they are endlessly fascinating to me. But let’s be real, none of us at age 13 were the best versions of ourselves. While I was a teacher, I caught myself saying (often),
“Dude. You just said that out loud. We don’t let those kinds of words fly in this classroom. Wanna try that again?”
You have no idea how often I’ve wanted to say those exact words to Biotech and Pharma leaders, even when I was in-house. Particularly when they were speaking to vendors– the service providers who partner with us in serving patients.
How many zeroes are in zillions?
My business-sensitive phrasing now goes something like this:
“Oooh, that was pointy. Maybe a mulligan?”
I once led (frankly, I inherited the responsibility) the request for proposals (RFP) for Patient Support (insurance coverage, financial assistance, patient and provider education) for a biotech manufacturer. We had provided a use case scenario as part of the RFP and asked the vendors to address their solutions (and rationale) within that context. One vendor team flew out on a cross-country redeye to meet us bright and early. They were (and are) a major player in the space, deep talent bench, proven expertise with a key payer we knew we needed to play ball with. We asked the vendors to plan on spending a solid half-day onsite to present on:
- Patient access barriers
- Anticipated complexity of the insurance coverage
- Analog product launches
- Their proposed solutions and corresponding Return on Objective
- Touchpoints with the manufacturer stakeholders (Brand Marketing, Sales, Finance, Legal, Commercial Learning, Pharmacovigilance)
We’re in a conference room. We find the correct dongles to negotiate the laptop/projector tango, and we have our bagels and coffees in hand. Seven minutes into the presentation, my boss asks if they could jump to the use case. The gentleman presenting starts to explain that they did see our use case, but…
My boss (of one week) cuts him off.
“You didn’t prepare for our use case?”
“No,” he begins to explain, “We…”
“We’re done here. You can leave now.” And with that, she gestures at the door, “Goodbye.”
Silence. Awkward disbelief.
And then to punctuate the moment, she stands and says, “You can go now.”
I wish I could say I was making this up. My colleague from Global Procurement and I just stared at each other across the conference room. What the hell just happened?
I escorted the team out. I could feel blush flaming across my cheeks toward my hairline. Front Reception stared at me in surprise when I returned the visitor badges and signed our guests out.
Later on in the day, Front Reception saw me walking across an empty lobby, chuckled, and said,
“But they just got here!?! What did you do to them?“
I have heard all of the following from my colleagues and leadership over the years, out loud and in group settings:
- “Maureen, just tell me: Whose ass do I need to kick?”
- “That hub was a dumpster fire.”
- “Oh my God, they were a hot mess until you got on the program.”
- “They keep telling me what they can’t do; when are they going to start telling me what they can do?”
- “You’re too nice to them.”
The last one always makes me smile because I sincerely doubt a vendor would ever label me as “too nice.” Like, never ever. I’m human; I lose my temper. I don’t always wear my stress well. My tongue is as sharp as anyone else’s. I’ve needed my fair share of mulligans over the years.
I traveled onsite for a vendor QBR with a different boss who opened a breakfast meeting with, “I love the smell of napalm in the morning.”
Cringe. Like, hard cringe.
Dude, what does that even mean? That you want to (figuratively) torch the team that directly serves your patients and HCPs? Do you not see how racially charged/ hostile/ business inappropriate that comment is given the (presumed) race and heritage of some of the partners sitting at this table? What is wrong with you?!?
Commercial Pharma Leaders, each time you’re tempted to say any of the lines above, pull out your cell phone camera and film yourself saying them.
- You need to see and hear how it sounds.
- You need to understand that it is just as much your fault if a vendor fails as it is theirs.
- You need to know that your direct reports are listening, and they are very clearly seeing what kind of leader (and human) you are.
- (Bonus): You are not demonstrating an understanding of your business.
Your Patient Support Services vendors’ performance will only be as good as the patient volume forecast and the business rules direction YOU provide.
I’m writing this in the last week of April. Q1 ended on March 31st. Data reporting was available on April 7th-ish. With religious holidays and school vacations this month, Pharma and their Service partners are probably scheduling their first 2021 quarterly business reviews (QBRs) for this week or next. I’ve written before that a commercial team must have a shared understanding of how performance is measured and whether that data is actionable. Galway Group is happy to help you develop a performance scorecard and conversation guides as you look at patient program performance.
Be warned: we might have some homework for the manufacturer’s commercial team, too.
I’ve made oodles of mistakes in my career, and I’m happy to share my experience. Here are a couple of gems from the archives:
Problem: Ice storm. Roads closed. Program staff can’t get into the office. Patients can’t call in because there is no one “to pick up the phone.”
Me (pulling my hair out on the phone with the service vendor): But you said every team member has their own laptop, and your phones are all VOIP!
Vendor: They do. But staff are not allowed to bring their laptops home due to HIPAA/PHI compliance. Yours is a new program, and we haven’t had the opportunity to certify their home workspaces and internet security yet.
My (manufacturer) lesson: The business continuity plan in the SOW clearly outlines remote work capabilities and timing.
Context: FDA approval received at 1:45 pm PST Friday before a long holiday weekend. Manufacturer Medical-Regulatory-Legal (MRL) promotional review committee has approved the copay website with one teeny, tiny change: a single asterisk on every page. Copay vendor is based on the East Coast and has gone home for the day.
Problem: Brand.com features the copay website. If the copay site can’t go live, brand.com can’t go live.
Me (pulling my hair out on the phone with the service vendor): But we’re approved! We agreed the website would go live as soon as we got the green light from MRL!
Vendor: We did. But we didn’t expect the asterisk change, and we didn’t have anyone from the design team stay late just in case. We built the site at risk with the “Approved pending FDA notification” version you gave us. The drug isn’t in the channel, is it? Patients aren’t going to need copay cards over the weekend, right?
My (manufacturer) lesson: Ensure the entire team is aligned on expectations, interdependencies (in this case, brand.com), and contingency planning around launch activities and go-live.
I’ve got a million examples. And every time, the vendor rallied, called in the cavalry, and fixed my mistakes.
I’ve spent a lot of time thinking about how Pharma and Biotech Commercial teams work lately. For the most part, these are not technical roles. We’re not running gels in a lab. Life-and-death, minutes-matter scenarios rarely land in our inboxes. So much of what we do is about communication and relationships. But it’s also about:
- The stress of managing high dollar amounts.
- Carrying the weight that is a fiduciary responsibility to shareholders.
- Recognizing that sales is a competitive sport. Market share doesn’t come out of an infinite pie.
- Demonstrating to our leadership that we’ve got the business acumen, we “have the goods.”
- Developing our own personal brand and careers.
Back to the RFP presentation gone wrong:
I called the vendor the next day to thank them for their time and effort. I learned a long time ago to never apologize for a boss; find a better boss instead. The representative was incredibly gracious. He offered to forward me the presentation deck.
I opened it and read it. On slide 11, there was a nice .ppt build outlining why our use case scenario was not relevant to our product’s disease state and payer mix; in fact, the vendor gently suggested, we needed to re-think our patient profile.
Boom. They knew their stuff. Better than we did.
* My students inspired me to go back to school to study public health and access to care issues, particularly those impacting the working poor.