Contract Sales Organisations (CSOs)
CSOs offer complete commercial packages and pharma companies engage with CSOs on a broad service level to create a complete product commercialisation strategy.
CSOs have established expertise in such areas as market analysis, targeting, access and reimbursement. They also offer call centres, nurse educators, medical science liaisons and digital platforms with built-in reporting to keep programmes on track. And, because CSOs have the advantage of working with a variety of customers across many specialties, their insights draw from a wide experience which provides a value-add to their customers.
The use of data and technology has become increasingly prominent in the CSO market and a key competitive differentiator for many customers. CSOs have access to unprecedented levels of data and digital marketing resources and are focused on the holistic and multichannel commercialisation strategies of payers and prescribers, rather than being focused primarily on personal promotion.
Although the primary drivers of CSO market growth are similar to CDMOs and CROs, the CSO industry is less mature than either of these sub-sectors and, although high-growth, global CSO penetration is estimated at only 14% today, in a market valued at c.€5bn.
The lower penetration of CSOs versus CDMOs and CROs is primarily attributed to the diverging regulatory dynamics in their activities. While CROs and CDMOs have benefitted from a global harmonisation of regulatory standards, sales protocols differ on a country by country basis.
This makes it more difficult for CSOs to offer a homogenous service offering across multiple territories and means their offerings need to be tailored on a country by country basis. This represents an opportunity to CSOs which are able to offer their customers country specific teams and expertise. As such, CSO penetration levels tend to be highest in niche and fragmented markets versus larger homogenous territories where it is easier for pharma to build sales forces in-house. For example, CSO penetration is significantly higher in the UK (c.30%) than in the US (c.15%) and Japan (c.5%).
Another key difference which may contribute to lower CSO penetration levels is the nature of their relationships with customers. While they offer fast and flexible salesforce solutions, contracts tend to be smaller, shorter term and can end abruptly, with less opportunity for follow-up work.
Although big pharma CSO contracts represent the highest value share of the CSO market, CSO penetration is significantly higher amongst small and mid-sized pharma and growing at a faster rate. Many of the small and midsized pharma companies are emerging businesses and typically have limited capital, smaller portfolios of specialty products, and a greater need to mitigate the risks associated with building a commercial footprint. Therefore, partnering with CSOs is seen as a more flexible and cost-effective solution amongst these companies.
As with CDMOs and CROs, pharma companies are looking for fewer, global strategic partners that offer multiple services across multiple geographies, a trend which has driven intense consolidation amongst the leading players in the industry. However, there is still room in the market for specialised and geographically focused businesses which are able to compete on a local level against the global players.