Operating Without a Commercial Blueprint: Empowering the Field for Niche Therapy Launches

Emerging biotech companies launching niche therapies (e.g., CAR-T, radiotherapies) operate without a commercial blueprint. Each disease state is unique. Each account has its own mix of stakeholders. Companies can’t rely on syndicated data to help them uncover all essential account-level insights. As a result, these innovative companies are all pioneers at launch, creating their own custom commercial models. Further, these companies need to rely heavily on their field teams to gather granular intelligence about accounts that cannot be sourced from syndicated data.

It’s therefore imperative that these companies—which are often lean and budget-constrained—create fruitful partnerships between home office commercial teams and the field force. The most successful of these partnerships will be marked by seamless information exchange and robust insight collection. Success starts with appreciating the uniqueness of niche therapy commercialization.

The unique complexities of niche therapy commercialization

Unlike traditional pharmaceutical products that cater to a large patient base, niche therapies (in therapeutic areas such as oncology and hematology) target small patient populations and are therefore relevant to only a limited set of physicians. Further, the complexity of administering the therapies and the intensive training required limits the number of treatment facilities. In CAR-T, for example, treatment involves T-cell extraction, reinfusion, and close patient monitoring.

Companies must gather granular account-level information to accurately understand opportunity. For instance, the number of apheresis chairs a facility has or how many ICU beds it reserves are key metrics that help a company with a CAR-T therapy understand opportunity.

There’s a moral imperative here, as well. Patients suffering from rare diseases deserve access to efficacious treatment. Therefore, a company’s effort to optimize its commercial model and onboard more treatment centers is also an effort to improve patient access and outcomes. To succeed in this complex mission, a company must look across its commercial infrastructure, starting with technology.

Build a dynamic commercial technology infrastructure

The technology at the center of niche therapy commercialization is the customer relationship management platform. For niche therapy commercialization, companies need powerful, user-friendly and flexible commercial technology that enables them to build rich account profiles. These profiles should incorporate the various pieces of data and information (some quantitative, some qualitative) that capture key operational details and reveal true opportunity within accounts. It should also help the company map stakeholders accurately, which will help the sales team hone its efforts. Further, this technology should:

• Empower the sales team in the field by equipping them with customized views summarizing target accounts and relevant insights.
• Facilitate a smooth two-way information exchange between the home office commercial team and the field sales force. Commercial leaders should be able to deliver information that helps reps in the field. Reps should be able to easily do everything from entering a call to adding contextual information about an account.
• Accommodate change as the company brings its therapy to market, expands its account targets, and adjusts to shifts in the dynamic niche therapy space.

Housing account plans in flexible, accessible, and user-friendly commercial technology can empower the sales force and add nimbleness to a company’s commercial operations.

Enable effective field intelligence gathering with sound process

A rare disease company can’t turn to syndicated data sources for certain insights into its target accounts. Uncovering opportunities within accounts requires specialized knowledge. A company gathers this knowledge to a significant extent through its sales force. Reps gather valuable insights about account capacity and capabilities, stakeholder mix, and more.

Commercial leaders must therefore equip reps with the robust and flexible technology tools we discussed in the last section, as well as clear instructions for how and when to share information via those tools. Asking for too much information from the sales force could limit information sharing, as reps struggle to comply with the commercial team’s time-consuming requests. On the flipside, sparse requests for information from the field limit valuable insight sharing. Commercial leaders should home in on the most essential pieces of information that will enable the company to develop rich account profiles and advance the commercial effort.

Prepare for a future of increased complexity

The niche therapy space is dynamic. For one, competition is increasing. As more therapies come to market, treatment sites will become increasingly crowded. Companies will battle over a smaller pool of opportunities, at least in the short term.

In the long term, companies are seeking to expand the number of treatment sites, equipping facilities beyond specialized tertiary care centers with the training and resources needed to administer niche therapies. The expansion of treatment will benefit patients. It will also further stretch biotech companies’ commercial teams as they expand their efforts to identify and engage with new stakeholders. In a hospital, for example, these stakeholders could span the entire organization—from the emergency room and intensive care unit to specific departments like neurology.

Companies that prioritize granular intelligence gathering in the field and enable it with flexible commercial technology (instead of trying to force new requirements into rigid tools), will be best equipped to navigate this complex and evolving space.

Develop two-way partnerships with the field

Commercial leaders at emerging biotech companies should view niche therapy commercialization as an account management exercise. Account management requires granular understanding of customers (in this context, treatment sites and the stakeholders within them). To gain that granular understanding, companies need to create a healthy two-way partnership between home office and the field sales force.

To enable this two-way partnership, companies must think bigger. View commercial technology as more than a place to log call activity. View sales force and home office engagement as something integral to daily operations (instead of something that happens during periodic status meetings). And understand the trajectory of the niche therapy space. It’s one marked by dynamic innovation, and, as a result, more competition and growth in the number of treatment sites. It's a space that promises to transform patient lives in the years to come. To ensure a company’s therapies breakthrough and reach patients in need, it must foster partnership with the field, putting robust and flexible commercial technology and sound process at the heart of the effort.

About the Authors

Jennifer Maurer is executive director of commercial and CAR-T operations at Legend Biotech, while Laura Riccio is an associate partner at Beghou Consulting.