Diversity Drives Success

AstraZeneca’s Florent Edouard discusses how cross-functional working equips pharma to compete in today’s complex healthcare ecosystem.



To succeed in today’s competitive pharma landscape, Pharma teams need to be not only motivated, but also diverse in terms of business origins, male-female ratio, their geographic mix, and a blend of experienced versus new blood, digital versus traditional, analytical versus emotional, and strategy versus execution. That’s the view of Florent Edouard VP Marketing GI-RIA, Commercial Excellence and IT at AstraZeneca.

Working cross-functionality is not something that we are very good at in pharma in general, nor specifically in Japan. Yet it is essential if companies are to compete and serve customers and patients effectively in an increasingly complex healthcare landscape, according to Edouard.

Following his presentation last year, Edouard updates about progress towards cross-functional working at AstraZeneca – including some of the barriers and challenges met along the way – and explaining how to maximize patient value in a Japan context.

Outdated approach

The traditional approach to working with one function handing off to another has its origins in the 19th-century work of Frederick Winslow Taylor, Edouard explains. One of the first management consultants, Taylor was an American mechanical engineer who sought to improve industrial efficiency. However, his views on vertical and horizontal structures within organizations are no longer so relevant in the context of flatter organizational structures and the more entrepreneurial ethos that seeks to deliver greater value to patients and providers. “In pharma, we’re still applying those principles from more than one century ago. R&D hands over to Medical who hands over to marketing who hands over to Sales. From a patient standpoint, this is slow and ineffective.”

So why is it important to work cross-functionally in pharma in Japan? Edouard explains: “Today’s world is considerably more complex than ten years ago. We need to be faster to bring the drugs to the patients, and those drugs are more complicated to market. ”

Today, there is more specialty care and more sophisticated products; it’s no longer just “a pill a day”; drugs are far more complicated to understand and explain. Medical reps are becoming more sophisticated; moreover, without close collaboration between R&D, Medical, Marketing and Sales, the reps won’t be credible in front of their customers. Meanwhile, customers are changing at a faster pace every day. Doctors are also changing; their demographic is evolving with more women and younger doctors, who are also digitally savvy.

In order to engage them, there has been a move away from focusing on products to “delivering a great customer experience”. In this context, companies have to work cross-functionally: for instance, with R&D working hand-in-hand with the medical people to put the patient needs and interest at the core of what they do, so the commercial teams can build on this to make sure they shape communications that are useful for the HCPs who need them, in the way they want to consume them and at the time they want them. “That’s fundamental; if you’re not there you will not meet your customers, and if you don’t meet your customers, they will move.” They will go to another community; they will go to another company.

 

All about the patient

This approach involves breaking down the silos and making the focus all about the patient: “One thing that should unite us all is the patient’s health,” Edouard declares.
At the same time, there is a need for transparency and an entrepreneurial spirit. This involves risk taking: you need to be able to take risks, learn from failure and then improve.

Of course, this necessitates clear ground rules and comprehensive representation across R&D, Medical, Marketing, Sales, Operations, and Finance – a clear team, with clear rules to ensure all functions are represented. The way to success involves:

  • No hierarchy across functions
  • All functions around the table when appropriate
  • Clear accountabilities per function
  • Clear and empowered leadership team
  • If possible, physically co-locate – this is important for team cohesion

You need to create nominative RACIs. “That is very important, ” Edouard adds. Underpinning this all is a need for talent diversity in all its forms and working in a cross-functional team should also serve as a talent accelerator, so that members of the team go on to be promoted.

Specific to Japan

What are the specific issues in relation to Japan, where the culture is traditionally more hierarchical and risk averse? “I think the Japan environment is changing and aligning to the rest of the world progressively.” The market is becoming westernized and competition is becoming tougher so that commercial practices are also changing. Furthermore, Japan is a world leader in digital healthcare, so we know we can make it.

Summing up the healthcare landscape, Edouard argues:

1. We are going through the same changes in Japan in terms of the drug pipeline – more complication, more small high-priced drugs, and less primary care which forces cross-functionality.

2. Japan is aligning to the rest of the world in terms of commercial practices. This used to be a very medical rep-driven market with a lot of services for the customer. Now there is a decreasing number of reps, access limitations, consolidation of hospitals and price negotiations. Japan is shifting towards US and European-style models of six or seven years ago. There is a move to working cross-functionally with better value propositions for payers, providers, experts and HCPs.

They need to understand the full spectrum of everything around their brand, whether it is market access, the science, the clinical studies, the marketing strategy, sales, the operations path – they need to manage their products as if it were their own company. We call the guy who is heading the One-Brand Team the CEO of the brand.

Meanwhile, market access is becoming increasingly important in terms of being able to launch faster and with the right price. Government is pushing for innovation in certain products and you need to be able to prove the real value of the product. Are companies working in this direction and responding to these drivers? Yes for AstraZeneca and many other companies, Edouard responds.

What is Astra Zeneca doing?

The company has responded by creating micro franchises within the larger enterprise. For every brand, there is a “One-Brand Team”: R&D, Medical, Marketing, Sales, Operations and Commercial Excellence. That group creates the brand strategy and is accountable end-to-end from two years before launch to five years after launch for the success of the brand. Co-located in the office, the team operates like a business unit so has P&L accountability, and they take and defend their decisions together.

“They need to understand the full spectrum of everything around their brand, whether it is market access, the science, the clinical studies, the marketing strategy, sales, the operations path – they need to manage their products as if it were their own company. We call the guy who is heading the One-Brand Team the CEO of the brand.”

Specific benefits and approaches

What have been the fruits of this approach? “There have been a lot of benefits for the brand and indirect benefits for the organization in terms of talent development.”

At the same time, the organization has moved on from a purely customer-centric approach over the past two to three years in Japan. “Thinking customer first is not anymore our approach; while the customer is still important, what we want to do is put the patient first and try to define everything that can improve things for the patient – that’s the mission for the brand team – and as a consequence give to the customer everything he needs to support the patient and improve his health using the right medicine the right way.”

What specifically did AstraZeneca do? The transformation sought to break down the walls of the various different kingdoms – sales, marketing, etc – and rotate the leaders from sales to marketing and vice versa. The company managed to create an experienced group of people, and defined detailed roles and responsibilities. “It took a lot of time to get it right.”

The transformation also opened people up to the benefits of challenge. The culture in Japan has in the past tended to push people to work within their own boundaries because it is “perceived as disrespectful to look at what the other guys are doing that they could do better”. However, challenge can make a contribution by simply helping other people. The key was to help people look left and right to gain more of an enterprise vision. Beyond that, steps were taken to address a culture that is very risk averse, where there is a fear of failing. “We had to address that.”

All of this required more coaching to bring them on the journey.

Emphasis on diversity

Finally, Edouard emphasizes that to be cross-functional you have to be diverse. This involves making sure the “guys in Medical are different from the guys in Sales and they can enrich each other by working together”. There was a recruitment target for young talented females; the company ensured a good work/life balance; and promoted internal communication around success stories relating to cross-functional working.

Inevitably, these plans met resistance from entrenched views in some “long time in place” mid to upper management. When despite explanations and coaching some of those people could not cope with the new culture it was agreed with them to let them go from a company that was no more fit for them.

Edouard concludes: “Pharma companies need to push cross-functional working and diversity or they will disappear, like the dinosaurs did.” They need to create clear ways of working; push talent diversity; and recognize the higher value of jobs delivered cross functionally. AstraZeneca Japan is trying to be a “3000 people start-up. But creating such a mindset has to come from the top. The Japan leadership has been relentless at building that culture in the organization, without this clear steer it would not have worked.”


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