LLY Eli Lilly and Co

By Peter Loftus and Jared S. Hopkins 

This article is being republished as part of our daily reproduction of WSJ.com articles that also appeared in the U.S. print edition of The Wall Street Journal (May 12, 2020).

Drug-company sales representatives, grounded by the coronavirus pandemic, are blasting out emails and hosting video calls to pitch new treatments for a variety of ailments to doctors, a different way of doing things for a field force that had relied on visiting with physicians in person.

On Friday, the U.S. Food and Drug Administration approved a new cancer drug from Eli Lilly & Co. The company plans to make the drug available within days -- and to spread the word by having sales reps, working from home, email doctors and set up remote meetings with slide presentations, and to run ads promoting the new medicine on websites aimed at health-care professionals.

"We have a responsibility to make sure we inform doctors, given that cancer is not going to take a break" during the pandemic, said Eric Dozier, vice president of North American oncology for Lilly.

The changes could impact company bottom lines, experts say. The industry has long considered the launch of a drug crucial to its sales performance.

Yet drugmakers can't now draw on the very tactics long counted on to give new products a strong start, such as reviewing the new drug's profile over dinner and dropping off samples at a doctor's office.

"If a rep can't go there, and a physician doesn't read emails thoroughly, the physician isn't going to be aware" of the new product, said Pratap Khedkar, principal with consulting firm ZS Associates. "The launch suffers a lot. That back-and-forth, the learning that happens in the first six months, is not going to happen."

The virtual drug launch is a big shift from the industry's longtime sales and marketing approach. Before the coronavirus, an FDA drug approval sent sales reps fanning out across the U.S. to tout the benefits of a product physicians might not know about otherwise.

The reps often brought free lunches for doctors, nurses and office staff to gain precious face time for their pitches. And the reps dropped off or arranged shipment of free drug samples, which doctors gave away to patients.

But drugmakers ordered reps to remain at home due to the new coronavirus. At the same time, hospitals and doctor's offices have barred visitors to minimize the spread of the virus.

To adapt to the new reality, many drugmakers have canceled the restaurant dinners in which they pay physician experts to discuss a new drug's benefits and risks with other doctors, switching to virtual events. And reps are trying to talk with doctors via videoconference.

Veeva Systems Inc. has seen a surge in use of the software it sells to drug companies to facilitate online interactions with doctors. In April, companies conducted more than 316,900 remote meetings with doctors and sent about 7 million emails to them globally, compared with 4,900 remote meetings and 1.2 million emails in January, according to Veeva.

Drugmakers tried some of these virtual tactics pre-pandemic, but with limited success. Doctors engaged less with the virtual interactions than in-person visits, industry officials say.

While nearly half of U.S. doctors allowed in-person visits from sales reps just before the pandemic, only 10% opened emails from company reps, according to ZS, which advises drug companies on sales strategies.

Due to the challenges, some companies have postponed the launch of new drugs.

Bristol-Myers Squibb Co. is delaying the launch of multiple-sclerosis treatment Zeposia partly so its sales reps can meet with doctors face to face because of the amount of education involved, said Chris Boerner, the company's chief commercial officer.

Bristol said last week it hopes to launch the drug in June, and virtual tools will likely be a part of the launch

"You do miss something in non-personal engagement you get from an in-person conversation, whether it's being able to read the room, being able to understand what's really on the mind of the customer," Dr. Boerner said. "There's simply no replacement for that."

The new Lilly drug, Retevmo, treats lung and thyroid cancers that have certain genetic traits. After many employees began working from home in March, the drugmaker prepared messages for sales reps to email to doctors upon FDA approval. The messages discuss how the drug helped the subjects of clinical trials.

Yet the company doesn't want to overwhelm doctors with pitches. "There's just increased pressure on the health care community right now, so the last thing we want to be is an added burden," Mr. Dozier said.

Lilly set a list price for Retevmo of about $20,600 per 30 days of therapy for each patient. The company said patients' out-of-pocket costs will vary depending on their insurance plans, and the company will offer assistance to eligible patients to reduce those costs.

Some doctors say the inability to pitch drugs in-person and employ tactics like dinners or meals in offices may be a positive move, given how research has indicated the industry's sales strategies can improperly affect physician prescribing practices.

"It's possible that their ability to influence physicians will diminish because of the much more impersonal nature of virtual interactions," said Aaron S. Kesselheim, a professor of medicine at Harvard Medical School.

Esperion Therapeutics Inc., instead of dropping off samples of new cholesterol drug Nexletol at doctor's offices, is sending them to patients directly, if a physician requests, Chief Executive Tim Mayleben said.

Due to limited face time with doctors, Biohaven Pharmaceutical Holding Co. Ltd. started airing TV ads months earlier than planned for its newly-approved migraine drug Nurtec, Chief Executive Vlad Coric said. The company also placed Nurtec information on the website of a telemedicine company several months earlier than planned.

--Denise Roland contributed to this article.

Write to Peter Loftus at peter.loftus@wsj.com and Jared S. Hopkins at jared.hopkins@wsj.com

(END) Dow Jones Newswires

May 12, 2020 02:47 ET (06:47 GMT)

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