The State of Customer Experience in European Pharma, 2017; Physician Interactions
Fueled by digital innovation, industry forces are reshaping pharma’s customer base. As payers and providers move to value-based care and patients demand more control and choice, pharmaceutical firms need a new approach to meeting their needs. While rethinking the business using a customer experience (CX) mindset will give pharma companies the direction they need, only three companies received a Customer Experience Quotient (CXQ®) that shows they’ve mastered this approach. The others need to step up their CX transformation effort by expanding the role of design in their organization.
Companies Researched For This Report: AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, Lilly, Merck KGaA, MSD, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi, Teva
Pharma’s Customer is ChangingThe healthcare industry is undergoing rapid change. A variety of forces are transforming the role of one of healthcare’s major stakeholders: pharmaceutical companies.
Industry Forces Are Reshaping Pharma’s Customer BaseHealthcare used to be straightforward: physicians diagnosed patients, chose a treatment approach, and supervised its application. But now, a range of other players—providers, insurers, patient advocates, pharmacies, policymakers, and payers—play major roles in making decisions about what is best for patients and how to manage the treatment process (see Figure 1). What explains this trend and what impact does it have on pharma companies?
- Rising healthcare costs. Per-capita healthcare spending in OECD countries has more than doubled since 2000.1 Governments—the main financers of healthcare—face a daunting task: controlling costs while improving the quality of care for an aging population. The quest for cost control is leading government payers to pull treatment options away from individual healthcare professionals (HCPs). As a result, pharma firms need to devote more resources to meeting the demands of payers at the expense of marketing to physicians.
- Consumer accountability As consumers become more accountable for healthcare expenditures, they want more say in where and how they receive care and from whom.2 Well-informed, self-directed consumers not only challenge HCPs during consultations; they also resist healthcare system restrictions by using tools from firms like Amino and Iodine to find and choose their own care. Pharma firms must respond by improving the information they provide and anticipating patient needs directly.
- Digital technology. Today’s world is a single connected marketplace where everyone has digital superpowers thanks to innovative processing, storage, sensor, and network technologies, and where millions of websites and apps offer new ways to improve not just individual lives, but entire industries—including healthcare. Investors have already sunk record amounts into digital health firms this year.3 Pharma needs to sort out what role all new entrants play in the healthcare system.
Pharmaceutical Firms Are Seeing Their Customers’ Expectations ChangeDriven by technology, external forces are changing the way the industry will have to adapt to meet the diverse needs and expectations of customers. But what exactly is in transition?
- Payers: from supplying medication in bulk to delivering patient value. In the face of rising healthcare costs and constrained budgets, payers want pharma to share responsibility for transforming the healthcare system into one that maximizes patient value. Payers increasingly expect pharma firms—via protocols, regulation, and incentives like pricing or reimbursement—to come to the table with solutions that deliver good patient outcomes at a reasonable cost. Pharma firms will work closely with payers to demonstrate the value of their products in real-world scenarios. They will also architect medicine-related patient experiences to deliver better health outcomes.
- Patients: from curing to supporting self-care and well-being. Patients are clear about what they expect from the industry: 55% of online Europeans want pharma firms to help them in ways that go beyond providing medication—an expectation that clearly aligns with what payers want from pharma.4 Roche’s takeover of mySugr, a platform that integrates support information, tools, and services for people living with diabetes, shows that pharma firms are taking notice and looking to develop patientcentric strategies that go beyond providing a pharmacological remedy.
- Physicians: from detailing to demonstrating value. Decision power is shifting to payers, but physicians are still patients’ main entry point into the healthcare system. Too often, pharma does its core job of information-sharing and education poorly: 68% of the time, company reps give physicians information they’ve already seen.5 Physicians also want pharma to shift focus to help address one of their main concerns: controlling the cost of care. Physicians expect the industry to provide better evidence of how treatments affect cost and to support the creation of cost-effective health services.
CX Design: An Effective Path to Meeting Customer ExpectationsBetter-informed patients, less accessible physicians, and increasing numbers of stakeholders and market disruptors are all forcing pharma to rethink how and where to create customer value. The transition will be complex; the industry will have to develop innovative solutions to meet a host of new expectations. But no matter how difficult the task, pharma firms can take comfort in a fundamental business law that will always hold true: living up to customer expectations drives value for the business. The processes, capabilities, and mindset behind this law are collectively called customer experience design—a principled approach to solving problems by putting customers and their needs at the heart of everything they do. Interactions, Journeys, and Ecosystems Are Key Layers in CX Design To offer customers end-to-end experiences that differentiate them from their competitors, pharma companies must first understand the three layers of CX design (see Figure 2):
- Interactions.Interactions—often called “touchpoints”—are individual moments when customers interact with a pharma firm’s products and services, such as a patient reading a leaflet, a physician visiting a conference booth, or a payer discussing real world data. For customers to leave satisfied, you must meet or exceed their expectations of the interaction. Designing a successful interaction involves anticipating who the user is and what they want from you and then helping them get it.
- Journeys. Interactions don’t happen in isolation. A patient reading a leaflet does so to understand what her treatment will entail and what alternatives she has. She’s on a journey—a series of interactions that are connected to the same goal. While individual interactions can be very successful, an entire journey may be unsatisfactory. This happens when companies don’t connect preceding and succeeding interactions or fail to anticipate that customers might switch to a different channel or device.
- Ecosystems. Patient care is delivered by a complex, interdependent network of manufacturers, providers, purchasers, payers, and other stakeholders. A patient gathering information on treatment alternatives will not only rely on one company’s leaflet; she’ll also talk to her doctor, read other patients’ stories, or even view a competitor’s materials. No one pharma firm controls the entire customer experience—but companies that include and influence partners design better CX than those that only consider their own view.
Design Thinking and Design Doing Are the Core of CX SuccessAs soon as companies look at design as the catalyst to seizing a business opportunity, they stop using it to judge beauty. Companies that do this begin to move faster towards design success as they scale up two design competencies: design thinking and design doing (see Figure 3):
- Design thinking means understanding the customer and the problem. Everyone in your company will say that they care about customers—but not everyone has the space, tools, and time to think about how to drive more business by improving customer experiences. Design thinking starts by recognizing the customer problem in an interaction, journey, or ecosystem and ends when a team develops a perspective that generates ideas and chooses the best one to solve the problem.
- Design doing is the development and implementation of a solution. Firms actualize experiences by developing and testing ideas—first as prototypes, then as “tangible” items—and then putting the best idea into operation. Part of design doing is how other groups in the company support the delivery of a new experience with aligned processes, systems, roles, and responsibilities.
The State of CX in Pharma: Physician Interactions, 2017Superior customer experiences are linked to better financial performance for many companies across a variety of industry verticals.6 But what customers consider a superior experience to be differs by industry, and pharma is no exception. Pharmaceutical firms need to know how well the experiences they create experiences please customers. How can they measure this? Introducing the Customer Experience Quotient To answer this question, we developed a methodology to objectively assess the experience of one of pharma’s three primary customers—the physician—at its most basic level: the interaction (see Figure 4). We call the metric resulting from this methodology the Customer Experience Quotient (CXQ®). Calculating a company’s CXQ involves three steps:
- Determine what makes a customer experience great. We asked physicians what they value most in their interactions with pharma companies. From this, we assembled a list of thirteen common qualities of pharma-specific CX, including the amount and relevance of information the physician received, the speed with which it was provided, and the integrity that the company displayed during the interaction.
- Review recent interactions in terms of the most important CX qualities. We then asked physicians to think back to their most recent interaction with a pharma company and assess their experience based on the three CX qualities that they collectively value most.
- Calculate the Customer Experience Quotient.We computed the CXQ by taking the responses of physicians who had strong opinions about their experiences and finding the proportion who had positive ones. By asking physicians to name the pharma companies they interacted with, we determined each individual firm’s CXQ.
CXQ Leaders: Novo Nordisk, Bristol-Myers Squibb, and RocheArmed with our methodology, we fielded an online survey to members of Univadis, the world’s largest HCP community platform, in the five European markets of France, Germany, Italy, Spain, and the UK. Survey respondents included general practitioners and specialists in six major areas. We focused on assessing digitally-infused interactions—those which either have a core digital component, such as a rep going through a tablet-enabled detail aid, or are purely digital, like a visit to a pharmaceutical firm’s website. In total, our sample included 2,223 physicians who reviewed a total of 2,885 interactions.7 We found that:
- Trust, relevance, and simplicity drive great CX. European physicians want pharma firms to design interactions that are trustworthy, relevant, and simple—in that order (see Figure 5). Companies that succeed at this instantly meet the expectations of about half of Europe’s physicians.
- Novo Nordisk, Bristol-Myers Squibb, and Roche have the best interactions. We have CXQ data for twenty-one pharma companies; our sample allows us to rank fifteen of them with confidence. Novo Nordisk, Bristol-Myers Squibb, and Roche share the top spot with a CXQ of eighty-four out of a possible 100—twenty points ahead of last-place Sanofi (see Figure 6). No company offers excellent customer experiences and only four offer good CX. In any given interaction, pharma firms fail to make any sort of impression—either positive or negative—on about a quarter of physician customers.
- CXQ correlates to a firm’s reputation and promotion. While the scores may appear impressive, they mean that all pharma firms deliver poor experiences to at least 15% of their customer base at any given touchpoint on a customer journey. A poor experience hurts a company’s reputation to nearly the same extent as it reduces the likelihood of one physician promoting the company to another (see Figure 7).
Raise Your CXQ by Expanding the Role of CX DesignTo raise their Customer Experience Quotient, firms must fix broken customer interactions. But they will reap far greater benefits when they realize that organizational factors are behind mediocre CX and make a broader effort to transform the entire company. Pharma firms embarking on their journey towards design-driven differentiation can avoid false starts by sequencing the phases of the journey correctly (see Figure 8). Phase one involves expanding the role of CX design and requires companies to:
- Assess it. We asked senior leaders at one pharma company about the role of design; answers varied from making look-and-feel decisions to creating a digital presence to instituting a method to drive corporate innovation. Divided leadership sends the wrong cues to the rest of the company and creates confusion as to where the firm wants to go. Firms that lack a single vision of the role of CX design prioritize CX initiatives poorly, drag out investment decisions, and fail to get their people committed to the cause.
- Define it. While a good functional definition of CX design already exists, pharma firms need to make it their own. Start by looking at your overall purpose, then give the vision company-specific context by including factors such as the company’s current strategy, overall ambition, and level of urgency to change. A strong definition of CX design gives everyone in the organization a sense of priority, size, and impact on their own work.
- Seed it . Once your firm has a clear CX design vision, don’t leave it to make its own way through the organization. Poorly-orchestrated communication can lead some parts of the organization to believe that CX design doesn’t apply to them or to interpret its value, purpose, and guiding principles inconsistently; fixing either situation consumes time and resources. To avoid false starts, the CEO and executive team must inspire the entire company and send the right messages about what CX design really means. Execs must make it meaningful by telling personal stories describing any unsatisfactory interactions between the company and a customer they have witnessed.
- Anchor it.To pick who should lead the charge towards design-driven differentiation, you need to know where resistance is low and enthusiasm is high in the organization, as the process of redesigning CX crosses R&D, medical, and commercial silos and must culturally align functions that have rarely worked together. When planning to scale up design thinking and design doing across functions and therapy areas, start small. Focus on a few customer journeys and improve the experience interaction by interaction. The closest exec should take charge initially and secure the resources to execute well, but a senior design expert should then step in to make strategic, investment, and governance decisions to empower a broader set of directors and their teams.
- Measure it.Transformation leaders who established a CX design role told us that they should have put a framework in place to measure design impact right from the start—not only to measure CX progress, but also to involve internal functions like finance, IT,legal, and HR in the transformation. Our recent assessment of the CX shortcomings of oncology portals found that the root cause was unrelated to a lack of customer empathy in the design process but to organizational factors like an IT system not allowing design changes or finance-set targets that cut customer research. To expand the role of design deeper into the organization, you must close the distance between customers and internal functions with a measure like CXQ to link the what with the why and the who.
DT Consulting’s Customer Experience Quotient Survey, European HCP Interactions 2017 is an online survey fielded in June and July 2017 to European healthcare professionals in general practice and six specialty areas: cardiology, oncology/haematology, pulmonology, neurology, endocrinology, and rheumatology. Via email, we invited members of Univadis—the world’s largest healthcare professional community platform, run by Aptus Health—to take the online survey. Respondents came from France, Germany, Italy, Spain, and the UK. To keep our sample statistically significant, we excluded from the CXQ rankings pharmaceutical firms represented by less than thirty responses. Please note that respondents who use online networks, are triggered by email, and participate in online surveys have more digital experience and are more likely and confident to interact with companies digitally than those with less confidence or experience.
Tim van Tongeren
Dennis van Rooij