Welcome to edition thirteen of The Beghou Biopharma Review by Marc Iskowitz.
When call plans fail to account for a physician’s past promotional exposure, every rep or MSL walking through the door can feel like an isolated interaction. During my reporter days, I heard this described as a common symptom of a deeper divide between pharma headquarters and the field.
This month, I’m revisiting that divide in two ways. The first is a research-driven piece drawing on Beghou’s new Field Force Pulse Survey, part of our Commercialization That Works research series, to pinpoint where the HQ-field intelligence loop breaks down. The second is my recent podcast conversation with Bicara Therapeutics’ Perry Monaco, a 28-year oncology sales veteran who makes the case for stronger communication and collaboration between the field and Marketing.
We mapped HQ-derived intel's weakest links
The Field Force Pulse Survey found that even as HQ invests in more dashboards and AI-driven guidance, field teams don’t necessarily trust or use what they receive. The data help pinpoint where that HQ-field intelligence loop breaks down.
These locations range from when the field receives and judges the relevance of HQ-derived intel, to whether they act or override it and how HQ learns from the response. My Beghou colleagues Gaurav Jha, Associate Partner, and Taylor Mikkola, Manager, and I mapped the weak spots along that chain in the form of reps' top five dashboard complaints.
Where the HQ-to-rep intel chain breaks: Intel is generated: information overload → Intel is received: over-tooling and poor fit → Intel is interpreted: guidance is out-of-touch → Intel is acted upon: there’s nothing actionable → Intel is fed back: the field is not being heard.
The takeaway: When reps don't act on an insight, it's usually because they have more confidence in their own judgment. A company's ability to address that trust factor is what separates simply giving reps more guidance from giving them guidance they’ll actually act on.
What to do now:
- Measure trust, not just usage. Ask reps where and why confidence in HQ guidance drops.
- Study the overrides. Patterns in ignored recommendations can expose stale data or market gaps.
- Pressure-test before scaling. Validate new guidance with experienced field users before rolling it out broadly.
⛓️💥Check out my interview with Gaurav and Taylor to read more about these five weak links in the HQ-field relationship and practical ways to address them.
The human collaboration to make it work
Better data alone won’t bridge the HQ-field divide. Commercial and Medical teams also need to communicate about what they know about customers and coordinate their interactions accordingly. That was one takeaway from my conversation with pharma sales vet Perry Monaco of Bicara Therapeutics, my latest guest on The Space Life Sciences Podcast. Perry argues that, within the appropriate guardrails, teams should be sharing what they know about an account, including recent customer interactions. An MSL shouldn’t walk into an account only to learn that a sales rep was there the day before.
He also shares how working in oncology gave him a powerful “why” as a professional, as well as why shrinking physician access makes coordination across teams even more important.
The following Q&A has been edited for length and clarity.
Q: How can we ensure Medical and Commercial operate in sync?
Perry: We know the guardrails for which both need to operate, and we're not asking people to do anything that's outside of those guardrails. But you should be able to collaborate and communicate about what we know about customers, what makes them tick, what was our last interaction with them like. There's nothing worse for an MSL to walk into an account and talk to an investigator and they say, "Oh, I just saw your salesperson yesterday." So why aren't we just putting these systems in place to talk about the account at an account level? If we're not communicating and collaborating that way, it's really inexcusable.
Q: What was your "welcome to pharma moment?"
Perry: The first time I set foot in an oncology clinic. I remember walking through the door. And I sat at the entryway probably for an uncomfortably long period of time. It just hit me: This is different. I'm not helping somebody with their seasonal allergies. I'm actually doing something that really matters. And I knew that I had to be different. I had to be sharper for customers, because looking at a patient that has lost their hair or is walking around with a continuous IV infusion, it just feels different.
Q: What’s making a pharma rep's job harder?
Perry: The time that we're actually able to get in front of customers has shrunk significantly. But because we're very compliance-driven, we only allow our salespeople to talk about a very small amount of what actually is needed for an account or a physician to make a decision for their patients. ... We have to figure out how we can get that customer what they need at that spot of interaction.
👂 Listen to the podcast here.
What's next...
Our upcoming presentation at Fierce Pharma Week (Sept. 15-17, Philadelphia, PA) will feature Beghou's Clare Gora on "The Next Act in Commercialization: From Market Signal to Coordinated Commercial Response." The session will cover how peers are connecting market signals and AI insights across commercial teams, which GTM model changes leaders are prioritizing to build trust and drive coordinated action across functions, and how to move beyond isolated AI pilots without committing to a costly, multiyear transformation. Learn more.
Our upcoming session at First Time Launch Summit (Sept. 16, Shepherdsville/Clermont, KY) is part of a full-day learning experience designed specifically for first-time launch organizations and their industry partners. Beghou's Robert Rouse will be a featured speaker, sharing practical insights on payer strategy and market access to help emerging biopharma companies get ready for commercialization. Register here.
That’s it for now. If you’re looking for more context on any of these stories, drop me a line at marc.iskowitz@beghou.com