How do you view CRM: as a chore, as a way of saving effort, or as a valuable window on your customers’ world? Leading CRM vendors tell Pf where the pharmaceutical industry sometimes gets it wrong – and how a combination of new business thinking and new technology can turn customer data into powerful insight.

Customer Relationship Management (CRM) is more than an electronic system for data handling. It’s a well-established business strategy for collecting and utilising the most relevant information about the market. As such, it is a function of the whole company that lends itself well to an integrated commercial strategy. A glance at the industry’s news shows that customer and sales data affect every aspect of a pharmaceutical company. Moreover, how a company uses those data to develop its products and communicate their value to customers can have a significant impact on customer relationships.

But is CRM in danger of going stale? Has it become something that only sales people use, and even then not whole-heartedly? Is a perceived lack of progress with CRM due to problems with the technology, the people using it, or companies’ approach to it?

The answer, according to the specialist CRM suppliers Pf spoke with, is all three. But as they also told us, these drivers of fail need to change. A new ‘golden age’ of CRM is on the way.

Dead-end data
According to David Round, General Manager at Cegedim UK, the most common problem of CRM use in the pharma industry is poor awareness of its potential: “If you have a particular group of users who don’t feel the system works for them, and therefore don’t put in the richness of information that they could, that has a bigger impact on the CRM project as a whole.” Unless the company is using CRM to its best advantage, field sales professionals may lack confidence in it as a tool. 

In addition, Round argues, not every CRM system is fit for purpose: “Where technology can be a hindrance is where the way that it works is relatively fixed or determined in some dark room somewhere, and it doesn’t match the day to day process of the people who are using it. The technology, if it’s not designed correctly with the end users in mind, can actually contribute to a lack of return or a reduced return on investment for the CRM solution.”

Adam Nicholson, Commercial Director at Conigi, identifies four sources of CRM blues: CRM only seen as a sales team tool, thinking limited by previous CRM experiences, fear of the system’s complexity and (conversely) fear/perception that it cannot deal with new commercial realities. All of these, he says, are consequences of narrow thinking: “The reality is that if you pick the right vendor and the right solution, you have enough headroom for development to build what you need now and as your business changes.”
Not seeing the wood for the trees, the insights for the data, is another source of CRM frustration. Dan Goldsmith, General Manager at Veeva Europe, argues that the most successful pharma companies are able to derive “rich and insightful information” from CRM by moving “beyond the operational or transactional information” to a deeper analysis of customer behaviours – with the CRM supplier “not just supporting their business processes but helping them innovate the way they engage and architect the customer experience”. 

Nick Plank, Director, C&C Group, says that CRM systems, like pharma’s operational model, have evolved to meet the needs of a changing NHS in the past decade – and will evolve further as technology continues to advance. “Ten years ago, the environment was very much focused on the rep and in particular on the traditional one-to-one face-to-face style of territory organised sales forces. Fast forward to the present and CRM looks very different, with KAM structured teams engaging with customers on an account basis as opposed to a geographical brick structure, plus a variety of new stakeholders in CRM from medical development advisors to medical science liaison. A fully-integrated CRM accessible to multiple stakeholders is now essential if business functions throughout the enterprise are to have holistic visibility of the account and contribute data from their specific areas such as information gathered during digital engagement.”

Keep taking the tablets
All relevant stakeholders are agreed on the revolutionary importance of the iPad and similar tablet computers for CRM in the context of field sales. These devices take CRM out of the office and onto the road more effectively than ever before. They also have the power to support closed-loop marketing and related strategies, giving CRM a more dynamic role in the customer relationship and in the pharma company.

David Round comments: “I think that CRM is about to enter a pretty golden age, because the birth of the tablet computer and the iPad in particular means that the rep can use the system much more effectively on the go. Reps are more inclined to enter information just after the call than wait until they get home, and what the iPad does is give them the ability to record this information with much more richness and much quicker after the interaction. Obviously, mobile access to the internet is still limited in many medical locations, and for this reason, the CRM must be able to provide most of its functionality in an office mode. As many reps would point out – what’s the point of having a mobile CRM that only really works online?”

In addition, the iPad gives the field-based sales rep rapid access to market information at a time when the UK drug market is going through dramatic change. The ability to keep track of the changing customer base and to structure new relationships with new types of customer is essential, and new technology is vital for this. As Adam Nicholson observes: “Gone are the days when you had a linear customer relationship in place and a linear CRM system to manage that. With the changes in the NHS, you’re going to have to have dynamic processes in place and a dynamic solution to manage it as you move forward.”

The iPad is arguably the first technology to make mobile CRM an effective reality. Dan Goldsmith argues that “it really hasn’t been until the introduction of the iPad that we’ve seen both widespread adoption and significant results delivered to pharma”. There are three reasons for that, he says: the mainstream adoption of mobile technology, the industry’s new appetite for “advances in digital and interactive presentations with customers”, and the reliability and simplicity of the iPad itself – “the ideal device at the ideal time”.    

A recent IMS report highlighted the growing importance of embedded business intelligence within the fully-integrated CRM. “This is where hosted European sales data warehouses are particularly useful, because they reduce costs by providing a single integration for analytical CRM across Europe,” says Nick Plank. “A managed hosted European approach to analytical CRM means employees across Europe can access market intelligence online when and where they need it without installing software. It also aligns well with the current move from on-premise systems to Cloud CRM because analytical data can be passed directly to the operational vendor using site-to-site integration – giving reps access to information immediately, wherever they are, via their mobile CRM tools or mobile business intelligence apps.”

Building dynamic relationships
What makes for an effective CRM system? The answer depends on how the sales professional and the company use the system. CRM is not about customer data: it’s about customer relationships.
David Round emphasises the need for “human-centred design”: it’s essential for the CRM user to be able to see the data in context and react appropriately. He uses the analogy of a sat nav system: it’s a superb tool to get you through unknown territory, but you also have to keep your eyes on the road. So the best systems support customer relationships instead of providing an electronic surrogate for them.

Round also warns against being too well-informed. If a rep greets a new customer they have never met before with the words Hi, I’m Jo. How are your children Sally and Billy? the relationship will get off to a bad start. What the rep really needs is the relevant background information to understand the customer’s role and make proactive suggestions from the start.

As Adam Nicholson observes, the CRM system has to deliver insights at both the quick overview and the deeper insight level: “We are rich with data within the industry; the old challenge has always been how you turn that data into information. Successful solutions should allow an individual to look at their data at a top level when they need it, but give them the ability to drill down into the customer data or the sales data to gain more in-depth analysis when needed.” 

The best CRM solutions are able to serve the needs of the most ambitious sales professionals and companies. Dan Goldsmith comments that cutting-edge CRM systems are enabling “interactive presentations, delivering better segmentation and targeting down to a more individual level, as well as collecting more psychographic or behavioural information”. The ultimate (and realisable) goal is a “behavioural profile” of each customer that feeds back into the sales message and interaction.

The bigger picture
The closed-loop marketing model implied by this approach cannot begin and end with sales. Adam Nicholson speaks for all forward-thinking CRM vendors when he says: “If you really want to make CRM work, it’s about engaging all the functions, be that marketing, medical, regulatory or finance, because if you implement the theory of CRM it actually impacts and improves business processes across all the functions.”

If you started reading this article with the mental image of a lonely sales rep (that’s you, that is) wrestling with interminable on-screen figures on a laptop in a hotel room, or on a tiny mobile phone screen in a rail station café, maybe it’s time for you and your company to consider upgrading your hardware, software and probably footwear. New CRM systems are able to support an integrated strategy of commercial interaction at every level of your company, and mobile devices exist to make the most sophisticated CRM systems easily applicable wherever you are.

With the right CRM system, the right mobile platform and the right attitude, you can: research each customer’s needs and behaviours; gain up-to-date information on the rapidly changing customer base; be fully primed with the right clinical information and tailored marketing messages; read and record key information without eyestrain or signal problems; and fit the technology to your individual needs and your company’s business goals. It’s up to you.

UK pharma companies are not doing enough to help medical sales professionals succeed in the modern environment, new qualitative research has shown.

The study, designed to understand the real world challenges of field-based executives, indicates that the working practices of UK pharma sales executives have changed dramatically in the past three years.

The combination of a maturing KAM model, the emergence of joint working and an increasing reliance on iPad technology, is driving a radical shift in the NHS/pharma relationship – and is forcing medical representatives to develop new skills to thrive in the new environment.

But many sales professionals claim that they have been given inadequate support to help them prosper in an evolving marketplace, and that some employers remain reliant upon traditional training methodologies to see them through, despite rhetoric to the contrary.

The findings are the result of the first phase of an ongoing research exercise by Pharmaceutical Field, and follow a series of one-to-one interviews and roundtable discussions with existing sales professionals in the first two months of 2012. “Early indications, from what will be a sustained research programme throughout 2012, are that, across the board, the role of the medical sales professional has evolved considerably,” says Chris Ross, Editor of Pharmaceutical Field. “In 2008, when we conducted a similar exercise, whilst the term Key Account Management was beginning to gain traction, the concept of joint working with the NHS barely merited a mention. But it would seem that both aspects are now playing a central role in the day-to-day work of the medical representative. The problem is, too many argue that the training they are given to manage relationships with their local health economies – and indeed the metrics upon which they are judged – mirrors that of the traditional drugs rep. And when it comes to joint working, the majority of respondents are describing confusion on both sides of the NHS/pharma equation. The industry clearly has work to do in this regard.”

The 2010 launch of the iPad, along with the subsequent introduction of similar mobile devices, has revolutionised customer communications for many industries – and it would appear that pharma is also beginning to enjoy the benefits of digital technologies, albeit slowly. It is estimated that around 25% of UK medical sales professionals are now using iPad or equivalent to detail their products to customers – and this is very much in line with Pf’s research. A fifth of those canvassed have been issued with mobile devices and are using them with customers. Feedback suggests that HCPs find multimedia presentations more engaging and memorable. One regional account manager, from a medium-sized UK pharma company, said: “Gaining time with customers remains one of our biggest challenges, and it’s not unusual to be given just a few minutes in a corridor or a hospital canteen. Making the most of that time is imperative. We’re finding that detailing our products via the iPad has a much greater impact than printed leave-pieces, and the customer experience is significantly improved.”

Despite this, representatives from some of the smaller pharmaceutical companies that have taken part in the study still appear to be using traditional detail aids – and believe that it will take some time before the use of tablet devices in the field reaches a critical mass.

The Pf study also indicated an increasing number of medical sales professionals are choosing to work on contract, rather than on headcount at mainstream pharmaceutical companies – with job security cited as one of the key factors.

Tracking and responding to NHS change in a highly competitive Olympic year will be a test of endurance for medical sales professionals. In a light-hearted article, David Round examines why winning a place amongst the medals will depend upon getting your preparation right.

It’s a well-worn cliché that a little knowledge is a dangerous thing. But as the UK pharmaceutical industry heads into an Olympic year when the pace of change amongst its NHS customer-base will undoubtedly increase, medical sales professionals will need to demonstrate more than a little knowledge to achieve a podium position for their products. The Health and Social Care Bill may still be some way from the finishing line, but as the health service continues its transition towards the seemingly inevitable, changes on the ground are already taking place. And the implications for pharma are huge. The industry cannot afford to sit and wait – it needs to act now to ensure its sales and marketing communications are reaching the right customers, with the right message at the right time. For pharmaceutical sales executives, it’s about developing more than knowledge: it’s a question of intelligence. And the answers may be right at their fingertips.

It has been widely documented that the NHS is working its way through a period of unprecedented change – both in its working practices and, of course, in its organisational structure. As a result, pharmaceutical companies – often criticised for being ‘data rich but information poor’ – will, more than ever before, need to maximise their data assets to deliver a more customer-centric approach to selling. And sales professionals will need to draw on all the information at their disposal to develop and deliver relevant and robust value propositions that satisfy customer need.

The noise-driven, share of voice model of pharmaceutical sales and marketing has become like Monty Python’s parrot: it has ceased to be. Today’s approach, which relies on a reduction in call volumes, is less linear, more selective and much more sophisticated. Key Account Management is leading the industry pack. But whilst the approach is, in theory, more measured, making it work requires quality customer data as a platform to identify ‘key accounts’ and, crucially, the ability to translate that data into meaningful market intelligence. Companies are becoming much smarter in segmenting their key customers – but faced with moving targets across a changing NHS, maintaining the accuracy, and in the process the efficiency, of the approach is not easy. It is, however, imperative.

The race to reform
The transition towards the new environment is already well under way. Last year in England 152 Primary Care Trusts (PCTs) were reorganised into 51 PCT Clusters of variable size, while the ten Strategic Health Authorities (SHAs) were restructured to form four large regional clusters. By April 2013, PCTs and SHAs will be extinct and Clinical Commissioning Groups (CCGs) and the National Commissioning Board will spearhead the commissioning of NHS services under a new-look structure. If you throw into the mix the onset of Clinical Senates, Health and Wellbeing Boards and new Commissioning Support units (which may well emerge as private organisations and therefore new customers), it is easy to see that an already complex customer matrix is set to become even more complicated. And that’s simply the start line.

Critics of the reforms claim that the situation on the ground is fast approaching chaos within the NHS, as the wider organisation struggles to implement changes even before the Health and Social Care Bill has achieved Royal Assent. But in the interim period while the health service readies itself for the inevitable, UK pharmaceutical companies cannot afford to let their sales and marketing operations become similarly chaotic. Tracking and more importantly responding to change throughout the transition period will be vital for medical sales professionals if they are to support their customers through the metamorphosis and, in the process, meet their own commercial objectives.

Access to quality data that can not only enable Account Managers to make the right targeting decisions, but can also help them engage in the most appropriate customer dialogue, will be critical to success. It is not simply a case of knowing who to target – understanding why and how they should be approached is equally important. It is this understanding that separates knowledge from intelligence. And separates winners from also-rans.

Keeping on track
Sales professionals not only need to identify their ‘key accounts’, they also need to understand the varied environments in which these individuals operate. What challenges do they face? What are their key priorities? Do they carry out more than one role – or sit on a variety of boards and committees in addition to their main job? If so, how does this impact their spheres of influence? How pivotal are they in driving service redesign, influencing formulary decisions, or facilitating joint working within their local organisation? Where do their roles and their needs overlap with your product or service?

This is standard market access. And it’s vital. Pharmaceutical sales professionals need to define how they engage with the NHS and why their customers should want to engage with them. They need to establish how they are going to deliver value and improve outcomes for the health service and its patients. And to achieve this, they must understand their local health economy, its priorities and objectives, and identify the key stakeholders whom they can help support to meet those needs. What is the structure of the local organisation? What is its indicative budget and its strategic plan? Who is responsible for commissioning in your disease area? What areas are emerging Commissioning Support Units going to be supporting commissioning in – and what are they not? As PCT clusters evolve and CCGs take shape, which customers are most relevant today, and how relevant will they be tomorrow or indeed in two years’ time? Only by tracking customers in real time as they make their transitional journey towards the new NHS can sales professionals be sure that their interactions are aligned with that change, and be prepared to respond accordingly when required.

Technology in a team sport
The Key Account Manager in the modern market must, therefore, have the mental preparation of an Olympic athlete – but work on the basis that the race is never won. The NHS is a dynamic marketplace where change is continual. The Key Account teams that are best able to track, capture and share intelligence will be best placed to emerge victorious. The role of the Key Account Manager is, after all, an individual pursuit in a team sport.

The tools to support ‘informed’ Account Management are already here. Customer Relationship Management (CRM) systems that help capture and share vital customer intelligence have been in common currency across the UK drug sector for many years. But never before has their value to the medical sales professional been so important. Industry surveys suggest that CRM usage amongst front-line sales professionals could still be improved – and this is essential. CRM systems are only as good as the data that is put into them. But when collected and shared properly, that data is there to help medical sales professionals. In a fast-evolving customer environment that will almost certainly intensify as the NHS continues its inexorable march towards a new structure, key account management can only be enhanced by the knowledge and intelligence a good CRM system can help deliver.

In fact, the sheer volume of likely NHS change in the next 12 months could provide a catalyst for 2012 to become the year when CRM finally comes of age. And those sales professionals who recognise its potential to significantly support customer interactions – and make for a more intelligent and appropriate engagement – will undoubtedly reap the rewards.

But the time to act is now. In an Olympic year, the fast track is the only option. After all, a little knowledge is a dangerous thing.

David Round is UK General Manager, Cegedim Relationship Management.

In the UK joint working is being encouraged to develop innovative services and propagate best practice. But in France, new legislation is placing significant barriers between pharma and its clients. Jérôme Guermonprez explains the implications for market access strategies in the country.

Across Europe pharmaceutical companies have been looking to underpin market access strategies with strong links to healthcare professionals. And while most pharmaceutical companies admit there are significant national differences that demand specific market access strategies, there has been a push, where possible, to leverage expertise, messaging and strategy to drive economies of scale.

Many organisations are now actively embarking upon innovative, cooperative working with regional decision-making bodies – such as the Clinical Commissioning Groups (CCG) in the UK; whilst doctors and pharmacists are increasingly involved in research projects, from clinical research to patient care, patient outcomes and procedures. Indeed, the UK’s amended Health and Social Care Bill strongly encourages pharmaceutical research, innovation and the use of scientific evidence in decision-making.

In France, the forthcoming radical overhaul of the drug regulatory system will significantly change relations between pharmaceutical companies, healthcare professionals, patient associations and physician associations. The “Reforme du Medicament” legislation aims to crack down on health practitioner conflicts of interest, restructure the country’s drug regulator and tighten the process for licensing drugs and for monitoring their effects once in use.

The proposed bill creates compliance requirements that far outstrip the UK anti-bribery laws and includes a number of significant changes which will directly affect the way pharmaceutical companies interact with opinion leaders across the French health service.

To minimise the risk of conflict of interest, the new legislation mirrors the US Sunshine Act by requiring pharmaceutical companies to disclose all financial relationships with healthcare professionals, patient associations and scientific experts.

With an emphasis on patient safety, the bill also requires far more detailed information and discussions about indications – from the provision of a helpline number on every drug packet to enable patients to report problems, to the creation of a government watch list of drugs under review.

It also demands pharmaceutical companies no longer undertake direct physician training but instead provide the funding for training to the government, which will then oversee independent training programmes.

 

Restricted access

Critically, from a market access perspective, the bill will prohibit individual medical representative visits to physicians within a hospital; visits must be collective to avoid any one-to-one relationships and ensure discussions are open and transparent.

The impact of this legislation – which is currently being discussed and should be passed by the French government by the end of 2011 – will be significant for pharmaceutical market access policies and demand companies gain new insight into key opinion leaders (KOL).

Under this new model, the industry will have to be incredibly careful about the type of relationships that are put in place with stakeholders; indeed, at least one pharmaceutical company has already announced it will no longer pay physicians directly in the future or invest directly in physician grants to avoid any regulatory compliance issues.

Furthermore, with many physicians likely to back away from any interaction with the pharmaceutical industry, at least in the short term, patient and physician associations will have a far greater role to play. Pharmaceutical companies will have to rapidly assess the way these associations and individual physicians respond to the new legislation and amend market access strategies accordingly.

 

Regional structure

This new challenge comes at a time when pharmaceutical companies are still adjusting to the major overhaul of the French healthcare system – which has seen the creation of 26 Regional Health Authorities (RHA).

While drug reimbursement is still set nationally as in the UK, since 2009, each region has found the responsibility to adapt national objectives to local or regional health and demographic problematic. Over the past year, each region has had to sign multiple year contracts between the  state and the region to deploy the health strategy.

As in the UK, over the past two years, pharmaceutical companies have realigned resources to create a regional approach based on a key account management (KAM) model. The regional structure has significantly broadened the number of stakeholders involved in decision-making, both financial and medical.

Furthermore, each RHA has a different demographic breakdown and health issues, creating very diverse goals for each region. This change has required a far greater insight into decision-makers and regional objectives; it has also demanded pharmaceutical companies use the KAM approach and strong CRM tools to drive synergies between teams at local, regional and national level.

Pharmaceutical companies in both France and the UK are now actively seeking in-depth insight into the KOLs within new regional structures. Information from the structure of the new organisations, including the multiple drug, technical and price commissions, to identifying specific members, roles and drivers is proving key to create the right regional messaging.

And with this regional, KAM-based model still in its infancy in France, pharmaceutical companies face a tough challenge to ensure the implications of the new medical reform legislation are incorporated.

Messaging, for example, must now be amended to include product safety, as well as quality and efficacy; while companies must ensure information is up to date to ensure changes in physician attitude to the pharmaceutical industry as a result of the new regulations are flagged to remove the chance of inappropriate or unwanted contact. CRM tools will also be essential to coordinate group visits to physicians to avoid any chance of the forbidden one-to-one interaction.

As in the US following the introduction of the Physician Payment Sunshine Act in 2009, pharmaceutical companies will also need help to meet their obligations to declare all activity with physicians.

 

What next?

It is tough to predict how the health service in France will respond to the new legislation over the next 12 months. For pharmaceutical companies there is no doubt that direct physician contact will decline and organisations will have to refocus efforts towards the increasingly influential patient associations and physician associations.

But for those organisations operating across Europe, the changes must demand very different approaches towards health service co-operation. As the UK market looks to drive service innovation and close ties with practitioners at every level, counterparts in France are being compelled to be transparent and improve patient safety. The concept of the global, or even pan–European, market access strategy looks ever less practical.

Jérôme Guermonprez is the Vice President and General Manager, France, Cegedim Relationship Management.