Everyone in pharma is talking about key account management – but what does being a KAM mean for the sales executive?

What is key account management all about? Perhaps an anecdote will help...

A travelling salesman was on the road and stopped in a small Somerset town. There appeared to be no hotel and the local pub had no rooms available. So he drove out to the nearest farm and knocked on the door. An ageing man answered. The rep explained his problem and asked if the farmer had any rooms available. “Sure,” the old man said. “My 19-year-old daughter normally lives here but she’s away at college, so her room’s free.” The rep nodded and turned back to his car. “Hang on,” the farmer said. “I said there’s a free room.” “I’m sorry,” said the rep, “I’m in the wrong joke.”

The point is that a traditional sales rep has a well-defined script, a known role, within which certain messages and behaviours are taken for granted. The rep just has to make contact and deliver the message. That’s why he or she is the butt of so many jokes. It’s also why the traditional sales role is disappearing from our information-charged world of informed customers and organisations that make decisions on a committee basis.

Read the joke again and think of it as a metaphor for a modern business relationship.  The farmer’s spare room stands for the technological and human resources the customer can draw on. The farmer’s daughter being in college stands for the customer’s new education and range of business contacts.

To employ a technical metaphor, if the traditional sales executive is a plug looking for a socket, the key account manager is a USB flash drive from which a wealth of complex information can be downloaded. The KAM is not only addressing a plurality of customers but representing a plurality of company perspectives: sales, marketing, research, finance and management.

You’ve heard of cloud computing. Key account management is cloud selling – a way of bringing together the best elements of your company’s business strategy with the key aspects of the customer organisation’s business strategy. That classic business cliché, my people will talk to your people, is at the heart of KAM.

Meeting the family
Key account management assumes that the individual customer belongs to a complex buying environment – he/she is influenced by a range of people and uses a range of information resources. The appropriateness of this model to the NHS is obvious – and while the current NHS reforms affect the structure and workings of key healthcare accounts, they certainly do not dilute the need for such accounts. The KAM has to work with the purchasing system by identifying, and building relationships with, its most sensitive points of contact.

Identifying the decision making units within the customer organisation and working strategically to maximise your company’s impact on them is half of the battle. The other half is directly or indirectly bringing the key elements of your own company into contact with the customer organisation. This is where new technology comes into its own: nothing will make connections better than well-presented information that conveys the richness and immediacy of your business case. Tablet computers and smartphones also make the co-ordination of KAM within your own company swifter and easier.

As many pharma companies have found out, simply creating a KAM role in your sales team and expecting that to make all the difference is foolish. KAM is a function of the whole company – which seeks to meet the needs of patients via the health systems that provide treatment. The product reaches the patient via a treatment pathway that the health system develops according to its clinical and financial priorities. That pathway and the reasons for it are what the company needs to understand and change.

Looking after people
Pf spoke with Paul Curbbun, National Key Account Manager at Rosemont Pharmaceuticals. Before taking on his current role, Paul was National Hospital Manager for the same company. Before that, he was working in FMCG and other sales sectors – where KAM has been prevalent for two decades. So Paul is the KAM who came in from the cold.

On how his working life has changed, Paul says: “My life hasn’t got any easier or any harder. The only thing I’ve cut down slightly is the mileage. I’m at home more than before because I tend to use home as my office. For instance, this morning I’m spending two or three hours at home preparing before going out. There’s a lot more reports to put together as well as analysis of sales.”

On the changes in his customer base, he observes: “As NHM, I was seeing everybody – pharmacists, nurses, doctors, therapists. That’s all gone now, and what I’m seeing is mainly the buyers from the key groups, from specific retail groups to wholesalers. A lot of what I’m doing is building up business partners.”

What KAM is all about, he argues, is looking after customers: “Nothing feels better than when you’ve asked for something and you get that something. It’s about not letting people down. It’s truly looking at their business and your business and linking the two together for the benefit of both.”

That contrasts with the traditional pharmaceutical sales role of hammering the product and the marketing message. The key account manager needs to identify opportunities and develop solutions, using the company’s product portfolio to optimal effect. “Whatever the account needs – it’s that simple.”

Don’t be a stranger
Rosemont Pharmaceuticals specialises in oral liquid medicines for people who have difficulty with tablets. Their products include a formulation of the diabetes drug metformin. With a clear USP and well-defined patient population, surely this is a case for traditional product-based selling? By no means, says Paul: “It’s critical that when a patient needs an alternative, a patient gets an alternative. So from a key account point of view, you can make sure our products are where they need to be, so that patients get the right medicine and, most importantly, there is continuity of supply.”

For the sales professional, Paul states, the difference between KAM and their previous approach depends on how well they did the latter. “If you’re making calls for the sake of it, just to tick a box, obviously that’s a long way off – but if you’re going into an account with complete business focus, asking what it needs, closing the loop whenever an opportunity arises, you’re well on the way to a KAM role.” Sales professionals who analyse their sales and construct a business-focused customer database are also showing KAM awareness.

For the sales manager, the key to effective KAM is empowering the sales team to manage and take ownership of their accounts while guiding them to optimise their work as a team. KAM is not a solo activity. Paul remarks with some bafflement: “Something I could never get my head around was the fact that you often had four or five people selling the same drug over the same area. If you were devising a business model tomorrow, that would certainly not be it.”

In fact, KAM is so integral to modern business that it’s worth asking why the pharmaceutical industry avoided it for so long. The answer lies in its assumption of a difference in professionalism and consciousness between seller and buyer. For decades, pharma regarded its customers as business-naive people fixated on the patient relationship. Hence the adoption of ‘persuasion’ techniques such as NLP.

Times have changed, and bad business habits now carry too high a price. As the NHS – with its emphasis on cost-effectiveness and generic prescribing – becomes more like a business, and the industry – with its emphasis on patient-centred medicine and disease area knowledge – becomes more like a doctor, a shift from sales transactions to commercial relationships is essential for both. KAM is pharma’s only way in from the cold.

With jobs at a premium and the cost of living continuing to rise, job security has suddenly become a main priority for employees.

The global recession has affected each and every one of us in one way or another. Sweeping job losses throughout the medical sales sector – and in the pharmaceutical industry in particular – have seen even the most experienced personnel joining the queue at the job centre. For those lucky enough to have avoided the dreaded axe, it seems to have made us appreciate our job a whole lot more.

Last year was somewhat of a breakthrough year for as far as job security is concerned. Results from last year’s Pf Company Perception, Motivation and Satisfaction Survey highlighted how job security had gone from a passing thought to one of the main motivating factors for respondents. Ranked behind salary, relationship with manager and work-life balance in the 2009 survey, job security was suddenly thrust into the top-two motivating factors last year.

It has maintained its position this year behind salary as the second highest motivating factor after pharmaceutical companies continue to introduce ‘efficiency’ plans in an attempt to sustain profits and counter bleak pipelines. During an uncertain last twelve months it would seem that satisfaction levels in job security have also improved. Job security moved from 14th position last year to 11th in the latest set of results. Are companies doing more to reassure staff their jobs are safe, or are employees learning to live with the fact that their week at work may be their last?

Moving on
Attitudes towards job security have also affected respondents’ outlook on where they’d like to be within 12 months’ time – see Figure 1. In last year’s survey, 15% of respondents indicated they were searching for a move away from their current employers with 56% content to stay where they were. However, this year’s results show a slight increase in those figures with 13% of people within the medical sales sector looking for a new job and 59% happy where they are. 

Its men that indicated a stronger desire to change companies with 17% wishing to move organisations and a further 24% saying it was a possibility. However, female respondents were less sure about joining a new organisation with only a tenth wishing to move away from their current employers.

The importance now placed upon job security may also arise from the fact that employees are still very mindful of a turbulent few years – despite a glimpse of light at the end of a very, very dark tunnel. Dr John Philpott, Chief Economic Adviser at the Chartered Institute of Personnel and Development (CIPD) recently told a panel of directors from Yorkshire that modest economic growth in the UK would see unemployment levels stabilise this year. He also discussed the potential of a stronger recovery resulting in a sudden, sharp fall in unemployment levels and employers again going on the hunt for talented staff to meet increasing demand.

Job security works both ways. It shouldn’t be something that only staff on the ground worry about. Stability and medium to long-term assurance ensures employees are engaged and motivated enough to be committed to company goals and objectives.

Although job security may be a state of mind, there are ways of improving one’s mindset. If a company can ensure or encourage career development and progression, an employee will feel a greater sense of loyalty and commitment. With this in place a sense of dedication allows employees to focus on their individual skills and capabilities and become a consistent performer. In turn, an employer gets a happy and productive employee in the work place.

Trust levels
However, it’s not always that easy it? Memories of colleagues and friends being made redundant can last for a very long time. Geoffrey James, argues on the website inc.com, that job security is defined by who you are, what you do and who you trust. If you’re an individual who is happy going along with your job, undertaking everyday tasks and playing second-fiddle to other staff then you’re more than likely to receive your marching orders, James says. Individuals should strive to stand out from colleagues and be different to the majority of the workforce. “If you really want job security, there must be something about you that’s different, that makes you more relevant than anybody else who does what you do. More importantly, other people must perceive that difference and see it as valuable,” he says.

Then, of course, there’s the trust issue. Do you think you can rely on your boss not to put a red cross next to your name if there are further redundancies? James – who pens one of the world’s most-visited sales-oriented blogs – suggests a novel approach to assessing trust whilst at work or in the field. People that you speak with on a daily basis – be they family, friends, colleagues or business associates – should be placed into three categories: those who trust you completely, those who moderately trust you, and those who vaguely trust you. When these have been grouped together, remove the people in the final two categories – these are the people unlikely to return sales calls, James adds – and then calculate the number of people who you believe completely trust you. If, he says, you have more than 20 people on that list, then you have a greater sense of job security. If you haven’t, it might be time to start building some bridges.

So there you have it. Job security ultimately comes down to who you can trust and who trusts you. Can you hold on to trusted colleagues at work whilst the UK tries to climb out of a double-dip recession. Or, are the people who you believe you rely on merely providing a crocodile smile during work hours? It’s probably wise to start drawing up that list...

Stephen Whitehead outlines the ABPI’s latest initiatives to facilitate collaboration – and how sales professionals have a key part to play .

This year the ABPI is launching a Regional Partnership team to help the industry establish and develop sustainable relationships with the NHS at a regional level. The team, deploying experienced industry professionals in each of the four regional SHA clusters, aims to promote and facilitate collaborative working as a means to improve patient outcomes. Its key objectives are to identify and remove existing barriers to accessing innovative medicines, to help develop regional partnership projects and to share best practice across the country. The initiative reflects the growing recognition that improving patient health in a constrained financial environment will be best achieved by adopting a more collaborative approach. And there is an increasing consensus across both parties that, after years of developing adversarial relationships, the direction of travel towards NHS/industry partnerships is the right one for patient care.

But progress is an incremental process. The perceived cultural barriers that have historically plagued the relationship and impacted access will not be overcome overnight. “Trust and reputation has widely been acknowledged as an issue for industry – but it’s getting better,” says Stephen Whitehead, CEO at the ABPI. “In fact, it has dramatically improved. You can 12 see that from the Innovation, Health & Wealth (IHW) review: the NHS really wants to partner with pharma. In turn, as an industry we know that we are operating within restricted NHS budgets, and that we need to make it clear that we are not always there to sell something. Joint working is not about developing something that can help companies achieve a sales target on a quarterly basis, it’s about establishing a new way of working that will redefine the relationship between us and the customer. That will take time.”

In an evolutionary process, the ABPI appears determined to take the lead – to trail-blaze the concept of partnership working from a top-line strategic position and help ease the concerns of more anxious NHS customers. “The driving platform for joint working from the side of the industry should be the ABPI,” says Stephen. “We established the joint working protocol with the DH, and have developed the code of practice and regulatory infrastructure to enable it to happen. We’ve therefore created the headroom to allow partnerships to be established. Most parts of the NHS have understood and grasped this. It’s now up to us to lead, and for companies to take the opportunities within that.”

IMPROVING ACCESS

With access to NHS customers a perennial problem for UK pharma, the battle to develop the joint working agenda is a challenging one for individual companies. Medical sales professionals are tasked with advancing discussions, but attempts are often stymied due to diminishing levels of customer access. The ABPI believes its NHS Partnerships initiative will play a major part in raising awareness of partnership working, and overcoming access issues on an industry-wide basis. “NHS Partnerships will help industry
engage with key NHS stakeholders in England and ensure partnership conversations happen at a regional level. It’s not about individual products – we will not be talking about those – but we will be a facilitator of dialogue around joint working, aligned with the partnership principles set out by David Nicholson. We will be looking closely at the national issues on uptake and access, and any policy that emerges around that – and reinforcing it locally. Critically, NHS Partnerships isn’t the creation of ‘talking shops’, it’s about being able to facilitate on the key issues – which are fundamentally about access and uptake of innovation.”

NHS Partnerships has already been welcomed by the Department of Health, whose Director of Innovation & Service Improvement, Miles Ayling, said: “The ABPI partnership team will help build stronger links between industry and the NHS, as described in IHW. Beyond medicines, we are also looking at how all concerned can share skills, expertise and knowledge to improve the health of UK patients and help transform lives.”

REPUTATION

The long-standing issue of industry mistrust does, at long last, seem to be fading within the NHS. This was reflected in the ABPI’s seat at the top table of discussions around IHW last year, and has been reinforced by Stephen Whitehead’s involvement on the IHW Implementation Board. In addition to the partnerships initiative, the ABPI (along with ABHI) has also established a series of pilot projects with the NHS Confederation to look at how joint working can make a difference in selected disease areas. Pilots are already underway in mental health, circulatory diseases, diabetes and long-term conditions. “This is about providing examples of best practice within the NHS so customers can understand what we mean and establish that there is nothing for them to be worried about,” says Stephen.

“We have a strong status, but we’ve not yet fully utilised it in the context of joint working capability. That’s what these initiatives have been set up to do. This is a whole new world and a very exciting one – ten years ago we could never have had these relationships. But now that we are here, we need to approach customers gently and appropriately, and work with the NHS collaboratively and co-operatively to ensure that we dispel any of those old misunderstandings.”

And so, in the new environment, what role will sales professionals and Key Account Management play in NHS engagement? “The role of sales is evolving quite rapidly,” says Stephen. “Sales engagement is increasingly about liaison, as well as detailing around a product. It’s about facilitating collaborative working – and the salesforce has a key role to play in this.”

Selling medicines in today’s marketplace should be built on partnership principles. ABPI CEO Stephen Whitehead talks exclusively to Pharmaceutical Field about the importance of NHS/industry partnerships.

Back in 2009, Chris Brinsmead – then President of the ABPI – told Pharmaceutical Field that the future role of the pharma field force would be to facilitate partnerships between the NHS and industry. Three years later and the partnership agenda is slowly inching forward. Progress has been made, but adoption of a more collaborative approach across the country has been variable. As ever, there are early adopters, and those that wait. Last month, Pf led with an ABPI announcement that predicted the NHS and industry would ‘become partners within 3-5 years’. Why not now, came the familiar cry? Why not, indeed. The ABPI seems determined to address this.

This month, Pf spoke exclusively to Stephen Whitehead as he approached the first anniversary of his tenure as CEO at the ABPI. It is clear that, in challenging times for the UK industry as it battles to ensure that patients gain access to life-changing medical innovations, partnership sits at the heart of the ABPI agenda.

“There is a currently a big commitment to move the joint working agenda forward,” says Stephen. “Strategically, over the past 15 years there has been the emergence of many different influences on prescribing – NICE, local commissioning and local formularies are obvious examples. The industry now has to work with a wide variety of stakeholders to demonstrate the value of its medicines. And traditional sales representatives have to work with many different and more complex audiences than they used to when they were purely detailing. Increasingly, I think joint working is the vehicle best suited to satisfy these varying demands.”

Innovation Health and Wealth
The environment for a more collaborative approach is certainly improving. The Innovation Health and Wealth review last December reiterated the need for greater partnership working to help accelerate the adoption and diffusion of innovation in the UK. Crucially, it said that the NHS needed to be ‘open for business’ on partnership. As such, advocates from both parties are working hard to raise the profile (and the benefits) of the approach. But resistance and misunderstandings around joint working remain.

“One of the problems is that there are variable definitions and understandings of what joint working is,” says Stephen. “In simple terms, joint working is a partnership approach focused on solving a patient-driven issue. The industry has disease expertise, it knows how to manage conditions and has developed medicines in those areas. Joint working is about bringing that expertise together with the providers and focusing on patient outcomes. And often we can find cost savings in delivering those outcomes as well.”

Importantly, says Stephen, joint working is not sponsorship. “This is not about industry paying for something. Historically we have funded a lot of things and sometimes there is a real benefit to us bringing money to the table. But this is about changing that perception. Partnership is where two parties, with different strengths and weaknesses, come together to focus on a shared goal. In this case, that has to be patient care.

“The fundamental issue is about recognising the value of innovation and its implications for a pathway of care. By working together to find out how these medicines can be used appropriately, we can save money in the system, we can prevent unnecessary and costly hospitalisation and we can improve patient care.”

Medicines in the middle
In recent years, discussion has focused on whether UK pharma companies should reconsider their product-centric approach to customer engagement, and concentrate instead on developing services with the NHS. The caveat being that a specific medicine would form the core part of any service. But joint working is not an exact science. There is no one-size-fits-all solution – it’s simply about working together to establish the most appropriate approach in a given disease area. “It’s about products and services,” says Stephen. “Some of our members do offer services. But the way I look at joint working is that there is always a medicine in the middle of it – because that’s what we discover, develop and sell. In today’s environment, the only way that the value of that medicine can be truly realised is through joint working that reengineers the pathway of care.”

At present, most joint working initiatives are being built around new innovations – and are being used to redesign services and improve the care pathway. A good example of this is in the field of anticoagulants, where a number of new brands are coming to market. “The new class of drugs have gone through NICE have been recommended and should therefore be utilised,” says Stephen. “Old warfarin clinics should now be closing as patients move onto the new drugs. But to achieve that, and to free up the funds to be able to use the new innovations, we need to take other measures. And you can only do that, in my view, through joint working.

“It is my passionate belief that in most cases, innovative medicines will save money in the system – in the short, medium and long term. We simply need to work together to deliver it.”

Implications for pharma sales
The implications for pharmaceutical sales professionals are significant. While joint working is not always appropriate – aspects such as disease area or where a particular product is along its lifecycle are key factors in whether the approach is applicable – adopting a partnership approach most certainly is. “Joint working is a natural evolution of partnership principles,” says Stephen. “Industry engagement has changed from being a simple seller/buyer transaction, into seeking to work in partnership with customers to ensure the NHS properly maximises the value of medicines. The UK has a low price and a slow uptake of medicine – and as a consequence, the UK system is not as efficient as it could be. It would be more efficient if it adopted innovation more quickly. And if it did, we would certainly have better patient outcomes.

“Joint working is best used when you want to coax the system into innovation. It is not always the most appropriate approach. But whatever you have in your medicine chest, partnership is always applicable. In today’s marketplace, how you approach selling that medicine should always be built upon partnership principles.”

A local information strategy is key to successful account management. The data is out there. Rhiannon Thomason explains how turning information into insight is all about context.

Despite reforms that appear to encourage decision-making and accountability at a local level, the UK health service remains a national one. The Health & Social Care Act actually strengthens the centralised power-base and, via the NHS Commissioning Board, issues a series of top-down directives that will cascade to a local level for implementation. Rumours of the death of the ‘N’ in our NHS are grossly exaggerated. But for Key Account Managers across the UK pharma industry, what happens at a local level is perhaps the prime focus. There is much talk of the need for ‘local health intelligence’. It is indeed a vital commodity. But it is important to draw the distinction between information and insight. The former is readily available. The latter is hard won and impossible to achieve in isolation. In the battle for local health intelligence, context is King.

The NHS is awash with data. Nowadays there is much more information available and the health service itself is increasingly placing useful data into the public domain. Examples such as QOF data, Joint Strategic Needs Assessments, HES (Hospital Episode Statistics) data, the Atlas of Variation and Public Health observatories provide a rich seam of information from which sales and marketing professionals can develop appropriate local messages. They combine to form a complex matrix of information. The challenge for KAMs is interpreting it and understanding what it means in their disease area and in their locality. There is variation right across the system.

In primary care, QOF data has become increasingly important. NHS customers are being tasked to reduce unnecessary hospital admissions, and the financial incentives from a local practice perspective are significant. But as the transition towards Clinical Commissioning Groups continues, practices know that they cannot work in isolation and that they must prove to the wider organisation that they are achieving their targets.

For the industry, QOF indicators have become a catalyst for improved customer engagement. Proactive sales professionals are no longer targeting GPs with messages based only on the clinical benefits of their products. They are instead identifying key local decision-makers and attempting to demonstrate how their product can impact a service, reduce hospital admissions, save a locality money and improve patient care.

Clearly, QOF data has become a strong lever for account managers to understand how their product can help customers meet their targets. In isolation however, the data can only take you so far.

When used in combination with other available information, a much more powerful package of metrics can emerge.

Sales professionals need to build the bigger picture of what is going on at a local level, to understand how their products can make a difference. This depends upon drawing together all the various strands of information, and developing value propositions based on the local context as a whole.

• How is each local health economy constructed? Which organizations are operating within each locality? What are the roles/responsibilities of each and how do they engage with one another? Who are the key stakeholders?
• What is the community profile? How many patients are there? What are the deprivation and ethnicity breakdowns?
• What is the patient pathway? What services are provided, by whom and how are patients managed?
• What is the cost of hospital activity? How much does each group of patients cost each locality?
• What are the outcomes? How much is each locality spending and how well are they managing each group of patients? How can the outcomes be measured?

The trick for pharma is to be able to use all of this information intelligently, in combination. Much of it is publically available, but without the knowledge and understanding of how it translates into what you are trying to achieve, it could, in a worse case scenario, send the sales professional in the wrong direction.

Variation in care
In a complex environment where context is everything, it is important not to lose sight of the bigger picture on a national scale. Many of the challenges being faced by local commissioners on the ground are around the treatment of diseases identified as national priorities. The implementation of commissioning plans at a local level largely cascades down from the key domains laid out in the NHS Outcomes Framework. The challenges manifest themselves in the local variations in care that are widely highlighted as being in need of redress. Once again, these local variations – if intelligently assessed – provide pharmaceutical companies with a powerful market access opportunity. Companies that can demonstrate that their products, not just their messaging, are aligned with local need will significantly increase their chances of uptake.
A good example of how the national agenda is driven by addressing variation in care at local level, is the treatment of diabetes.

Diabetes – a mini case study
The national picture
An estimated 3.8 million people in England have diabetes, with 2.45 million QOF registered patients. This is forecast to rise to 4.6 million by 2030. Diabetes and its complications costs the NHS around 10% of its annual spend. £725 million a year is spent on diabetes medication (8.4% of NHS drugs spend), and an additional £600 million is spent on diabetes-related hospital activity. An estimated 80% of the NHS’s £9.8 billion UK diabetes bill is spent on treating diabetes complications. It is predicted that diabetes will cost the NHS £16.8 billion by 2035.

National and local initiatives
As part of QOF, practices are to be encouraged to provide lifestyle advice and annual glucose checks to everyone judged as high risk from the age of 25 – even those with normal HbA1c levels. NICE is piloting new QOF indicators that promote tight cholesterol control in diabetes.
The introduction of insulin pumps instead of injections, as well as educational programmes such as the DAFNE (Dose Adjustment For Normal Eating) course are good examples of local initiatives to combat diabetes.

Local variation
NHS Hampshire has the highest number of diabetes patients on the QOF register (54, 761). Hospital admissions (inpatient, outpatient and emergency attendances) are costing NHS Hampshire £3.7 million each year – one of the highest of all PCTs. However, its cost per thousand patients is low – ranking 113 of all PCTs. It also has the lowest death rates from diabetes. Therefore, although it has the highest number of diabetes patients, NHS Hampshire appears to be managing its patients well.

NHS Kingston has one of the highest diabetes spend per thousand patients in England. Compared to other PCTs in its SHA, it also has a higher number of Finished Consultant Episodes, longer lengths of stay, higher emergency admissions and the lowest elective admissions. Compared to NHS Hampshire, this suggests  that NHS Kingston could be managing its diabetes patients more optimally.

Lessons for pharma
The diabetes example outlined above provides a clear indication that a one-size-fits-all approach to pharmaceutical sales and marketing will no longer work. The apparent variation in care between two diverse PCTs highlights that every local health economy has different needs. A diabetes KAM working in Hampshire could not relocate to Kingston and challenge stakeholders there in the same way, with the same proposition. The situation, and the opportunity, in each PCT/CCG is totally different. The ensuing approach must be similarly distinct.

A local information strategy is critical for Key Account Managers engaging with today’s NHS. Understanding local dynamics is critical, and the information to facilitate this is increasingly within reach. The key is joining it all together and placing everything in context. It’s a mixture of local and national. Top-down directives issued at national level are providing important indicators by which local commissioners are measured, and are in turn are becoming powerful levers to help pharma develop value propositions that align with local need.

The data is out there. But success is in understanding the difference between information and insight. After all, context is King.

Rhiannon Thomason is Business Development Manager, Cegedim Relationship Management.

There’s never been a greater need to impress customers and make them understand the value pharmaceutical companies offer. Following on from his article on the concept of mass customisation, Apodi’s Tony Swift discusses how this theory can also be applied to two customer segments: the patient and the GP.

With the reduced number of blockbuster products entering the market, many sales and marketing departments are tasked with gaining market share for products and services that may have similar characteristics to competitor products. These departments are skilled at identifying traditional routes to market with the result that the promotional strategies deployed are often quite similar from one company to the next. The only real differentiator may be how much budget each company is willing to allocate to support respective products.

However, some companies are starting to implement mass customisation strategies, because as Jack Welch, former CEO of General Electric stated: “We have only two sources of competitive advantage: 1) The ability to learn more about our customers faster than the competition, and 2) The ability to turn that learning into action faster than the competition”. These companies are focusing on identifying what value means to each individual customer, collating that information effectively and delivering the value in an efficient and economic way.

The patient

Traditionally, pharmaceutical companies have focused on engaging with GPs and other payer stakeholders rather than on building relationships with the end user – the patient. However, companies are realising that engaging with patients can lead to improved adherence results, better compliance and more appropriate use of their product. The attempts to engage with patients vary in levels of sophistication. At a basic level, companies are investing in digital IT platforms where websites attempt to inform patients about the therapy area and the products available. These sites might also attempt to improve adherence through reminder systems such as emails and texts to encourage compliance.

More sophisticated solutions now aim to identify key characteristics of patients and their behaviour and to customise the offering to them. For example, by identifying why a particular type of patient fails to adhere, the offering can be customised to that patient. By having a clear understanding of why people fail to comply, a company can then identify groups of patients whose reasons for non-compliance are very similar – i.e. one group responds better to online health monitoring, another to reminder systems, another to better education etc. As a result, each individual patient is allocated to a group and the adherence offering is then customised to each group.

Successful implementation of adherence programmes which include customised solutions to patients is still quite rare. The reasons for this may differ. However, I believe it all starts with the product-centred cultures that are prevalent in many companies. Historically, companies have been focussed on winning market share and new customers. Whilst this, of course, still remains important, many companies now have to focus on customer retention, customer loyalty and customer satisfaction. Where this strategy is in its infancy, many companies look to IT for salvation – if only it were that simple! Customer Relationship Management (CRM) is more than deploying similar marketing techniques and new information technology. It needs new skills, systems, processes, behaviours – in fact, a CHANGE IN CULTURE. This can only be driven by the leadership of the business once it has decided that CRM and mass customisation are a strategic imperative.

This new strategy, if executed effectively, can lead to a range of new tactical initiatives in the area of patient adherence, such as improved technology, clinician-based call centres, education programmes, patient acquisition programmes, patient service programmes and so on. With the appropriate systems and processes, these initiatives can be developed to provide real customised value to patients.

The GP

Because pharmaceutical companies have been engaging with GPs for many years, mass customisation programmes aimed at GPs rather than patients should be easier to deliver. They know where GPs are, often know them personally and still have access to many – although the ability to engage is declining quickly.
Currently, however, successful customisation programmes aimed at GPs are few and far between. The reasons are similar to those above and result from the product-centred nature of most pharmaceutical companies. This product-centred approach can impact on the daily life of GPs in numerous ways, including:

• The traditional detail deployed by many sales representatives when visiting GPs.
• The practices, processes and systems that define ‘sales excellence’ in the industry.

An example of this is a detailed follow up I reviewed recently for a company. This was an extremely professional piece of work that identified the impact of the visits of a sales force on GPs. Multiple questions were asked about the ability of the representative to convey the product’s characteristics and benefits – and from this point of view the exercise was worthwhile.

However, there were few questions based around what value each visit had created for individual GPs. The assessment was almost solely based on the product and what was important to the company, rather than what value could be created for the customer both now and in the future.

For companies wishing to deploy VALUE-BASED MASS CUSTOMISATION, the following key initial steps could prove useful. These steps would run alongside more product-focused activities, not replace them.

1. Build a structure based on Customer Account Managers driving key messages and value to targeted healthcare professionals.
2. Develop a segmentation strategy for identifying segments of GPs based on value characteristics.
3. In each interaction with GPs, identify what value characteristics are important and allocate to a segment – commit to developing a mutual LEARNING RELATIONSHIP where knowledge of the therapy area, product and patient outcomes are paramount.
4. Access IT systems where the value identified can be saved and distributed to key management and marketing professionals – some existing CRM systems can be customised to make this happen.
5. Develop value solutions that can be quickly deployed to individual GPs – these can include additional services, product support, access to Key Opinion Leaders, clinician staff training, and services that improve the patient experience.

The role of IT

IT has a vital role in the development of value-based mass customisation strategies. I recently spoke to an expert in the industry, Charles Roots of Actis Sales Technologies, who explained that:

• Successful implementation of CRM projects needs input from senior management, IT departments and marketing departments. Technology implementation must be aligned with the business strategy and, in the area of mass customisation, with the whole initiative of providing value to customers one at a time. If only one of the above parties is included in the implementation process, the strategic benefits that could be obtained often fail to materialise
• Some organisations believe that installing technology is the determining step in the drive to a more customer and value-focused organisation. However, it is clear that truly successful companies understand that the process begins with a strategy to transform the company from a traditional selling organisation to an organisation where delivering value and developing learning relationships comes first. In these companies, IT becomes a very powerful enabler of business strategy.

Conclusion

Many commentators have noted that the pharmaceutical industry is at a crossroads. With fewer blockbusters, governments facing huge financial challenges and health services looking for more value for money from all suppliers, times are hard. This is causing difficulties in the marketplace and many people have lost jobs in the resulting turmoil. Company leaders are under pressure to maintain and increase profitability and restructuring is increasingly common.

And yet comparatively, healthcare budgets are being protected and there has never been a greater need for a positive contribution from the pharmaceutical industry. Despite the distrust that has arisen between the industry and the NHS, enlightened leaders from both parties understand how a partnership between the two is of critical importance.

Whilst researching for this series of articles, it has become clear to me that this partnership can only prosper if the industry is willing to, and be allowed to, engage with the NHS in a positive and economically viable way. I believe pharmaceutical companies should play their part by focusing on delivering real value to all key stakeholders, including patients, GPs and other payer stakeholders. That is not to say this is absent in the industry, but there is no doubt that more can be done.

For those companies embarking on such a journey, the impact on customers (NHS and patients) could be dramatic. But it will also benefit employees of such companies. The vast majority of people want to do something worthwhile and being able to see how their work creates value for the customer and improves patient outcomes is just about as rewarding as it gets.

Tony Swift is the Managing Director of Apodi. He may be reached on tony.swift@apodi.co.uk.

Charles Roots is the Managing Director of Actis Sales Technologies. He may be reached on charles.roots@actisst.com.

The UK pharmaceutical sales force and Daniel Bedingfield don’t seem to have that much in common on first inspection. Or do they…

It’s in our nature to want to succeed and develop. All of us have experienced a winning mentality somewhere along the way. While we might not always show it, all of us want to have a metaphorical gold medal around our necks. There’s nothing better than being the best.

Pf’s Company Perception, Motivation and Satisfaction Survey celebrated its 10^th anniversary last year. From 2001 onwards, salary has always ruled the roost where motivation is concerned. It makes the world go round in the medical sales industry. But back then, closely on its coattails was personal development. Opportunities were there for employees, promotions were available and money was to be made. Even Daniel Bedingfield earned his first number one in the charts! A decade on, nobody cares about personal development anymore. Even Bedingfield can’t get thru this.

Last year’s survey results showed personal development was voted as the ninth most important motivational factor – participants admitted they appreciated a pat on the back more than improving their own skills. A year before that it struggled to get in the top ten motivating factors. Driving a nice car was more important.

So what changed in a decade? Why did employees within the medical sales industry stop wanting to progress with their own careers and be happy to sit and count their wages? When did they become content to stay on the same rung of the ladder? Standing still gets you nowhere in life.

A lot has to do with job security. After years of ‘streamlining’ and workforce reductions, why take the risk taking on a new position, especially at a new company? Everyone knows it’s last in, first out, right? Personal development has been pushed to the back burner in favour of putting food on the table – you can’t blame people for adopting this mentality.

However, it can’t stay like this forever. In the modern day healthcare environment there’s a requirement for sales executives to learn new skills to deal with very real challenges. Personal development has again got to take priority. Those standing still and happy to use the same techniques, which may have served them adequately over the last ten years, will quickly be overtaken by those aiming for that metaphorical gold medal. Yet it doesn’t have to be like this.

Personal development doesn’t have to take over your life. Online literature has made it easier than ever to learn new skills or techniques whilst you’re taking a break on the road or from the comfort of your sofa. Alternatively, convenient day courses provide timely refreshers. This month’s issue of Pf – out on 27 March – offers advice from experts on how to up-skill in the current environment. You’ll learn that personal development has never been more important.

One thing is for sure, the sales force cannot maintain its apathy towards training and development. In a changing market, we gotta get thru this.

The 2011/2012 survey is now open. Have your say on what matters the most to you here.