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5 key challenges and roadblocks in biopharma commercial models

How pharmaceutical sales models impact revenue growth

pharmacist viewing a perscription

Growing revenue and capturing share in the pharmaceutical market has always been challenging. Leaders are faced with new entrants, new products, increased patient and provider expectations, and pressure to maximize both sales volumes and the exclusivity period. COVID-19 only increased the pressure to maintain revenue growth and margins while offering new services to engage providers virtually and digitally.

Traditional commercial model issues did not go away or get easier; if anything, the situation became more complex and challenging across the entire front office (e.g., sales, marketing, market access, patient access). Commercial leaders today need to re-examine their sales models to ensure they are keeping up with expectations. Pharma sales models and incentive structures are changing to generate authentic clinician buy-in and respond to legal and societal scrutiny.

In this first article in a series of three articles, we consider the biggest challenges and roadblock to commercial models, the most common issues with traditional models, and the transformation efforts that smart sales and commercial leaders are taking to transform.

The “big rocks” blocking revenue growth

There are five key challenges that biopharma commercial leaders must adapt to if they want to drive profitable revenue growth:


1. Patients and providers increasingly expect excellent and digitally enabled customer experiences

  • Personalization of the patient and provider experience is a differentiator in a competitive but regulated marketplace. Examples of personalization include personalized patient communication (e.g., refill notifications to maximize adherence), and customized provider training (e.g., tailored disease state and technical education programs)
  • AI (Artificial Intelligence) is being used to further enable personalized medicine, connecting all aspects of the care continuum from risk assessment to monitoring; 84% of medical device industry leaders say that AI will soon transform personalization in healthcare1
  • While patients and providers expect a more personalized experience, 52% of pharma leaders say that customer experience is an industry wide area for improvement2
    • Implications: Sales and marketing leaders need to prepare sellers to understand and help sell alongside increased expectations and a patient-focused ecosystem to help clients improve their patients’ experiences.


2. Government action may force pharma companies to run on narrower margins 

  • New Medicare and Medicaid programs aim to control costs via legislation (e.g., Health Care PRICE Transparency Act, Inflation Reduction Act)
  • The Inflation Reduction Act lets Medicare set prices 9-13 years after FDA (Food and Drug Administration) approval, depending on the type of drug, and may require companies to spend more on rebates, affecting margins and increasing the importance of pricing strategies
  • Many pharma organizations are proactively and voluntarily capping prices of their drugs in anticipation of widespread pricing regulation
    • Implications: Commercial leaders need to adjust their strategies and expectations to align with new pricing legislation and train their teams to navigate changing rules with payers and providers.


3. Providers and patients accept telehealth treatment more often

  • COVID-19 accelerated the use of virtual technology, changing provider behavior and expectations of pharma vendors
  • CMS (Centers for Medicare & Medicaid Services) changes in 2020 and 2021 opened the door for comprehensive telehealth coverage and virtual clinic models, cementing these changes in treatment models
  • In 2021, less than 25% of clinicians said they will go back to "business as usual," and expect to make telehealth and virtual vendor interactions a normal part of practice operations
  • Many providers are now flexing to remote and hybrid work environments, both for themselves and their staff, making digital and virtual technologies and interactions crucial for pharma sales team success
    • Implications: Sales and marketing leaders need to help their teams adapt to hybrid work models to access patients and providers that need more flexible marketing, sales, and account management approaches.


4. Focus shifts toward the economic buyer

  • Hospital margins continue to erode because of increased pressure from private and public payers. Private payers are narrowing their networks and increasing access to less expensive digital/virtual offerings and public payers are grudgingly increasing reimbursement rates
  • As sites of care and health systems run on increasingly thin margins, the power of finance and procurement functions at these sites of care continues to expand
  • More advanced therapies (e.g., CAR-T) require integrated offerings (e.g., therapies, software, diagnostics, services) that expand the buying audience and increase the need to manage a wide variety of economic stakeholders (e.g., procurement, payers, CFOs, etc.) beyond clinical staff
    • Implications: Commercial leaders need to manage and balance the needs of both clinical and economic buyers, not just sell the clinical story.


5. Challenges across the clinical pipeline stunt long-term revenue growth and commercial planning3

  • Finding patients for clinical trials can be difficult due to small patient populations, increasing focus on rare diseases, critical staffing shortages, and patient resistance to in person trial requirements (e.g., testing, treatment, diagnostics) - for example, more than 40% of National Cancer Institute (NCI) sponsored trails close without meeting enrollment goals4
  • Clinicians are unfamiliar with the new techniques that innovative therapies and precision medicine in development require, limiting the ability for pharma companies to conduct clinical trials
  • Clinical trials are generating more unstructured data. In 2021, phase three clinical trials were generating three times more data than ten years prior. The complexity and scale of clinical trial data requires more sophisticated data management to ensure data integrity and usability
    • Implications: Smart organizations are more carefully managing a new generation of clinical trials, which, while challenging, will ultimately help commercial organizations decrease time to peak sales for new products and improve competitive positioning.

In our next article, we explore the top 4 challenges from traditional commercial models.


Alex Tolmasoff, Director, KPMG Sales Transformation and HCLS Lead 


1Source: Forrester, “The State of Customer Obsession in Healthcare” (January 2022)

2Source: Forrester, “Top trends in Pharma, and Trust Are needed to build resilience in 2022”  Eric Bellomo, (Sept 3, 2021)

3Source: The Wall Street Journal, “These Drugs Are So Futuristic That Doctors Need New Training”, Amy Dockser Marcus, (April 5, 2023)

4Source: National Library of Medicine, “Prediction of clinical trial enrollment rates” (February 24, 2022)

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Payers, growth challenges may be hiding in your sales model

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Meet our team

Image of Walt Becker
Walt Becker
Principal, Customer Advisory, Sales Transformation Lead, KPMG US
Image of Alex Tolmasoff
Alex Tolmasoff
Director, Customer Advisory, Sales Transformation, KPMG US

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