The role of the pharmacist is evolving, and with it, community pharmacy’s importance as a customer of the pharma industry. So what do you need to know about these new healthcare providers?
In the not so distant past a sales call to pharmacy customers was often managed with a few boxes of extra stock, pens or note pads for the assistants and a quick chat about the latest discounts or advertising campaigns. However, changes within the NHS and changing roles for community pharmacists means that sales forces have to develop new strategies to work more effectively in community pharmacy and build mutually beneficial relationships.
Clinical experts on the High Street
Pharmacists are no longer simply dispensers, counting and labelling medicines, but are being actively promoted as readily accessible clinical experts on the High Street. NHS patients are increasingly being encouraged to visit their pharmacist for advice and treatment before requesting an appointment with their GP. Last year, almost one in five patients in a Department of Health survey put their pharmacist as their first choice when seeking information about their long-term condition and almost two-thirds of people with long term conditions who visited their local pharmacist felt encouraged to self care. Therefore, pharmacists are taking greater responsibility for prescribing and disease management in association with patients and GPs. Pharmacists are also influencing medicines usage at a number of levels from medicines use reviews (MURs) through to independent prescribing, which makes them an important audience for pharmaceutical companies and their sales forces.
The vast majority of pharmacists welcome this shift to a more clinical role that allows them to become more engaged with their customers and patients. In the past few years over 1800 pharmacists have undergone additional training to become an independent or supplementary prescriber. Understanding the different levels of clinical engagement of your pharmacist customers is important for pitching your sales or product presentation at the appropriate clinical level and building relationships with a new group of prescribers.
Supplementary prescribing is a voluntary partnership between the independent prescriber (doctor or dentist) and supplementary prescriber (pharmacist). With the patient’s agreement the prescribers implement a patient-specific clinical management plan (CMP) which enables the pharmacist to prescribe any medicine for the patient that is referred to in the plan until the next review by the doctor or dentist. There is no formulary for supplementary prescribing and no restrictions on the medical conditions that can be managed and the pharmacist has the discretion in the choice of dosage, frequency and product as specified by the CMP.
Independent prescribing was introduced in 2006 as a means of improving patient care and choice and access to medicines. Pharmacist independent prescribers can prescribe any licensed medicine for any medical condition that the prescriber is accredited to treat. This includes most medicines in the British National Formulary with the exception of Controlled Drugs.
Pharmacists with Special Interests (PhwSI) are pharmacists who deliver a clinical service normally through their pharmacy, beyond the scope of their normal professional role. A PhwSI has to be individually accredited by the primary care trust (PCT) to provide a specific specialist service and they will normally work across a locality or PCT within a clinical network. Although they are not required to qualify as prescribers, as they work closely with GPs and other primary care professionals they play an important role in prescribing decisions. Service areas for PhwSI range from anticoagulation services to the management of long term conditions such as diabetes or asthma.
Pharmacists can also deliver prescribed medication through Patient Group Directions (PGDs) and Minor Ailment Schemes. A little research before you visit a pharmacist for the first time can ensure that you provide the appropriate information at an appropriate level of detail.
Medicines Use Reviews
Compliance is a major issue with medication in the UK and can result in patients not getting the full benefit of a medication as well as drugs being wasted.
MURs are an Advanced Service within the Pharmacy Contract and consist of accredited pharmacists undertaking structured concordance centred reviews with patients on multiple medicines, particularly those receiving medicines for long term conditions. The review is intended to help patients understand their treatment and identify any problems they are experiencing along with possible solutions to enable patients with LTCs to manage their condition better. A report of the review is provided to the patient and to their GP. Some pharma companies offer tools to assist pharmacists in carrying out such reviews.
Medicines Use Reviews and Prescription Intervention Services represent an opportunity for pharmacists to improve the service they offer patients and generate additional income. Such reviews also offer pharma companies and sales reps an opportunity to support pharmacists and discuss your products – benefits, interactions etc.
Role of education and training
Top tips for sales reps
Raj Patel, superintendent pharmacist at Mount Elgon Pharmacy in London offers his tips to sales reps to ensure a successful call:
• It may be obvious but do make an appointment to see the pharmacist and their staff. If you haven’t met them before find out their name before you visit.
• Make sure you’re on time – allow plenty of time to find a parking spot, particularly in city centre pharmacies. If you’re delayed or have to cancel always phone to let the pharmacist know.
• Keep up to date on changes within pharmacy – those driven by the profession, by government, by local primary care priorities and by consumers – and use your knowledge to identify opportunities for the pharmacist and your company.
• Be aware of the priorities of local primary care organisations (PCO) and whether these offer opportunities for you and your pharmacist customers.
• Understand what pharmacists and their staff need in terms of marketing support materials and training. Ask for feedback on materials and pass it back to head office.
• Know if your pharmacist is a prescriber or has a Special Interest, so you can pitch your discussion at the appropriate level.
• Recognise that pharmacists are healthcare professionals as well as business men and women, so presentations based purely on commercial benefits are unlikely to have as much impact as ones that integrate the professional and commercial aspects.
• Respect the fact that pharmacists have little time to spare, so keep your presentations short and to the point.
• Be polite to counter staff and always leave the door open to come back again.
• Be smartly dressed – they will be!
Developing all the new pharmaceutical services proposed by the government in community pharmacies will require trained pharmacists and adequate remuneration will be a key factor in determining where and how pharmacists do this training.
Pharmacy staff will also require training to supervise certain aspects of the dispensing and supply of medicines which will help free up pharmacists to use their clinical skills to better effect, e.g. carrying out MURs, and to improve the range of services available in the pharmacy. The changes in the pharmacist supervision requirements also provide opportunities for pharmacy staff to develop their skills.
Although there are ambitious plans for pharmacies and the services they could offer in the future, you will appreciate from visiting busy pharmacies that most pharmacists are already overstretched with dispensing and the other obligations of running a business and staff management. Another concern for pharmacists is how such new services will be funded, particularly as their NHS income has already been effectively cut by Category M changes in the Drug Tariff.
Pharma companies are ideally placed to offer some support to pharmacists in their new roles. Through development of training materials, sponsorship of equipment and even remuneration for specific MURs, pharma companies could find themselves in the advantageous position of having a key input into emerging practitioners, which would then have positive effects on brand awareness and recommendation. By asking your pharmacists what support you or your company could provide to enable them to carry out these new services, you will build a stronger relationship and perhaps grow your category and brand share.
If you are introducing new product lines or switching a product from POM to P, make sure that your pharmacists and their staff are fully prepared for launch. Many pharmacists find it helpful to have training materials for new products or initiatives presented in brief face-to- face seminars as staff have the opportunity to ask questions.
Share your knowledge and expertise of sales and marketing with your customers. If you are aware of initiatives or promotions that have worked well for other pharmacy customers, discuss with your pharmacist how they could introduce or implement similar changes or training programmes. Television or press advertising drives customers into pharmacies so make sure you give advance notice of campaigns and their key messages.
|Fawz Farhan and Paul Lowndes are directors of Mediapharm, a marketing communications consultancy specialising in pharmacy education. Mediapharm produce Pharmacy Insight, a free monthly report for marketeers on pharmacy and the new opportunities for pharma companies.You can subscribe at www.mediapharm.co.uk.