Despite huge investments into CRM systems some pharma companies still struggle to get all of their staff to embrace and fully interact with them. Pf’s Iain Bate explores why, and what the future holds for technology in the industry.

There’s no doubt that technological developments have changed the way we live and work from year to year – maybe even from month to month in the 21st Century. But has the world of healthcare been travelling in the slow lane of the intergalactic highway?

The potential that technology offers to pharma, and the general world of healthcare, is enormous. But is the pharmaceutical industry, and its staff in particular, using it to maximise the returns of billion-dollar investments?

It would seem that technology is the ‘buzz word’ on the lips of a few of healthcare’s major players at present. The DH recently invited people to nominate their favourite health-related mobile phone ‘app’ – be it for keeping fit, to locate a hospital or chemist, or helping to manage an illness. Creative minds were also asked to design their own health app with a panel of DH judges deciding on their favourite from the most popular entries.

Health Secretary Andrew Lansley says it’s the Government’s intention to give people better access to information using modern technology and the exercise is a “unique opportunity for the NHS and those who develop apps to not only showcase their work, but to bring to life new ideas and realise true innovation in healthcare”.

As part of the DH’s technology revolution, patients may also soon be offered online consultations with their GPs using programmes such as Skype. Clearly the Government is embracing the convenience technology offers to patients, but are other sectors in healthcare as interested? It would seem there is still some way to go.

 

In two minds

Pf ’s 2010/11 annual Company Perception, Motivation and Satisfaction Survey suggests that not all respondents are completely convinced by the power of technology in the workplace. Although the Survey – which relates to 2010 and the early part of this year – found that nearly 90% of respondents have access to a CRM system, only 43% find time to use it in the field and more than a fifth of people fail to accurately record post-call reports with important clients.

Questions have to be asked as to why, despite multimillion pound investment and training by pharma companies, there remains a percentage of staff that still ignore the power and potential of the technology at their finger tips.

Results from the Survey reveal there’s no difference in uptake by key account managers, primary and secondary care representatives, those in primary care roles only, firstline sales managers and secondline sales managers and the use of CRM technology between differing age groups – although surprisingly 10% of respondents in these positions with less than two years of experience said they did not have a CRM system, compared to just 5% more experienced colleagues.

The launch of the iPad in March 2010 promised to revolutionise the way sales representatives, and those in similar roles, use CRM systems in the field. However, nearly three-quarters (70%) of respondents from the Survey are still presently sent out with laptops containing their customer-relationship systems.

When quizzed on what they’d change about the hardware which houses their system, the majority of respondents said that their CRM was too awkward to carry, with poor running systems an issue and that batteries ran out too quickly. Apple claims its second-generation iPad now enjoys ten hours of use away from a plug socket in the field.

Yet the switch to the latest convenient tablet devices may not necessarily be about high levels of investment, it may be down to maximising value for money as Paul Shawah, Vice President, Multi Channel Strategy, Veeva Systems explains. “I would say the life cycle of devices within the industry is generally about three years, sometimes a little bit longer,” he said. “When a company invests in new technology they typically depreciate that over that period, so they don’t want to replace it in the field for that time to maximise their investment.

“However, with the introduction of game changing technology like the iPad, this has changed. We see a number of our pharmaceutical customers are justifying the business case to move to the iPad even before their tablets are fully depreciated. This speaks to the business benefit that pharma expects to achieve from the iPad and the related applications only available on that device.”

A convenient shield

Despite technology eliminating mundane process in the workplace and offering the potential to assist employees and improve their efficiency at work, it has historically been used as a shield to mask poor performance and abused as a means to waste company time – a recent online survey by AOL found that nearly half of Americans (44.7%) rank surfing the web as their primary activity during the two hours they ‘waste’ each day at work.

But it would seem that a high number of respondents do value the opportunities CRM offers. Almost two-thirds (64%) said they always enter correctly the amount of customer sales they make into their CRM. But 21% admitted they fail to always report face-to-face meetings with clients. More surprisingly, over a fifth of participants said they do not always record the number of products they had sold to clients.

The lack of honest accuracy is surprising considering the amount of time spent using CRM systems each day. A third said they spend between one and two hours a day on their system with a fifth spending three hours or more on their CRM. During their time using the management system, more than half (55%) said that call reporting was the most useful feature.

Although respondents were less impressed with the KAM abilities of their software with only 19% believing it to be the most useful facility. When questioned about what they would change given the chance, 45% said they wanted an improved database, over a quarter (28%) called for their system to be overall more useful, and 18% said they would prefer their CRM to be easier to use.

 

The next level

But what of the future of CRM systems? Will they be easier to use and have improved customer databases? David Round, General Manager, UK, Cegedim Relationship Management, says the regular interaction we now have with technology means we’ve all come to expect the latest developments.

“End users are significantly more ‘technology-savvy’ than their counterparts of even five years ago,” he explained. “If anything, the challenge for companies is to ensure that they provide their end users with the types of technology that they use as consumers. It’s also important to focus on the usability of your software to ensure maximum use. Technology companies – and pharma – must work together to develop a better understanding of the interaction, to ensure it meets users’ needs in the field.”

One main reason that users have become more ‘savvy’ is down to the use and interaction with social media. Whether at home or at work, websites such as Twitter, Facebook, LinkedIn and most recently Google+ have driven an increased use of various forms of technology – especially on devices such as smartphones or tablet devices which reps are calling for in the field.

Pharma companies, both in the US and UK, have flirted with the idea of fully embracing the power social media harnesses, but at present are restricted by the PMCPA’s Code of Practice and by the FDA – who has again delayed the publication of its guidance.

The FDA says it is “difficult to provide a timeframe... due to the extensive work and review process, or ‘Good Guidance Practices’, which ensures that FDA’s stakeholders are provided well vetted guidances articulating FDA’s current thinking on a topic”.

Although the FDA may be unsure on how to direct healthcare companies, David Round believes the introduction, both professionally and personally, of social media has had an impact on staff and their expectations.

“For the modern professional person, much of their everyday life is conducted online – for example on shopping, utilities, insurance or booking a holiday – and many users then want the same level of capability from the tools they use in their job,” he added.

Dan Goldsmith, General Manager, Veeva Europe, agrees there has been a significant shift in the way we operate and interact due to our experiences online through tagged posts or hash-tagged searches. But although the 800 million users on Facebook – more than half which ‘log-on’ every day – and 175 million people on Twitter have no problem saying hello to friends, pharma finds it more difficult reaching out to people.

“Social media create a new avenue for healthcare dialogue and will only continue to pervade our lives,” said Dan. “Consequently, I believe that pharma faces two challenges. The first is to decide how to participate in the online dialogue with stakeholders and then to create those interactions through the channels we’re all familiar with, such as Facebook and Twitter.

“The second is to figure out how to leverage the model of social dialogue internally to support stronger collaboration and more focused communication among employees. Already, we see some companies taking advantage of the latest social business tools to connect employees with one another and to access and share information in real time.”

Clearly CRM solution providers understand the potential modern technology and social media platforms offer to companies. Whether pharma and its workforce get fully up to speed on the intergalactic highway sooner or later remains to be seen.

Sometimes, reporting on the UK pharmaceutical industry feels a bit like Bill Murray’s Groundhog Day. In the late 1990s, when I edited my first title for UK pharma, all the talk was of the move from GP Fundholding and the imminent introduction of Primary Care Groups.

By 2000, New Labour’s NHS Plan promised a revolution in healthcare built around delivering improvements in ‘partnership, performance, patient care and prevention’. The politicians were about to ‘modernise the health service’.

Fast forward almost 12 years and we’re still being read the same script; new politicians, the same old lines. Four Ps – partnership, prevention, productivity and patient care – continue to dominate airtime, only this time, of course, it will be different.

Different? Some hope. This is Groundhog Day. So how is the UK pharmaceutical industry responding to change? Its customer-base, meticulously redrawn through 10 years of implementing the NHS plan, is yet again being reshaped. PCTs are on the way out. CCGs and Clinical Senates are on the way in. Keeping track of decision-makers and influencers is critical. Getting in front of them in the right volume, at the right time and with the right message is life and death.

The industry is currently pinning its hopes on Key Account Management (KAM), supported by a Customer Relationship Management (CRM) philosophy that promises to enable the field force to have a more detailed understanding of individual customer needs across a diverse and complex landscape.

The tools to support the CRM approach are impressive, established and evolving in time with the modern technological advancement. They also provide huge value to medical sales professionals, and the ability to enhance customer interactions.

But, as ever, this is Groundhog Day. Twelve months ago, Pf’s annual survey into field force attitudes revealed an apathy amongst some sales professionals towards the use of CRM. A year later and it appears that, despite its many advantages, the value message for CRM is still not being heard by all of those who can undoubtedly benefit from it.

This year, 90% of Pf’s survey respondents have access to a CRM system – but only 43% of these find time to use it in the field, and more than a fifth admit that they fail to record post-call reports accurately.

In a fast-moving, dynamic marketplace, generating, sharing and maximising real customer insight is one of the best ways for sales professionals to achieve competitive advantage. CRM tools provide the perfect mechanism for this. Only the foolish would pass up the opportunity.

I feel like I am repeating myself. But then again, this is healthcare Groundhog Day. Next month: more NHS reform.

Chris Ross
Editor

Sanofi Pasteur has signed a research and development agreement with the University of California, San Diego, for its experimental acne vaccine and treatment.

The R&D pact includes a two-year collaboration with Chun-Ming Huang and team at UC San Diego School of Medicine.

The team’s immunological approach to acne prevention and treatment targets the neutralisation of Propionibacterium inflammation.

Elias Zerhouni, President of Global Research and Development at Sanofi, said that the vaccine and treatment could address an unmet medical need.

“This investigational vaccine and treatment may lead to a better solution for the many who suffer from this skin disease,” said Mr Zerhouni.

According to the vaccine division of Sanofi, the annual market for acne therapeutics is in excess of $3 billion.

Pfizer is to invest $200 million at its Grange Castle biotechnology manufacturing site in Clondalkin, County Dublin.

The new investment will see Pfizer introduce two new processing suites to expand its current production and product testing capabilities.

Frank D’Amelio, Chief Financial Officer, Pfizer, says “Ireland is a prime location for this major investment” after a “long history in pharmaceutical excellence”.

The biotechnology manufacturing facility is already one of the largest in the world and produces two of Pfizer’s main products, Prevnar and Enbrel.

More than 1,100 staff are currently employed at the site. Irish Prime Minister Enda Kenny says that the new investment highlights “the tremendous contribution to Ireland’s life sciences industry since it (Pfizer) first established here in 1969 and this investment is a further demonstration of the company’s continuous commitment”.

In total, Pfizer has 4,300 staff employed across the country in eight separate locations in Cork, Dublin, Kildare and Limerick. Its latest investment means the company’s outlay now exceeds $7 billion in the country.

Sanofi Pasteur is donating a vaccine strain used for polio eradication to the World Health Organization (WHO) to produce oral polio vaccines (OPV).

The vaccines division of Sanofi is providing the original viral seed which is used to produce large volumes of OPV against the type 3 virus.

Olivier Charmeil, President and CEO of Sanofi Pasteur, says the donation is a “logical next step” in the division’s “unconditional support to OPV producers”.

Since its inception in 1988 by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF, the Global Polio Eradication Initiative reduced the number of polio cases across the globe by 99%.

Sanofi Pasteur has supported the Initiative for the last three decades and recently responded to a request from UNICEF by committing to provide 400 million doses of OPV for use in developing countries. The donation saw the amount of doses provided by Sanofi Pasteur exceed five billion doses of OPV to UNICEF.

“Sanofi Pasteur is a leading contributor to the fight against polio and committed supporter of the Global Polio Eradication Initiative," added Sanofi Pasteur’s President.

WHO will now be in full control of the storage of the vaccine strain and its distribution to vaccine producers across the globe.

Boehringer Ingelheim and Eli Lilly have launched Trajenta (linagliptin), a single dose, once-daily tablet for adults with type II diabetes mellitus (T2DM) in the UK.

Trajenta has been shown to deliver significant HbA1c reductions compared to placebo and was generally well tolerated in clinical trials involving more than 4,000 patients.

Professor Anthony Barnett, Consultant Physician and Emeritus Professor of Medicine, Heart of England NHS Foundation Trust and University of Birmingham, says its release is “an important advance in the management” of diabetes.

The drug is licensed for adults with T2MD as a monotherapy in patients inadequately controlled by diet and exercise alone, and for whom metformin is inappropriate due to intolerance, or contraindicated due to renal impairment.

It is also licensed in combination with metformin when diet and exercise plus metformin alone do not provide adequate glycaemic control; and in combination with a sulphonylurea and metformin when diet and exercise plus dual therapy with these medicinal products do not provide adequate glycaemic control.

In clinical trials, a mean HbA1c reduction from baseline of 0.7% was sustained over 102 weeks as add on to metformin and a sulphonylurea in patients using Trajenta.

Around a third of people with diabetes are affected by chronic kidney disease. The convenient tablet is the only dipeptidyl peptidase-4 (DDP-4) inhibitor which is primarily excreted via the bile, and the first in this class licensed for use in T2DM, irrespective of degree of renal impairment.

“Linagliptin offers the benefits of the DPP-4 inhibitor class with good tolerability, weight neutrality and low risk of hypoglycaemia and the additional advantage of health professionals being able to prescribe without dose adjustment irrespective of the patient's renal function,” added Professor Anthony Barnett. “Renal impairment is common in people with type 2 diabetes so this latter point is extremely important.”

A convenient oral treatment patients can take at home to prevent venous thromboembolic events (VTE) following elective total hip or knee replacement surgery is now available in the UK.

Eliquis (apixaban) has been launched through a collaboration between Bristol-Myers Squibb and Pfizer and could help prevent up to 25,000 deaths each year resulting from blood clots.

Dr Ander Cohen, Honorary Consultant Vascular Physician at King's College Hospital, London, says the treatment “represents a new option” for surgeons in the UK.

VTE can lead to two serious conditions: deep vein thrombosis and pulmonary embolism which can lead to death if not treated.

The license of Eliquis is based on the ADVANCE-2 and ADVANCE-3 clinical trials in patients who underwent elective total hip or knee replacements. More than 8,000 patients were assessed during the trials which assessed the efficacy in preventing blood clots and death, and bleeding risk of Eliquis when compared to enoxaparin.

“Clinical data showed that apixaban was more effective than the anticoagulant enoxaparin and importantly, it also showed no increase in bleeding rates compared to enoxaparin,” said Dr Cohen.

Dr Rick Lones, UK Executive Medical Director, BMS, said the two companies “hope to reduce the burden of blood clots” in patients undergoing major surgery after the drug’s release in the UK.

The NHS Alliance and the National Association of Primary Care (NAPC) have joined forces to create an independent body representing Clinical Commissioning Groups (CCGs).

The coalition will be the collective voice for practising clinicians, CCGs and their leaders to ensure that commissioning bodies are fully involved with the new NHS.

Dr Johnny Marshall, Chairman of NAPC, said: “We are seeing many obstacles, from all quarters of the NHS and elsewhere, being placed to deter and restrain the successful engagement and operation of CCGs.”

Dr Michael Dixon, Chairman of the NHS Alliance, commented: “We will listen to and represent CCGs’ views and concerns without compromise, wherever and whenever necessary. We will be a united voice that will serve to balance the top heavy approach often seen in the NHS.

“As the two organisations that have wholeheartedly championed clinical commissioning over the last two decades, we have a long history of commitment and dedication to the clinical commissioning cause.”

The coalition has agreed a number of shared principles. They include:

• NHS commissioning should be a public function exercised by statutory bodies in the public sector alone. NHS commissioners should be free to choose the support they need from whatever source they feel to be appropriate.
• The NHS should be based on an approach that maximises local responsibility and ownership through local determination rather than central direction, meaning that the NHS Commissioning Board should only take responsibility for things that must be done at national level.
• CCG Boards should have GPs as majority members with a strong primary care focus.  Boards will need to ensure the appropriate involvement of other clinicians and managers and have strong representation from local communities and independent directors.
• NHS provision should be appropriately distributed across the public, third and independent sectors according to the public interest. Those providing NHS services should clearly subscribe to NHS values of openness, transparency and accountability and behave in a manner consistent with those values.
• The NHS should develop integrated care, centred on the needs of the patient rather than the providing organisations, supported by appropriate payment systems.

The coalition has also established a number of priorities it sees as essential. They include:

• To lobby the Government to review the role of the NHS Commissioning Board to ensure that it is set up as an organisation that enables rather than controls CCGs’ work.
• CCGs’ self-determination – Clinical Senates, Clinical Networks, and Local Health and Wellbeing Boards should help not hinder CCGs, who must have the final decision with their patients. 
• Work with the Government to ensure that aspiring CCGs receive the funds intended to support their development.
• Oppose suggestions that CCGs should be constrained in their choice of commissioning support.
• Monitor and CQC to demonstrate that they are acting in the public interest. The coalition will seek to ensure that CCGs have the means of challenging their decisions.
• Transparency - the coalition believes that the payment of any quality premium to reward CCGs which commission effectively should be transparent, represent good value for money and be in the public interest. 

Both forces will contribute to and have ownership of the new initiative, whilst acting as individual identities regarding other functions.

Dr Johnny Marshall added: “Our respective organisations bring their particular strengths to the table to enable us to be bigger than the sum of our parts.

“The strength of our two organisations working in partnership on the same agenda should reassure Clinical Commissioning Groups of our commitment to their cause and that of their patients.

“We will strive to ensure that CCGs are not overburdened with NHS bureaucracy and red tape and are set free to deliver innovative and population focused services.”

A steering group is advancing the coalition's collaborative work.

Merck has secured the worldwide exclusive rights to PI-2301, an experimental drug for multiple sclerosis (MS).

The acquisition from Peptimmune Inc covers the development and commercialisation rights for the product which has just completed Phase 1b clinical trials.

Susan Herbert, Head of Global Portfolio Development at the Merck Serono division says the drug “could play a valuable role in the treatment of this debilitating disease”.

The second-generation peptide copolymer is believed to enhance the regulatory response of the immune system. Merck will now investigate the application of the product in autoimmune diseases as it progresses to Phase II clinical trials.

“Over the years we have continuously worked on developing innovative treatment options that meet the individual needs of people living with multiple sclerosis,” said Susan Herbert.

Alkermes (ALKS) has marked its first day of operations at its new Dublin HQ with a long term multi-million dollar manufacturing contract with one of the world’s top pharma companies.

The pharma company’s finished product will be manufactured at Alkermes new Athlone facility in Ireland in a deal which could be worth up to $20m by 2016.

Richard Pops, CEO of Alkermes, said the company was “excited to have our operations based in Ireland, which we view as a gateway to the European Union and global pharmaceutical market”.

The company employs more than 450 staff based in Ireland and more than 1,200 worldwide.

The plant in Athlone is one of three facilities owned by Alkermes where the company manufactures proprietary, partnered and contract-based drug products.