The pharma commercial model is broken. Everyone knows it. Almost no one is fixing it

Most pharmaceutical companies are not engaging their HCPs. They are bombarding them.

More emails. More rep visits. More webinars. More channels. More 'omnichannel.' More, more, more — as if sheer volume might somehow compensate for a fundamental lack of relevance.

It won't. It isn't. And deep down, most commercial leaders already know this.

The industry has spent a decade digitally transforming itself into a more sophisticated version of the same broken model. Slicker pipes delivering content HCPs largely don't want, through channels they're tuning out, measured by metrics that tell us almost nothing about whether we're actually making a difference.

That's not transformation. That's expensive noise.

Here's the good news: this is fixable. Not through more technology, more channels, or more activity — but by rebuilding the foundations underneath. The companies that are starting to do this are already pulling ahead. The rest of this piece is about what they're doing differently, and what it would take for the rest of the industry to follow.

The Silo Problem Nobody Wants to Own

Most pharmaceutical organisations are structured like this when it comes to HCP engagement: Medical does its thing. Marketing does its thing. Sales does its thing. And somewhere in the middle, an overstretched Customer Excellence team tries to hold it all together with good intentions and a project management tool.

The result? The HCP receives fragmented, inconsistent, and frequently contradictory communications — from three different people, representing three different internal agendas, none of whom appear to be talking to each other.

The HCP doesn't care which internal department sent the email. They don't care whether it was the MSL or the rep. They care whether it was useful. Whether it was timely. Whether it was worth the thirty seconds it took to open.

The regulatory boundaries that created these silos were designed to govern the content of interactions — what can be said, and in what context. Somewhere along the way, the industry interpreted those content rules as instructions to build walls between entire functions. The HCP is standing in the middle, watching the lanes, wondering why no one is driving anywhere useful.

A small but growing number of companies — Roche among them — have started quietly dismantling this architecture. They're experimenting with unified customer-facing roles that flex to the nature of the interaction rather than the job title of the person delivering it. That's the direction of travel. The question is how many will wait until it's urgent before they follow.

The Volume Fallacy (And Why It's So Hard to Kill)

When engagement rates are low, the traditional pharmaceutical instinct is to increase volume. Send more. Call more. Reach more. Compensate for a 10% success rate by doing ten times as much.

This is the Volume Fallacy, and it creates a vicious cycle that the industry has been stuck in for years:

Low-quality engagements produce poor response rates. Poor response rates trigger calls for more activity. More activity further dilutes quality. HCPs grow more resistant. Companies respond by pushing harder. Repeat.

The cycle doesn't break because the metrics reward the wrong things. Call rates. Email volumes. Open rates. Attendance numbers. These are activity metrics — and measuring activity is not the same as measuring impact. An HCP who opened your email and immediately deleted it still counts as an 'open.'

We are measuring ourselves into mediocrity.

The alternative is harder. It requires the courage to send fewer emails and accept that fewer-but-better is a legitimate commercial strategy. It requires measuring outcomes rather than outputs — did this engagement shift a belief? Did it change a behaviour? Did it make the HCP's job even marginally easier?

Companies that have made this pivot consistently report stronger engagement quality. Fewer, better-targeted communications generate more responses. More selective face-to-face interactions produce deeper conversations. The maths is straightforward. The cultural shift is anything but.

The Architecture That Actually Works

The commercial model of the future is not a technology problem. The tools exist. The data exists. The capabilities exist.

It's an architectural problem — and it starts with separating two functions that have been conflated for too long: Customer Enablement and Customer Engagement.

Enablement is the engine room. Data and CRM infrastructure. Content development. Channel management. Customer journey design. AI-driven decision support. Performance measurement. These are specialised, technical capabilities that require genuine expertise. They should be structured as centres of excellence serving the whole organisation — not siloed by brand, lifecycle stage, or function. One team. One source of truth. One operating logic.

Engagement is the front line. The actual interaction with the HCP, delivered by teams organised around the customer rather than around internal departmental logic. Customer-facing 'pods' that combine scientific credibility and commercial acumen, able to adapt to what the HCP actually needs rather than what their job title technically permits them to say.

This isn't a radical concept. But it is a significant mindset shift. Moving from a role-defined model to a need-defined model changes the customer experience fundamentally — and it's the architectural prerequisite that makes everything else (omnichannel, AI, advanced analytics) actually deliver.

The pattern we see consistently: organisations with a clear Enablement / Engagement separation move faster, waste less, and protect the ROI of their digital investments. Those that conflate the two end up with brilliant capabilities trapped inside broken structures — and no amount of new technology layered on top will fix that.

Digital and Human: Both, Not Either

One of the more persistent false dichotomies in pharma is digital versus in-person engagement — as if the field force and digital channels are competing for budget rather than serving complementary purposes at different moments in the customer journey.

The smarter model treats digital as filtration, not just broadcasting. Use digital signals to understand which HCPs are engaged, which are resistant, and which are hungry for more. Use that intelligence to direct human resources — the field force — where they will have the greatest impact.

'Digital first' doesn't mean 'digital only.' It means using digital intelligently as the first layer of engagement — to filter, to learn, and to deploy human resources where they create real value, rather than spreading them evenly across a target list regardless of potential.

The high-potential HCP who is immune to digital noise deserves a rep visit that counts. The self-sufficient prescriber who would rather self-serve doesn't need one and resents being given one. Treating these two the same is not omnichannel strategy. It's omnichannel theatre.

Measure What Matters, Not What's Easy

The most damning indictment of the current model is its measurement framework. We know how many emails were sent. We know open rates, click-throughs, call rates, and congress attendance. We know all the things that are easy to count.

What we mostly can't answer: did any of it make a meaningful difference?

If the honest answer is 'we don't track that' — or worse, 'we don't know how to track that' — then the measurement framework is actively working against you. It is creating a false sense of progress while the fundamentals remain unresolved.

The HCP audience isn't disengaged. They're finding information elsewhere — through peer networks, independent platforms, and increasingly through AI tools that synthesise across sources at speed. The response to that cannot be more volume. It has to be more value. And value only becomes visible when you measure outcomes, not outputs.

The Real Barrier (And What It Takes to Cross It)

The tools for the rebuild are available. The data is there. The frameworks exist.

The barrier is not technical. It is organisational — specifically, the courage to do less, but better. To measure what matters rather than what's easy. To restructure engagement around the customer rather than around internal org charts. To invest in the unsexy foundations — clean data, coherent segmentation, properly designed customer journeys, agile operating models, outcome-based measurement — rather than the shiny technology that sits on top.

The companies that will lead HCP engagement over the next five years are not those with the biggest budgets or the most advanced AI. They are the ones rebuilding the foundations underneath. Fewer interactions, better designed. Cleaner data, more honestly used. Customer-facing teams structured around what the HCP needs, not what the org chart allows.

That isn't a radical agenda. It's a practical one. And it protects and multiplies the ROI of every digital investment a company has already made.

The question every commercial leader should be asking is simple: are we actually helping the HCP, or are we just making noise in their direction?

If the honest answer is the second — and for most, it currently is — that's not a verdict. It's a starting point.