What doctors really talk about – and how to truly understand them

A deep-dive into 18 oncology indications in Germany

In pharma, understanding your audience means more than just counting doctors. It means knowing who shapes conversations, which channels they use, what concerns they raise, and what they need but don’t get. We recently analyzed 18 cancer indications in Germany, with a clear purpose: to map the landscape of relevant medical voices – and to understand what they actually talk about.

Here’s what we learned – and why it might change how you think about engagement in oncology.

Step 1: Who is truly relevant?

In every indication, there’s a subset of HCPs who consistently publish, present, and shape discussion. These are not just prescribers. They’re influencers – often across disciplines, centers, and networks.

Below is a snapshot of how many of these high-relevance HCPs we identified per indication, along with the number of unique sources they used to communicate:

This isn't just volume. It's precision: relevant voices, speaking in relevant places.

Step 2: Where do these conversations happen?

Doctors don’t just speak in journals. They share insights at congresses, participate in collaborative studies, publish in patient association newsletters, contribute to hospital bulletins, and co-author trial updates. In our dataset, HCPs communicated across tens of thousands of unique sources.

Understanding where your audience speaks – and listens – is foundational to engaging them with relevance and respect.

Step 3: What are doctors talking about?

Let’s take Non-Hodgkin Lymphoma as an example. In indications like DLBCL, PTCL and MCL, doctors are focused on five core topic clusters. These are not product briefs — they’re pressing clinical priorities:

1. Innovative therapies Physicians are exploring new treatments such as CAR-T cell therapies (e.g. Tisagenlecleucel for DLBCL) and immune checkpoint inhibitors (e.g. Nivolumab). The potential of these approaches is widely discussed in clinical forums.

2. Clinical trials New antibody constructs, targeted agents, and combination regimens are central topics — with active studies tracked via UKSH and CIO registries.

3. Subtype-specific treatment There’s increasing awareness around biologically distinct subtypes — such as peripheral T-cell lymphomas or B-cell NHLs — and the need to tailor therapies accordingly.

4. Diagnostics & prognostics Progress in imaging, biomarkers, and minimally invasive diagnostics (like liquid biopsy) is seen as critical to earlier detection and risk stratification.

5. Supportive care & quality of life Topics include survivorship, fertility preservation (e.g. FertiPROTEKT), and psycho-oncology — all receiving increasing attention in patient-focused literature and professional guidelines.

Step 4: What are the critical voices saying?

Beyond therapy innovation, many HCPs express concerns about how the industry operates. Again, focusing on NHL, here are some of the most frequent and pointed criticisms:

1. “Trials are designed to exaggerate benefits — using PFS instead of OS.” PFS as a primary endpoint often inflates efficacy while offering no confirmed survival benefit.

2. “The pricing of NHL treatments is unjustifiable — even when they work.” Despite their efficacy, CAR-T therapies remain unaffordable for many.

3. “Your ‘new’ drugs are often minor modifications — with a 10x price tag.” Next-gen BTK inhibitors, for example, are marketed as breakthroughs with minimal added value.

4. “You push off-label use — without strong evidence.” In diseases like aggressive T-cell lymphoma, doctors report being pressured to try non-approved regimens.

5. “You downplay side effects — until they become life-threatening.” There’s concern that marketing often lags behind clinical realities.

These critiques aren’t just abstract. They shape trust — and how openly doctors engage with partners in pharma.

Step 5: What questions remain unanswered?

Doctors aren’t just talking. They’re asking tough questions — questions that often highlight deep gaps between clinical need and commercial focus:

1. “Why are there still no effective therapies for refractory PTCL — after decades of research?” Standard chemo has failed. Investment in rare subtypes is low. Sources: Onkopedia, Charité

2. “DLBCL is aggressive — why is molecular testing still not reimbursed?” Subtype distinction (ABC vs GCB) is essential for treatment, yet many don’t get access. Sources: UKSH, DGHO

3. “CAR-T cells are promising for relapsed mantle cell lymphoma — so why do trials exclude 90% of patients?” Strict eligibility criteria shut out high-risk groups who may benefit most. Sources: ASH 2024, CIO registry

4. “Why is there no standard for MYC+BCL2+ (double-expressor) lymphomas?” Physicians are forced to experiment with combinations — without guidelines. Sources: Cologne University, Haematologica

5. “Why do we ignore long-term toxicities in NHL survivors?” Late effects, like secondary cancers, are underreported and under-monitored. Sources: RLP Cancer Registry, DLH insights

Each of these questions is a potential starting point for trust-building — or erosion.

What does this mean for you?

Whether you’re shaping strategy, planning engagement, or just trying to better understand your medical audience — these five questions matter:

1. Who is relevant? Which HCPs — and referrers — are truly shaping your indication?

2. Why are they relevant? What makes them strategically important beyond prescription volume?

3. What are they talking about? Which products, topics, and unmet needs dominate their conversations — and in what context?

4. Where can you reach them? Which congresses, platforms, formats, and institutions matter most?

5. Which message matters most? Which narratives resonate — and which ones raise red flags?

When you have these answers, you don’t just “target” doctors. You understand them. And that’s the foundation for meaningful engagement.

Let’s stop guessing — and start listening better.

If you’re curious how this works across other countries or indications, or want to go deeper into your own target segment — feel free to reach out.

Ps: I am very interested in your opinions on our approach:

Marcus Bergler Gaby Perfahl Karsten Schmidt Carsten von Blohn Marco Andre Carlos Eid, MD Dan Buckland Joanna Sadowska, PhD, EMBA Sander Ruitenberg Daniel Tertel