ZoomRx, in its pharma engagement tracking benchmarks published in 2024, measured that in-person interactions between HCPs and pharmaceutical representatives have returned to 90% of the post-pandemic total and that the average duration of a single visit has gone from less than three minutes pre-pandemic to about sixteen minutes. The Veeva HCP 360 Trends Report of 2025 and of the first quarter of 2026 confirms the global picture and introduces an observation that is relevant for Italy: the average Italian representative makes twenty-eight weekly F2F interactions with HCPs, against seven by the British representative and eighteen by the French. Italy is not only the most F2F-centric country in Europe: it is the one in which F2F is proportionally growing, not shrinking.
The context around Italian face-to-face has nevertheless changed structurally. IQVIA ChannelDynamics in November 2025 measures Italian HCP preference for F2F at 45%, slightly down from 46% in 2024, while preference for email grew to 15% in 2025 from 14% in 2024 and 10% in 2023, and that for in-person conferences is stable at 16%. The alignment of channel mix with the declared preferences of Italian HCPs remains at 67%, the highest value in EU5. The winning pharma model in 2026 is not the one that pushes Italian HCPs toward a forced U.S. omnichannel: it is the one that orchestrates F2F as the main channel and uses digital to amplify it before and consolidate its value afterward.
The Italian paradox: fewer visits, but denser
The structural transition of Italian face-to-face is from volume to value. ZoomRx measures an average global visit of sixteen minutes against less than three minutes pre-pandemic, and the 2025 Italian ISF Observatory published in June by Informatori.it and Bhave reports an average duration of about fourteen minutes for the Italian market, in line with the global benchmark. The sales force is no longer organized around the "door-to-door" logic that characterized pre-2020 pharma: the average Italian representative is fifty years old, has more than ten years of experience in 69% of cases, and engages in a conversation with the physician that has become scientifically denser. The value per minute of the visit has grown, and the cost per minute of a single F2F interaction is today higher than that of any other available channel.
IQVIA ChannelDynamics measures in 2024 and 2025 data that 64% of "impactable" pharma sales in Italy come from the F2F channel — the highest value in EU5 — and that the combination of high-interactivity channels, F2F plus phone plus synchronous remote, reaches about 80% of impactable sales. Phone alone is worth 18%, a non-trivial share that is often under-invested. The operational meaning is clear: reducing F2F as a cost-containment strategy is a choice that directly erodes the main commercial value channel. The real optimization for 2026 is in the mix that remains around F2F, not in its replacement.
The remote gap: 60% ask, 40% receive
Across Health, through its Navigator365 updated to 2024 and 2025, measures that 60% of European HCPs declare themselves interested in remote engagement with the pharma sales force and that only 40% actually receive it. It is a structural 50% gap that reflects under-supply of the remote channel by companies. Only 6% of EU5 specialists are served in a truly multichannel way — rep plus email plus synchronous remote — and 50% of visited physicians remain monochannel, reached only by the in-person representative. The Italian white space of 2026 is therefore not the leap to full U.S. omnichannel, but the transition of the average representative from F2F monochannel to the two-channel model of F2F plus post-visit Approved Email.
Veeva, in its own 2025 surveys, quantified that companies that have implemented video meetings with HCPs who requested them obtain an effectiveness three times higher than F2F alone for that segment of physicians. The data is important because it qualifies the leap to video: it is worth three times more, but only for the subset of physicians who actively prefer it, about one-third of accessible HCPs in Europe. The correct deployment of video meeting is not blanket across the entire sales force but offered as an option for that third, while maintaining F2F for the rest.
Veeva, Salesforce, and 2026 orchestration
Between October and December 2025 the two most widespread CRM platforms in pharma brought into production their own interpretation of multichannel orchestration. Salesforce launched Agentforce Life Sciences on October 11, 2025 with voice-activated account prep, hands-free narrated briefing on the move, smart summaries, and Marketing Cloud Next as the journey orchestration layer. AstraZeneca, Novartis, Pfizer, Takeda, and Chiesi are among the customers announced in the first six months. Veeva brought AI Agents for Vault CRM into general availability on December 3, 2025, with an Anthropic and Amazon technology stack on Bedrock, and integrated Engage Meeting as a native remote-detailing platform in the representative's workflow. Aktana, one of the most widespread pharma NBA platforms, was acquired in January 2026 by PharmaForceIQ with a repositioning oriented to optichannel.
The structural point is that the core of 2026 pharma orchestration has shifted from the CRM to the Next Best Action engine. The CRM remains the system of record, but the system that decides which channel to activate at which moment for which HCP is the agentic layer sitting above. For the Italian decision-maker, the choice between Veeva and Salesforce is no longer a choice of functional depth — both cover F2F, email, remote, portal — but of AI economic model, cohesion with the rest of the technology stack, and maturity of the local system integrator.
The under-34s are 8%, but they drive the model
The 2025 ISF Observatory photographs an Italian sales force in which the under-34 segment represents only 8% of the population, against 69% with more than ten years of experience. Below the aggregate demographic averages, however, there is a generational dynamic that matters for the design of the 2026 operating model: medical sales representatives under 34 natively use a mix of F2F plus email plus webcall plus mobile messaging, and reach digital engagement levels that the demographic average does not reflect. Companies that have built their operational planning following this segment — few in numbers but more scalable in model — anticipate the dynamic that the rest of the sales force will acquire in the next five years.
The Italian regulatory constraint shapes the operational choice in a specific way. The Farmindustria Code of Conduct of February 21, 2025 applies identically to F2F and digital: same MLR, same annual ACCREDIA certification, same traceability of promotional content. GDPR and the Italian Privacy Code require explicit HCP consent for recorded remote meetings, and Article 4 of the Workers' Statute applies to the recording of the worker — the representative — during the remote meeting. The F2F-plus-digital model built around the existing Italian sales force is the one that best absorbs these constraints. The full-omnichannel model imported as-is from the U.S. market does not. The 64% F2F paradox is not a backwardness of the Italian market. It is its competitive specificity.
