Debunking Pharma Stigma: How Industry Partnerships Benefit Clinical Oncology Pharmacists

In the early 2000s, the pharmaceutical industry was largely driven by sales metrics. A few bad apples with limited morals pushed the envelope on acceptable sales techniques, leading to legal action and widespread mistrust of the entire pharmaceutical industry. This sentiment of mistrust among clinical oncology pharmacists has alienated clinical staff and led to a significant division between clinical pharmacists and the pharmaceutical industry responsible for producing medications. However, as a result of strict updates to policy by the FDA and reimagined strategy among pharmaceutical industry executives, the role of industry within the oncology pharmaceutical field has changed dramatically.

Within the oncology field, the pharmaceutical industry now provides clinical oncology pharmacists with tools and support to ensure patients receive the best possible care. Compared with the traditional pushing product mentality, the guideline-driven landscape of modern oncology treatment led industry personnel, including key account managers, oncology account managers, field reimbursement managers, and medical science liaisons, to serve in more of a supportive capacity. This allows for better access to cutting-edge medications, quality improvement project support, and enhanced educational opportunities for pharmacists and other health care professionals.

Although policies against pharmacist interaction with industry are still relatively common among health systems, these policies are largely outdated and do not consider the recent changes to pharmaceutical industry operation, showing a lack of understanding of the benefits that clinical staff can obtain through industry interaction. Throughout this review, the authors aim to outline these key benefits for clinical oncology pharmacists and debunk the stigma behind industry interaction.

Key account managers cover a small group of large institutions/health systems within a region that are the key customers for a particular company and help to coordinate all services between the pharmaceutical company and the institutions they oversee. They act as the quarterback between the institution and company, helping to triage questions or problems to the appropriate person or department. They also assist institutions with quality improvement projects, with a recent focus on addressing health disparities within oncology screening and treatment.¹

Additionally, key account managers gather clinically relevant feedback from health care professionals (HCPs) and staff, delivering actionable insights to their organizations to support data-driven refinements in medication utilization strategies and address institution-specific access challenges. Overall, key account managers can serve as a clinical pharmacist’s go-to contact for anything related to their respective products.

Oncology account managers carry a variety of names and titles across pharmaceutical companies, but these individuals are most commonly referred to as sales reps. The term sales rep often makes pharmacists squirm, but FDA guidance and changes in strategy, especially since the COVID-19 pandemic, have significantly impacted the way that sales teams are able to operate. There is, of course, a promotional role to the position, but sales reps now primarily focus on presenting HCPs with key trial data and discussing the place for a specific therapy within national guidelines. Because of the guideline-driven nature of oncology treatments, oncology tends to be a difficult field for sales teams to push traditional sales approaches.

Sales teams within the oncology industry understand this and know that pushy sales techniques may be detrimental to their relationships with HCPs. Oncology account managers also provide educational opportunities to HCPs through speaker programs, which bring in experts within their field to discuss both branded and nonbranded information. The presentation of trial data directly from an HCP speaker who has firsthand experience with the medications or testing being discussed offers valuable real-world considerations. These programs lead to networking opportunities with both local HCPs and the expert speaker. Finally, oncology account managers can provide medication starter kits, which include educational information approved by the FDA, and tools such as symptom trackers and coupons.

Symptom trackers are helpful for patients to document adverse effects for more accurate and effective reporting during follow-up visits and phone calls. Similarly, the coupons are very valuable to patients with high co-pays or when expensive supportive medications are recommended. Clinical pharmacists will likely have the most opportunity for interaction with these frontline team members of the pharmaceutical industry, and they can help pharmacists stay informed with the most up-to-date data releases and offer valuable support for patient education.

Field reimbursement managers (FRMs) are underappreciated but invaluable assets to the entire pharmacy team, as pharmacy is often the leader in drug access and reimbursement for health systems. FRMs become involved only after the decision has been made to utilize a particular medication. They can assist with prior authorizations, insurance appeals, and patient assistance programs. Larger health systems may have their own specialized medication access teams who handle insurance approvals and patient assistance. However, even in those large health systems, FRMs can play a key role in troubleshooting and overcoming unique problems that arise, and helping to speed up the process when medication is needed urgently.

For smaller health systems or community clinics, FRMs can be integral contacts to help with the access process when a dedicated team is not available, saving hours of pharmacist and nurse time per patient. Finally, FRMs are pivotal for ensuring timely access to newly approved medications. Within oncology, especially in academic centers, providers look to utilize new therapies as soon as they are approved by the FDA. This is often before insurance systems have added the newly approved drug to their formulary. By leveraging FRMs, clinical pharmacists can escalate cases to pharmaceutical company payer teams that assist in adding newly approved drugs to insurance systems in a timely manner, ensuring prompt patient access to potentially impactful treatments.

Medical science liaisons (MSLs) may be the most helpful industry team members for clinical oncology pharmacists. MSLs can review clinical trial data, late-breaking abstracts, or data readouts presented at major conferences and speak off-label, offering insights into potentially unpublished internal data. Clinical oncology pharmacists are well-trained to complete literature searches and critical reviews of trial data, but MSLs offer another layer of interpretation, answering deeper questions that may not be clear in the published manuscript. If MSLs cannot directly answer questions posed, they will triage to the headquarters medical team for further evaluation. MSLs also play a critical role in postmarketing safety and monitoring of medications.

Pharmacists can report adverse events to MSLs for reporting back to the pharmaceutical company and FDA in order to help describe and quantify potentially rare adverse events, which helps to expand upon current prescribing data to ensure improved patient safety. Clinical oncology pharmacists can enhance their knowledge and provide key information to the multidisciplinary team by actively engaging with MSLs.

Involvement and open communication with the oncology pharmaceutical industry can lead to a mutually beneficial relationship between clinical pharmacists and industry representatives in a variety of roles. Industry personnel in the current era have strict FDA compliance guidelines to follow and understand the importance of patient-centered care. Professional partnerships with industry have the potential to enhance the level of care provided to oncology patients and ensure that patients have access to the best medications available.

Considering the substantial benefits to clinical oncology pharmacists, institutions with highly restrictive industry policies must actively reevaluate and modify these policies to reflect the current state of affairs, ensuring the delivery of optimal patient care. The oncology pharmaceutical industry has matured and now focuses on the patient, helping to provide positive outcomes. Why perpetuate the stigma, cutting off and isolating this essential and beneficial part of the cancer care continuum?

REFERENCE

1. Lally A, Skoczynski M, Shah P, et al. MA18.12 Innovations in lung cancer screening: adoption of the pink and pearl campaign. J Thorac Oncol. 2024;19(10):S132-S133. doi:10.1016/j.jtho.2024.09.238