Are you proactive or reactive?

OVER THE PAST couple of years, the pharma industry has begun to make longoverdue changes. Field forces are being reduced, some by almost 20%. The number of group meetings, as opposed to details, has begun to grow. But is this shift being driven by the pharmaceutical companies, or is it a forced response to the fundamental changes being undertaken by the NHS? If this is a market-driven change, are the pharma companies ready and able to adapt?

Changing call patterns

    There is no doubt that the way pharma companies interact with individuals across the NHS is changing. Figures from Cegedim reveal that average representative call rates dropped from four per day in 2004 to less than three per day in 2005. Since this figure is driven by a comprehensive reduction in the number of doctors prepared to see representatives, the 25% drop in productivity has reinforced the argument for reducing field force numbers.
   Similarly, an increasing number of GP practices have banned representative visits, instead preferring a group "lunch and learn" session if they receive representatives at all. This shift is reflected in data revealing that the proportion of meeting-based sales activity has grown from 20% in 2004 to 30% in 2005, and then to 45% in the first four months of 2006.
   But just how effective are pharmaceutical companies in this new model? Are they really providing representatives with the new skills, training, materials and access to Opinion Leaders required to maximise the lunch and learn meeting opportunity? Or are representatives simply trying to apply the same detailing know-how to what is now a fundamentally different sales environment?

Following the trend
   Given the fact that there has been no overall increase in call rates to pharmacists, despite the new contract, and that nurse visits remain static around 20%, there are clear indications that the pharma industry is following rather than driving the new market.
   Surely this strategy is highly dangerous. The NHS is changing faster today than at any other time in its history – and if pharma companies are to retain a place and deliver value in the new NHS, they need to create far more proactive strategies to meet the diverse needs of individuals, practices, commissioning groups and Primary Care Trusts.
   Simply shifting the representative’s goal from the traditional detail to a lunch and learn will not demonstrate the level of commitment and understanding that is required to attain – or retain - a foothold in the new prescribing environment. If a pharma company can get a number of relevant individuals one room for an extended presentation, that opportunity needs to be maximised – or there is a risk of long-term brand damage.

Relevant messages
   Pharma companies cannot expect the skills and expertise of a typical detailing representative to transfer automatically to the new environment. To create the right lunch and learn format requires new tools and new skills that enable representatives to go beyond one-to-one communication towards effective management of large meetings.
   Speaking skills, presentation development and support in accessing and securing relevant Opinion Leaders should become a standard component of the representative’s armoury. This changes the role of the marketing team. Rather than provide a single, consistent product message, marketing needs to be able to work with representatives to modify the message in order to reflect the issues and needs of each specific group.
   Furthermore, it is important to recognise that the message is now not just about product efficacy. By combining local understanding with a willingness to help a practice or commissioning group achieve the new measurable goals defined by Government, the pharma company can begin to deliver quantifiable value.
   More help, therefore, will be required in identifying relevant groups of people across both primary and secondary care and researching key local issues, disease incidence and QOF data. This information should then inform the creation of tailored messages, supported by a relevant Opinion Leader if necessary.
   Critically, the message must be delivered by a representative who is confident both in public speaking and in the accuracy and relevance of the supporting information. The representative has the opportunity to create a far more proactive role within the NHS – and that can only be achieved by individuals with the right skills and tools.

Maximising value
   Given the new Account Management focus, the ability to understand the needs of each practice and commissioning group will be essential for representatives to ascertain market potential and prioritise attention. Accurate, up-to-date profiling information is a fundamental component of the new business-led Account Management role that representatives will have to adopt.
   Without the ability to combine up-to-date prescribing information with insight into the strategies of the local PCT and an understanding of the constantly evolving Opinion Leader network, Account Managers will struggle to maximise value in what is now a far more expensive sales environment.
   At the same time, every pharmaceutical company is sending multiple tiers of sales and marketing activity to address different components of the NHS, from Opinion Leaders to nurses. With all of these individuals receiving tailored messages, there is a very clear danger of information inconsistency.
   Improved communication across these overlapping teams will become increasingly important as pharmaceutical companies improve profiling and tailored message delivery. In this complex environment, representatives cannot be expected to manage the diverse message delivery and multi-tier Opinion Leaders without access to good CRM that provides immediate insight into every relevant interaction.

Proactive change
   Of course, given the increased frequency of lunch and learn meetings, many pharma companies may insist that this shift in strategy is already underway. But how effectively are budgets being spent today – and, more critically, how confident are representatives in their ability to operate in this new, far more challenging sales situation?
   To be frank, if the needs of doctors were being met, call rates would not be dropping. If pharma companies want to keep the door open, they need to improve customer understanding, create a relevant message and deliver that message in the most appropriate way. Today, many are simply creating a halfhearted response to NHS-led directives and goals, leaving representatives to manage the new model with little coherent support.
   This lacklustre approach will result swiftly in the lunch and learn also falling out of favour, leaving the sales force with no way to make direct contact with the front line in patient care. Those organisations that combine Account Management skills with a willingness to understand local needs will drive change and reap the rewards.

Gareth Thomas

Cegedim is the European leader in the production, use and distribution of data and services linked to medical information and CRM activities. For more information, contact Cegedim UK at www.cegedim.co.uk.