Twitter ye not

Friday, August 28th, 2009

Attitudes, perceptions and regulatory restrictions within the pharmaceutical industry have a significant impact on its utilisation of digital media for the purposes of marketing products and communicating with customers. In a recent meeting of the Healthcare Communications Association (HCA), existing barriers to greater use of digital media and potential solutions were debated.

Healthcare professionals are consumers too

Kai Gait, from GlaxoSmithKline, asked the assembled audience “Where is it all going?” referring to trends in the usage of digital media, especially the Internet. He stated that the Internet can be used to build brands, manage relationships, develop products and enhance interaction with customers, in particular gaining their feedback on a number of issues. Although traditionally the pharmaceutical industry has been risk averse, largely due to the constraints imposed by the ABPI Code of Practice, Mr Gait commented that “We can do whatever we want… and change the way that healthcare operates”.

Currently, an estimated 96% of GPs use the Internet and 90% direct their patients to websites. In addition, NHS Direct uses Twitter to post announcements, advertise jobs and gain customer feedback; therefore, in this respect, the NHS is overtaking the pharmaceutical industry.

Mr Gait highlighted the phenomenon of online social networking. He asked: “Is social media the cavalry that will save pharma?” He emphasised, however, that the entire Internet is social media; social networking sites represent just one channel within this space. A key issue, therefore, is that because there are so many channels available, communications may become diluted. In addition, using social media is challenging as it requires the pharmaceutical industry to relinquish control, which is a potentially unfamiliar and uncomfortable proposition.

The advent of the Internet has made many of us into ‘instant consumers’ – we want answers quickly and get bored rapidly. Mr Gait suggested that pharmaceutical marketers need to develop a greater understanding of the capabilities and restrictions of social media, including how it can build or destroy products through opinions and communications. Marketers, therefore, need to go where the conversations are taking place and to join likeminded individuals in existing online communities, rather than trying to start new communities and then get others involved. Mr Gait emphasised that “We are all consumers, whether at work or at home”, including healthcare professionals. Within promotional and educational campaigns, digital media is often an afterthought, but consumers frequently use Google to search for new product information. There is a need to think creatively and do things differently in future, identifying what will resonate with customers. Conventional methods of market research may not provide an accurate picture of what customers are searching for or talking about. Instead, using online tools such as Google Insights may provide this information.

Reaching out to audiences

A different perspective on the use of digital media was provided by Laila Takeh, Online Manager for the British Heart Foundation (BHF). She stated that the BHF aims to raise money but also achieve behavioural change among patients and the general public: “We want to be the BBC of heart health information”. A recent campaign focused on heart attacks, the aim of which was to act as a call to action for the over-35 age group. The centrepiece of the campaign was an innovative 2-minute television advertisement, which illustrated the experience of having a heart attack (available at: http://www.2minutes.org.uk). Prior to its transmission, an online teaser campaign was employed, including banner advertisements, a Facebook group and digital previews for journalists and MPs. After the TV advertisement was aired, the BHF website was utilised to spread the word about the symptoms of heart attacks and what action to take.

A more recent campaign ‘Food for Thought’ has focused on diet and lifestyle issues for 13 year-olds in order to address the increasing incidence of obesity among this group. Children can make miniature digital versions of themselves – a Yoobot – with which they can discover the effects of diet and exercise on their weight and health and even their mortality (available at: http://www.yoobot.co.uk). This campaign uses a ‘fun first’ then education format and is accompanied by a Bebo campaign in order to reach the target population. Parents of these children are also communicated with through a blog linked to the website of The Guardian newspaper.

What limits pharma’s participation in the digital space?

Numerous barriers to wider use of digital media in marketing campaigns exist due to current regulatory restrictions. One of the key issues is pharmacovigilance, in particular adverse event reporting and monitoring, customer and patient privacy and protection of intellectual property. While pharma may feel comfortable with one-way communication, such as disease awareness websites and webcasts, which are limited to restricted communities, two-way conversations such as those conducted within online forums can present a host of regulatory issues, including determination of the limits of pharma’s responsibilities and a need to relinquish control over content. This fear of the unknown can present a significant obstacle to producing outputs within the digital space, and the need for input from multiple stakeholders can often complicate the creative process and dilute ideas. Unrealistic expectations of digital deliverables and how they can be evaluated also contribute to their currently limited development. Details of projects themselves can also hinder their delivery, such as language issues (and translation) and whether they are for a domestic or international/global audience.

Achieving change

Conversely, digital media can also present a number of opportunities for pharma and for its creative and communications agency partners. A key factor is that online deliverables can reach new audiences who are already receptive or interested, rather than conventional ‘cold calling’. This can form part of improved market intelligence and may even serve to enhance the reputation of pharma, in particular if safety issues are identified and acknowledged more rapidly. In addition, the speed of communication achieved with digital media outstrips that of other vehicles, e.g. print materials, and allows for more rapid updates or corrections, if necessary. This can translate into greater cost-effectiveness of online campaigns.

One of the practical solutions to overcoming many of the barriers to using digital media effectively is to employ an internal ambassador or ‘champion’ for such projects, i.e. a full-time person with the expertise and commitment to ensure efficient delivery. A willingness to listen to customers is also essential to achieve success and existing online tools such as Facebook or Twitter and search optimisation can be leveraged for this purpose.

The meeting attendees felt strongly that they deserve the “Right to have two-way conversations on the Internet” with their healthcare professional customers, rather than continuing with the current didactic approach. Sarah Matthew, Chair of the HCA and joint CEO of Virgo Health, stated that as a result of this meeting, the organisation would be convening a new Digital Working Group to assist their membership with some practical help and advice in the field of digital healthcare communications, and to collaborate with the Pharmaceutical Marketing Society from a broader industry perspective.

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Key Account Management – Challenges for the Industry

Wednesday, August 26th, 2009

It is now widely accepted that ‘one size fits all’ is no longer relevant in the modern NHS and that key account management is the way forward. But how do companies and individuals need to change to make KAM a success? Management Consultant Joanna Allen explains.

 

Key Account Management has been widely recognised and successfully practiced in various sectors for many years, particularly the fast moving consumer goods (FMCG) industry. It is a business-to-business practice, which advocates that companies use a different strategy with customers they consider to be strategically important to their business. The whole crux of undertaking an account management strategy is to add value to both the customer and the organisation. The difficulty lies in measuring the value that is not wholly sales-based.

When adopting an account management approach, the offering to the customer needs to be streamlined and customised to meet the requirements of the individual, whilst establishing long-term relationships built on trust. It is not a quick fix but a long term commitment to change which may also go some way to bridge the trust gap in the relationship between the industry and the NHS that has emerged over many years.

 

The long-term approach

The NHS continues to change rapidly and industry needs to adapt to this change by placing the customer central to their strategic plans. However, not all customers are equal – if they were there would be no need for key account management. In the pharmaceutical industry for many years target customers and practices have been defined using various methods. Some of these include therapy class potential, demographic data, existing sales or account potential defined by practice or hospital size. In most cases this is a nationally dictated strategy with minimal input from representatives at a local level. Previously, with national targets and the old GP contract based on quantity not quality, this was an appropriate way to define target customers.

However, with the focus now on patient-centred care and the building of services around the patient, one central targeting strategy clearly does not fit all. The NHS has made major steps forward in recent years, standardising policies at a national level, whilst allowing for elements of this to be localised to fit the needs of population where it is being implemented. Also, at the same time, ensuring that standards are maintained and targets achieved. In this way, the Department of Health are able to view the NHS in a converged and diverged way at the same time. It is now time for the industry to adopt a similar view.

 

Figure 1: Structure of the NHS

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This change in the NHS has led the industry towards adopting an account management approach, as the need for flexibility in the dynamic world of the NHS has been recognised. This need has been greater enhanced by the change in the way drugs are purchased, as the decision-maker can be three to four times removed from the end user. The short-term sale approach to gain prescriptions is no longer viable, collaborative long-term relationships need to be formed, not just by individuals, but by organisations. Securing organisational relationships leaves the company less vulnerable to representatives leaving and taking the account with them. In building these relationships with the purchaser, opinion leader and prescriber most companies take a team approach, with several representatives and head office personnel involved with the account.

 

From the inside out

In itself, the team selling approach creates challenges, especially in managing the account plan and the cross-team communication. Teams can span territories, regions, managers, and even companies, further increasing the challenge and creating the need for comprehensive plans and co-ordination of the multiple communication channels that exist. Accountability and responsibility for these needs to lay with one person without this success will be difficult to achieve. In their work on customer-facing people and marketing departments, Christopher et al (1991) recognised that "relationships outside the organisation depend on the quality of relationships within it”.

One of the critical success factors, therefore, is the strengthening of internal relationships across all functions, sales and marketing especially, which is everyone’s responsibility. How often in the industry do we lay the blame at the doors of others? The marketers are often accused of not listening to sales people and sales people blamed for inappropriate use of materials or not executing the campaign as was originally planned. To effectively sell as a team we need to effectively function as a team, departments need to be working in harmony towards a common goal that everyone understands.

Pivotal to any organisation is the marketing function, which is central to identifying the requirements of the customer now and in the future and formulating plans to meet these needs. Traditionally the role of the sales function is to tactically deliver these plans to meet the identified customer needs, so in essence sales is a function of marketing. In recognising this interdependence and placing the customer as the sole focus of all that we do, internal relationships can be strengthened and the communication gap bridged.

Key Account Management recognises that customers need to be placed central to the planning process, creating challenges arising from the diversity of the customers and the wants of these. One issue for the industry is that products are researched and developed to meet unmet or already met clinical needs with little thought for the wants of the buyer or end user. The challenge for organisations is to market these products to meet the wants of the buyer in a localised way.

 

Remaining relevant

Key account management is a fundamental mind shift for the whole organisation. It is no longer about regional project champions at representative level feeding back and having input into marketing tactics, it is about local Key Account Managers and representatives influencing local marketing strategy. Whatever the selling role is, it is essential to identify how to influence what happens within your locality, both internally and externally. To do this you need to be aware of your local priorities and issues. Take time with your customers to understand what their problems are and what their individual wants are. The needs of the whole account will not differ much from customer to customer, but their wants will. This is where you can start to go beyond selling and be part of the solution and not the problem.

Identifying the wants of the individuals within an organisation will help you to best fit the resources that are available to you to plan to meet these needs or eliminate the account. True key account management is resource-heavy and is not a short-term process. There maybe some accounts where you are not able to meet the needs/wants of the customer and continuing to push your products is not the answer. Focusing your efforts on areas where synergies exist in order to pull the customer towards your product is. Defining your customers into these two groups will help you to prioritise your accounts.

Successfully implementation of a key account management strategy needs to be supported throughout the whole organisation. Key Account Managers need to be placed central to the account, taking overall responsibility for the business plan and central to all communications. They need to be empowered, working with autonomy whilst being accountable for their actions and co-ordinating the activities of others working within the account.

Flexibility in approach to accounts and market-specific materials are a key requirement to success. One size does not and will not fit all anymore, the NHS will only continue to evolve and the challenge for the industry is to remain relevant to the customer in their ever-evolving world. True competitive advantage is gained through the ability to be able to constantly and consistently innovate products and services. In the pharmaceutical industry we have little, if any, ability to influence product innovation. Our real power lies within our abilities to influence and innovate the service that we provide to our key strategic customers. Everyone possesses the ability to influence both internally and externally, use this to help you stay ahead of the game and gain the edge over your competitors.

 

Joanna Allen is a Management Consultant with 15 years industry experience, providing a range of tailored programmes to improve people performance. Joanna can be contacted at joanna@jostconsulting.co.uk.

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THE DUCKHOUSE RULES (with apologies to John Irving)

Monday, August 24th, 2009

DuckLast year’s MP expenses scandal taught the valuable lesson that no one can keep breaking the rules and get away with it. Code of Practice expert Joan Barnard takes a look at the rules that govern the pharmaceutical industry and the thorny issue of compliance.

You would have had to try very hard last year to avoid hearing about MPs’ expenses – second homes, bath plugs, moat cleaning and, the now infamous, duckhouse. The whole affair exposed the fact that the system was not fit for purpose. The rules were wholly inadequate and poorly understood, both by the MPs submitting expenses and by those responsible for approving them. Such rules as there were could easily be circumvented by MPs. With no system of checking, this was unlikely to be detected, and even if it was, it appears that there were no effective sanctions. The outcome of this is that MPs will lose the right to regulate themselves and their expenses will be overseen by an independent body.

The pharmaceutical industry has had its ‘duckhouses’ over the years – trips on the Orient Express, lap dancing clubs – which have attracted criticism in the medical press and been a gift to certain areas of the lay press, and thus, in the words of the Code, ’brought the industry into disrepute’. Even though there have been no such attention-grabbing activities over the last few years, there remains a deep distrust of the industry. When did you last see a positive article in the press about a pharmaceutical company? How many GPs refuse to see sales representatives? And what about meetings? – a recent report from the Royal College of Physicians called for an end to all industry-sponsored medical education within five years.

However, unlike MPs, the industry has understood for some time the importance of getting things right, and of being seen to be getting things right. In 2006, the ABPI Code of Practice was substantially revised and tightened up and this stance has been maintained in the 2008 Code. The ABPI has not been acting in isolation, as there has been similar toughening up at European level, with the EFPIA Code becoming significantly more demanding, and also at International level. This has been particularly evident in the US, where several companies that have breached the rules on promotion have received fines of billions (yes, billions) of dollars. If you work for a US-based company, you will certainly have heard of FCPA (Foreign Corrupt Practices Act), which means that similar fines could be imposed in relation to activities taking place outside US.

All of these factors have contributed to the emphasis there now is on compliance. But what is ‘compliance’? Compliance should be considered as a function. The function will take different forms in different companies but it will, in some way, address all of the following.

 

Set of rules

‘A duckhouse is not an allowable expense’

In the UK, in relation to pharmaceutical company activity, there are several layers of rules. First there are laws governing what can and cannot be done. Secondly, there is the ABPI Code of Practice. This goes beyond the legal requirements to include additional and more detailed requirements. Thirdly, each company should have a set of SOPs (Standard Operating Procedures) which incorporate the requirements of the Code into processes for undertaking all the various activities a company may be involved in. SOPs therefore will be practically focused, specific to each company and almost certainly more prescriptive than the Code.

As an example of how these different layers operate, in relation to meetings:

  • The law states that ‘hospitality should be “reasonable” in level’
  • The Code states that ‘The level of subsistence offered must be appropriate and not out of proportion to the occasion’
  • A company SOP will specify upper limits for the cost of hospitality in different situations.

 

Rules understood by everyone

‘Claim only essential expenses – a duckhouse is not considered an essential expense’

There is no point having rules if no-one understands how to apply them so an essential element of compliance is training. The Code states that ‘all relevant personnel’ must be trained, which means anyone involved in any activity which may be covered by the Code, thus including a wide variety of employees and third parties acting on behalf of the company.

The training needs to ensure that individuals understand how to apply the Code and company SOPs to their specific function. Companies provide this training in many different ways, including face-to-face and online, and will often support the training with guidance documents. It is also important that there is a management system in place which can provide individuals with access to ongoing advice, and direction in relation to specific issues.

An essential part of effective training is ensuring that everyone understands why the rules are the way they are.

 

Management to ensure adherence to rules

‘Detailed claims will be examined to ensure that only essential expenses are paid. A claim for a duckhouse will not be approved for payment’

Usually, there will be a requirement for approval of an activity before it takes place. This may be done in a number of different ways. Advertisements, detail aids and most other printed material will go through a comprehensive and detailed approval system centrally before they are released for use. Meetings are likely to require, at the very least, the approval of line manager, based on details of content, arrangements and attendees. Expense claims are also likely to require the approval of the line manager and of the finance department.

 

Documentation of activities in relation to the rules

‘All claims must be made in writing and must be accompanied by receipts, clearly identifying the item for which the claim is being made. A receipt for a duckhouse will be rejected’

No-one likes paperwork but a certain amount is essential in relation to compliance. There is a good reason for this, and a less good reason. The good reason is that documentation, as indicated above, is an integral part of any management system to ensure compliance with the rules, i.e. the documentation is a means of making sure that the rules are not broken. The less good reason is that documentation will provide the evidence if there is ever a complaint about an activity, i.e. the documentation is a means of proving that the rules were not broken.

Documentation covers a wide range of material including training records, briefing instructions, expense claims, records of customer contacts. Although your company will ultimately be responsible for maintaining and retaining documentation, it is also in your own interests to ensure that you correctly document your own activities.

 

Assessment of adherence to rules

‘Examination of all expense claims showed that no payments were made for duckhouses’

In compliance terms, this is audit, i.e. an examination of a sample of an activity to assess the extent to which is complies with the rules. Audit can be conducted based on any relevant documentation or interviews with any relevant person, usually both. Companies are required to conduct routine audits of representative expenses, and are also likely to audit other areas of activity, e.g. meetings, customer records.

 

Sanctions for breaking the rules

‘Anyone submitting a claim for an unacceptable expense, such as a duckhouse, will be fined’

Companies are likely to include requirements for adhering to the rules in contracts of employment, and then to deal with any employee who breaks the rules through the disciplinary procedure, with the possibility of dismissal for a serious offence.

Under the Code, however, it is always the company which is held responsible for the actions of its employees, even if these are acting contrary to instructions. A range of sanctions may be applied, with expulsion or suspension from the ABPI considered the most severe.

 

Transparency

Case reports of complaints received by PMCPA have been made publicly available for many years, and since 2006, serious breaches of the Code have been advertised in the medical press. There is therefore a high level of transparency in relation to things going wrong.

On a more positive note, a great deal has been done over the last few years to make doctors and other people outside the industry aware of the Code of Practice – you may have taken part in one of the Code Awareness weeks that have been organised. This, and other activities, means that most doctors are now at least aware of the existence of the Code, although a much smaller number will have any awareness of what the Code actually says, and fewer still will have any understanding of the considerable lengths companies go to to comply with the Code.

Good compliance should be less about stopping people doing the wrong thing and more about helping them do the right thing. The challenge for the industry now is to continue to find ways, not just of doing the right thing, but of being seen to be doing the right thing. In that, everyone has a part to play.

 

What is Compliance?
  • Set of rules
  • Rules understood by everyone
  • Management to ensure adherence to rules
  • Documentation of activities in relation to the rules
  • Assessment of adherence to rules
  • Sanctions for breaking the rules
  • Transparency

 

 

Dr Joan Barnard is Managing Director of Code in Practice Ltd, which specialises in providing training and guidance on interpretation and implementation of the Code. Joan is the author and publisher of ‘The Code in Practice’, a practical guide to the ABPI Code for Head Office staff, and ‘The Code in the Field’, a guide to the ABPI Code for Medical Representatives.

joan@codeinpractice.co.uk www.codeinpractice.co.uk

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Asserting the value of pharma – ABPI Annual Report 2008/09

Friday, August 21st, 2009

Richard Barker, ABPI Director General, defended the pharma industry in an editorial for the BBC.barker 001

In his May Viewpoint piece, Richard Barker emphasised the ‘painstaking work’ required to bring a new medicine to market, the role of the ‘unsung heroes’ in research and development and the ‘world-class’ status of the industry in the UK.

The BBC article coincided with the publication of the ABPI Annual Report 2008/09, which provides an update on the activities of the Association over the past year, as well as the challenges and successes of the industry as a whole and plans for the future.

The latest report looks back on 2008 as a year in which the industry has laid the groundwork for new and better relationships with the NHS and government, particularly through the renegotiated Pharmaceutical Price Regulation Scheme (PPRS).

It highlights some of the ABPI’s key achievements, such the PPRS negotiations, the creation of a new Office for Life Sciences to promote continued investment in the industry and the initiation of a new programme of joint working between the industry and SHAs.

President Chris Brinsmead writes: “Member companies are reshaping their businesses, with added urgency provided by the difficult economic climate. This makes it all the more important to maintain strong relationships in 2009 and beyond. Trust can be gained or lost as a result of our behaviour day by day.”

 

The four imperatives

The report is divided into four main sections, which also represent the ABPI’s four strategic imperatives: Value, Innovation, Trust and Access.

The four imperatives are described as a ‘call to action’ for the member companies and will be the basis for a number of campaigns and projects as part of a three-year strategic plan.

Value

Linked to Richard Barker’s BBC editorial, this imperative will be about ensuring that society has a better understanding of the value provided by the industry.

The report states that just 14% of the medicines available on the UK market were introduced in the last five years. However, it is hoped that the new PPRS agreement, reached in December 2008, will begin to address this problem.

Under the new agreement, the industry has accepted a number of concessions, such as profit control and price cuts, but gained various commitments in return, including mandatory NHS funding for NICE approved drugs, patient access schemes for drugs not yet assessed by NICE, and published local and national data on the uptake of medicines.

Innovation

This imperative will include various projects to ensure the industry remains a world-class centre for R&D, particularly in areas of unmet medical need.

Part of this, and to address issues of access to information, the ABPI has published its Best Practice Model for the Disclosure of Results and Transparent Information on Clinical Trials, intended to set the ‘gold-standard’ for the presentation of clinical trials.

As one of many activities in this area, the Association has also been involved with lobbying the Intellectual Property Office over two threats to the value of patents: proposals to create a pan-European litigation system for granting patents and the WHO proposal to force the industry to engage in ‘patent pooling’.

Trust

“Building trust means raising awareness of what the pharmaceutical industry is good at and the benefits it brings to society,” the report says, adding: “The pharmaceutical industry is changing how it does business to match how the NHS and its other customers are also changing. A new understanding is required and a new openness and new ways to behave.”

As part of this, the ABPI is establishing various partnerships with patient groups such as the Neurological Alliance, and through the launch of ABPI Northern Ireland, now has representation throughout the UK.

To better engage with the NHS, the ABPI has developed support materials to help companies and the NHS to combine their efforts in joint working projects, and the ABPI Outreach project has had continued success in working with PCTs who have not collaborated with the industry previously.

Access

In efforts to improve access to medicines, the ABPI is continuing to work closely with NICE, as well as the SMC.

It is hoped that this will be supported by the implementation of the NHS Constitution, which states patients’ rights to new medicines and to greater transparency of decision-making, and the Darzi Review, which demonstrates a new commitment to supporting innovation and quality improvement.

Various initiatives have been put in place to further overcome the obstacles of ‘overregulation’ such as the Pharmaceutical Oncology Initiative, working with the NHS to improve access to cancer medicines, and a new government/industry working group set up to look into a UK Compassionate Use scheme for areas of currently unmet needs.

 

The full report can be found at www.abpi.org.uk/recent.asp.

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Budget’s price cuts are bad news for branded pharmaceuticals

Tuesday, August 11th, 2009

The Pharmaceutical Price Regulation Scheme (PPRS) will cut branded drug sales by £550m ($800m) during 2010–11. Datamonitor pharmaceutical strategy analyst Alistair Sinclair comments.

As part of the UK government’s drive to save £2.3 billion ($3.4 billion) in the NHS during 2010–11, £550m ($800m) will be cut from the prices of branded drugs as a result of the revised Pharmaceutical Price Regulation Scheme (PPRS) included in Alistair Darling’s 2009 budget delivered last month. Consequently, with the volume of branded drugs having remained flat over the last four years, the total sales of the UK branded pharmaceutical industry are forecast to decline from 2009 onwards.

 

Piling on the problems

Due to the global economic downturn, branded pharma sales are already suffering in countries such as the US, which lack a nationalised healthcare system. The rising number of unemployed and, therefore, uninsured patients are switching to cheaper generic drug alternatives, the result of which will be a knock-on effect on branded prescription drug sales, which are now forecast to decline by one to two percent in 2009. However, this is not the case in the UK, where patient out-of-pocket costs are capped at £7.20 ($10) for prescriptions of either generic or branded drugs (where no generic is available). Moreover, in many cases the prescription charge is waived due to the financial status of the patient. Nevertheless, the global economic downturn has exacerbated the challenges that branded pharma face in the UK market.

The UK pharmaceutical market is already highly genericised, with generic drugs responsible for 65% of drug volume and 25% of sales, and with uptake set to rise as many big name branded products lose patent protection in the UK within the next decade. More than 87% of prescriptions are written generically, with the remaining 13% likely attributable to branded biologic drugs which are yet to face non-branded ‘biosimilar’ competition. Furthermore, generic substitution by pharmacists will become mandatory from 2010, unless the physician has ticked a ‘do not substitute’ box.

The latest initiative undertaken to reduce the NHS drug bill is to cut spending on branded pharmaceuticals by £550m ($800m) during 2010–11, as part of a wider scheme to save the NHS £2.3 billion ($3.4 billion) over the same period, as announced in the UK’s 2009 budget.

The savings will be derived from the newly revised Pharmaceutical Price Regulation Scheme (PPRS), which came into effect in February 2009 with a 3.9% reduction of prescription drug prices. A further 1.9% price cut from February 2010 will provide additional savings to the NHS, which could in fact exceed the £550m ($800m) target announced by the government.

 

Some good news…

However, the branded industry has been compensated by price increases of 0.1% in January 2011, 0.2% in January 2012, and 0.2% in January 2013. Plus, a flexible pricing scheme aimed at rewarding innovation will be introduced in February 2009 to offset the impact of the PPRS price cuts and growing generic incentivisation initiatives. The government has also announced a new £750m ($1.1 billion) Strategic Investment Fund to support advanced industrial projects of strategic importance, which can potentially be accessed by struggling UK biotechnology companies. However, with £250m ($363m) earmarked for low-carbon investment, the £500m ($727m) to be allocated across the rest of UK R&D is too little, too late for small biotechs, many of which have already gone to the wall. More will undoubtedly follow before the year’s end.

On top of the PPRS price cuts and growing genericisation of small molecule drugs, branded pharma now faces a new threat from biosimilars (generic versions of biologic drugs), which are expected to enter the UK market imminently providing a lower cost alternative to expensive branded biologics, Datamonitor pharmaceutical strategy senior analyst Alistair Sinclair says.

“While uptake may initially be slow, it will inevitably grow, driven by the need to cut healthcare costs, coupled with growing physician and patient confidence in the drugs over time,” he says. “Consequently, with the volume of branded drugs having remained flat over the last four years, total sales of the UK branded pharmaceutical industry are forecast to decline from 2009 onwards due to the multitude of negative factors facing the industry.”

 

Datamonitor.jpg

Datamonitor is a leading provider of online data, analytic and forecasting platforms for key vertical sectors. Through its proprietary databases and wealth of expertise, Datamonitor provides clients with unbiased expert analysis and in-depth forecasts for seven industry sectors: Automotive & Logistics, Consumer Markets, Energy, Financial Services, Healthcare, Retail and Technology. See www.datamonitor.com for further details.

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Effective team meetings

Tuesday, August 11th, 2009

How can you build a team from the individuals that work for you? Ama Verdi-Ashton gives away her top tips for inspirational team meetings.

Our illustrious industry never ceases to amaze me with its adoption of ‘buzz words’. We have had ‘cSMART’, ‘drivers’ and still have ‘key account management’ to mention but a few. Many of these ‘buzzwords’ come and go, but one has longevity above all others and that is ‘teamwork’. We ponder how to build a team, debate how to recruit the best in a team and lose sleep over how to get more results from our team.

I believe that by delivering an excellent team meeting with all the components that I shall discuss here, you will build your team more than any other activity you do, and I am happy to be challenged on this!

For the purpose of this article, I am going to concentrate on a team meeting lasting a day. Of course, you can use elements of the ideas for half-day meetings, rather like a tool bag for you to pick out what you need according to your objectives. Depending on resource, I also believe that regular area meetings are key to a team’s success, at the very least once a quarter for a whole day, with half-days dotted throughout the quarter.

 

Strategy outline

Let’s begin with the foundation of your team meeting or the skeleton of your meeting. These components will form the basis of your meetings, although the information included therein will be different.

Objective of the meeting

Ask yourself “Why am I having this meeting? Is it because I have a genuine reason? What information do I need to impart to them? What help/training do they need that I can give them at this meeting?” Whatever your answer, please see your meeting as a golden opportunity to:

  • impart information as required by the business and company e.g. new targets
  • build your team and have some fun.

Review of the business/key account plan

You could get your team members to present this back to you if you wish. This can be extremely dreary for everyone else, however, so I usually find getting people to give their ‘successes’ and ‘issues’ is more interesting.

Review of sales and activity

Led by you as the manager, review sales nationally and locally. Remember to praise the individuals who are doing well and challenge those whose territory is not performing. Keep it objective – it’s about the business, not the individual.

The best meetings should be fun. You can be business focused, achieve lots and still have fun. In fact, enjoying work has been linked to being more motivated. Consider the quote from Ken Blanchard in his well known book One Minute Manager: “Happy people are productive people”. Don’t forget that for us in pharma, it is not what your people are demonstrating with you, but what they are doing when they are NOT with you. Our industry is built on trust, so use the time you have your team with you at a team meeting as a real opportunity to give them a motive for action!

So, back to why you are having your meeting. Ask yourself this question to help you focus: “What do I want my people to be able to do, or demonstrate, etc when they leave this meeting today?” The answer to this question will give you your objectives/goals for the day. They might look like this:

  • Demonstrate an understanding of new campaign.
  • Work with new coverage and frequency list (you decide what ‘work with’ means for you).
  • Action plan for the above.

Once you have your goals/objectives then we are ready to add in the next components.

 

Key tactics

The body of the meeting should include components of Skills, Knowledge and Attitude.

This is a simple way of giving you a structure to work with. Below are a few examples of what have worked well for me. Please note, these are only examples and the list is by no means conclusive!

Skills examples

Business Skills

  • Individuals in the team share how they prioritise their business via a 10-minute presentation on sales analysis, key opinion leaders, etc.
  • As a whole team, brainstorm criteria for coming up with a list of key opinion leaders i.e. adopters of your product. You as the manager can facilitate this or get a keen team member to do it for you. Do offer them the benefit of ‘feedback’ from you that they can use for their ‘brag file’.
  • Does one of your team members ‘close’ better than others – get them to do a quick refresher on ‘closing the call’ for the rest of the team. Again the incentive of feedback for the ‘brag file’ stands here.

Challenge Sessions

These sessions have to be set up as ‘purely about the business’ and not used as an opportunity to single people out. Everyone gets to look at a ‘challenging’ piece of the business and brainstorm what else could be done, what has been tried, why it didn’t work, the consequences of trying A or B, etc. This is an extremely useful exercise in gaining results, best facilitated by you to keep focus and stop individuals from becoming defensive. This is similar to the difficult cases that doctors discuss at their multi-disciplinary meetings.

Knowledge examples

Product knowledge

Get your Medical Information department to present on a certain aspect of your product that may be needed as a refresher.

NHS changes

  • An ever-changing arena, so ensure you keep the team updated by either getting your local NHS liaison person in or get the team to work via Wellards training and present back to the team.
  • Don’t forget to include how this will impact on your business locally to make it real for the team.

Secondary Care

Again, if you have a hospital representative, you could get them to present their plans on local key opinion leaders.

Best Practice

These sessions could be led by someone in another team where they have achieved success. They could present on what was done to gain such results.

 

The winning attitude

I am not usually pedantic or prescriptive, except when it comes to having a passionate belief in working on individual’s attitudes. It is an absolute must for success. If you were to ask me the one thing I did differently with my team to get them to work so hard (one manager described their results as ‘super-human’), I would say it was to simply nurture their attitude by tapping into their self-belief system and their self esteem.

I can guarantee if you work on your team’s psychology, they will be ‘with you’ and won’t be bored in your meeting, writing shopping lists or doing doodles. Working on their attitude, however, does require some hard work from you. You need to read up on ideas from the internet, think about your people, what makes them tick, and ask yourself the all-important question: “What can I do today to make them work hard tomorrow?”

Attitude examples

Self-belief cycle

This works on the principle that your sub-conscious brain is much more powerful than you think. Just by thinking in a certain way, e.g. “It’s August so it is really quiet and I will not see anyone today”, you can make the statement come true. The self-belief cycle shows how a thought results in your actions either being of a poor quality or excellent quality. It is down to your belief system. Change your thought to a good one, e.g. “Today I am going to achieve results” and see what happens. It works!! Please email Pf (Diana.spencer@healthpublihsing.co.uk) for more information or Google ‘self-belief cycle’.

Social styles/Values

See my recent Pf articles for quizzes/discussions that can be useful at a team meeting.

Positive self talk

What we say to ourselves is extremely important. It is noted that by the time we are five years old, we have heard the word ‘don’t’ 800,000 times – this can make us negative adults. How can we change the things we say to ourselves to be more positive? Again, I am happy to help if you email me via Pf. This is part of the fascinating psychology of ‘Transactional Analysis’.

Anthony Robbins’ goals

Anthony Robbins believes passionately that people can achieve anything they want to, as our actions are 80% psychology and 20% mechanics. Visit his website, it is full of fantastic information and recently he was giving away an hour’s free coaching.

 

Fun awareness

We talked earlier about having fun. Here are some ideas that you could use to inject this element:

  • Photos of the team as youngsters, gained from them individually. Get the rest of the team to guess who it is. Use as an attention grabber at the start of the day and intersperse throughout the day.
  • To demonstrate teamwork, show film clips where you see teams in action, e.g. Toy Story, Antz.
  • To demonstrate passion and belief – clips from the film Gladiator before Maximus goes into arena and plans his strategy for survival or his ‘pep talk’ to his soldiers at the beginning of the film.
  • To demonstrate that we must differentiate ourselves and ‘stand out from the crowd’, use photos of a crowd of people and get your team to pick out the famous person.

Finally, it is also useful to have an actions session at the end of the day before you summarise and close. A good question to flipchart is: “What three actions will I take as a result of this team meeting?” Agree when you will follow up on these actions and send them out via email as a reminder.

 

Ama

Ama Verdi-Ashton has 25 years’ experience in the pharmaceutical industry. Her roles have included hospital representative, head office trainer and 12 years managing primary and secondary care teams, taking her last team to AstraZeneca’s highest accolade, the AstraZeneca Academy. More recently, Ama has been working as a Training Consultant.

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Pensions reform – The most important thing?

Sunday, August 9th, 2009

PensionsFew people are making sufficient preparations for their retirement and the government hopes reforms to pension schemes will prevent mass poverty. Diana Spencer takes a look at the proposed reforms and how the pharma industry shapes up in this area.

“When I was young, I thought that money was the most important thing in life; now that I am old, I know it is.” Oscar Wilde

Age discrimination, pension schemes and the age of retirement are all hot topics at the moment. Yet, although we are starting to admit that we will need to work for longer than our grandparents’ generation and it is unlikely we will be able to rely on a state-funded pension, few of us are actually making adequate preparations for the future.

According to recent research by Scottish Widows, 49% of us are not saving sufficiently for our twilight years. Help the Aged also revealed that the amount of pensioners living in poverty rose by 300,000 between 2006 and 2007, so it is not surprising that many people feel concerned about what the future will bring.

So is it all down to the individual to prepare for their financial security in later life? Some would say that it is, but the government is introducing various reforms in an attempt to avoid the mass poverty that has been threatened for the country’s elderly.

 

New tricks

The most significant change could be an alteration to the age of compulsory retirement. Many have welcomed the government’s decision to bring forward the review of the default retirement age to 2010, with hopes that this will in some way alleviate the potential pension crisis.

Dianah Worman, Diversity Advisor at Chartered Institute of Personnel and Development (CIPD), comments: “The economic situation and panic about pension income means maintaining the default retirement age is unsustainable. In these tough times the government has no choice but to bring this review forward to help organisations make better use of the talent, skills and knowledge of experienced older employees, but also to help supplement their diminishing pensions.”

One reform that is guaranteed, however, is the reform to pension schemes under the 2008 Pensions Act, planned to come into place in 2012. According to the plans, in three years’ time virtually all companies will be required to offer a pension scheme and contribute to it

Under the reforms, people will be automatically enrolled in their company’s pension scheme or a new low-cost national scheme called Personal Accounts, with the option to opt out if they wish. Those within the scheme must contribute at least 4% of earnings, to which will be added minimum contributions of 3% by the company and 1% via normal tax relief.

A study by the Department for Work and Pensions (DWP): Savings for retirement: implication of pensions reforms on financial incentives to save for retirement states that, not only do they believe that 95% of people will receive more back than they put into the scheme, but that 70% can expect to receive twice as much as they contribute.

The Enabling Retirement Savings Programme, made up of the DWP, the Pensions Regulator and the Personal Accounts Delivery Authority, will be responsible for delivering the workplace pension reforms.

 

A great save?

Predictably, there have been varied reactions to the proposed new scheme. For a start, there is no way of predicting how many people will choose to remain in the programme. An optimistic figure is that just 20% will opt out, but more pessimistic predictions put this at 50-60%.

Another unknown factor is how many employers will choose to contribute above the minimum 3%, an amount many feel is inadequate. New research conducted by PricewaterhouseCoopers revealed that 90% of companies are concerned that they will be asked to increase their payments at a time when money is tight.

Indeed, some predict that all schemes will ‘dumb down’ to the 3% level. Professor David Blake, who runs the Pensions Institute, a research group based at City University’s business school, has a negative view for the future.

He told People Management Magazine: “On present trends, there won’t be much in the private sector by 2030 outside Personal Accounts and some DC schemes by those employers who feel pensions are a part of a benefits package their employees would value. Tragically, 150 years of development of occupational pensions is coming to an end. The typical employer has worked out that employees don’t value what their company is putting into the pension scheme. So it will be much more down to the individual in the future.”

 

Tomorrow’s world

One question that remains, however, is how much do we really care? Do we value pension schemes enough to be attracted to a company that boasts a good one? It seems many of us would rather put off thinking about retirement for as long as possible, for many, until it is too late. Yet the recent threat of a pensions ‘time bomb’ has increased our awareness in this area to some extent. Of several pharma sales people I spoke to the majority said they were concerned about their financial security in old age.

One Key Account Manager said: “There are always conflicting views even from financial advisors particularly regarding state pensions. The company pensions worry me slightly too and I am not sure whether it would be better to save personally or invest in property as a pension fund security for the future.”

Worries such as these may lead most people to remain in the new scheme – if their company does not already offer a better one. The latest Pf Company Perception, Motivation and Satisfaction Survey showed that pension scheme was not a top motivator for sales people when choosing their employer. However, it is usually those areas that are positive that are overlooked in this section of the Survey – we tend to rank as most important those things that we are dissatisfied with. Confirming this, the Survey also revealed that the majority of sales executives within the industry are happy with their current company pension scheme, so this does already seem to be an area of strength for the sector.

One company in particular has received much attention for its pension scheme, though it is likely that many other companies now at least match its offering. The Confederation of British Industry recently highlighted GlaxoSmithKline (GSK) as a benchmark for good practice. Under its money-purchase pension plan, launched in 2000, GSK makes a 4% contribution for all participants and pledges to match further employee contributions up to an additional 4% – unsurprisingly, the company boasts a 99% take-up level.

 

Out with the old

The government’s scheme could prove especially valuable to anyone whose company does not currently provide a pension scheme, or who have been remiss in enrolling on one that is already available. At the very least, the new scheme will force us all to reassess the impact that saving will have on our future happiness.

However, for those who already enjoy a good company pension scheme, as many pharmaceutical companies offer, the reforms are likely to have minimal impact. With schemes like that of GSK leading the way and offering a positive example to others, it is unlikely that pension saving options will decrease in the future.

Increasing coverage of the issues around pension provision and the problems posed by an aging population mean that many of us are more aware of the importance of a suitable saving scheme, and are beginning to consider this more when choosing an employer. An industry that traditionally offers exceptional remuneration packages is unlikely to let an increasingly significant part of its offering suffer.

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More than pushing pills: Pharma to refocus salesforce

Tuesday, August 4th, 2009

The pharma industry’s salesforce will be replaced by a new model over the next ten years as the industry shifts from a mass-market to a target-market approach, according to a recent report by PricewaterhouseCoopers (PwC).


The pharmaceutical industry’s current sales and marketing model will no longer be practical as the industry is forced to change its approach in response to market pressures, industry analyst PricewaterhouseCoopers (PwC) has claimed.

According to the report Pharma 2020: Marketing the Future, the industry will have to shift its focus from simply ‘pushing pills’ to demonstrating through products and services that it can promote health, improve quality of life and reduce healthcare costs.

One in five doctors now refuses to see any sales representatives and returns on sales visits to doctors have declined in the developed world, the report states. There is increasing resistance from doctors and regulators and growing public scrutiny over the interaction between pharma companies and healthcare professionals.

Pharmaceutical manufacturers have responded with various cost-cutting measures so that by the end of 2008, PwC claims, big Pharma had announced plans to shed over 60,000 jobs globally, many of them in sales and marketing.

According to PwC, the pharma industry’s salesforce of the future will be dramatically smaller, more agile and require new skills. Tomorrow’s field force will need an education in science or health, greater understanding of specific complex diseases and the ability to negotiate with powerful payers and medical specialists. Its focus will no longer be just selling products, but better managing health outcomes through a full complement of health management services..
Steve Arlington, global pharmaceutical and life sciences advisory leader, PricewaterhouseCoopers, commented: “Products alone will no longer guarantee the pharmaceutical industry’s long-term future. The shortcomings of pharma’s current marketing and sales model can no longer be addressed by simply reducing the size of the sales force; the problems go deeper.

“If pharma succeeds in bringing bold, brave changes to the current model it will be in a much better position to ensure that the billions of dollars it invests in R&D are wisely spent, and eliminate the need to spend massive sums persuading increasingly sceptical doctors to prescribe medicines whose clinical superiority may be questionable. The pharma industry will be able to slash its expenditure on sales and marketing by selling products and services that the market will pay a premium price for.”

 

Balance of power shifting to payers

For years, pharmaceutical companies have decided what their products were worth and priced them accordingly, investing little effort in understanding the payer’s perspective or what the market was willing to buy. With healthcare costs rising, payers including governments and private insurers are becoming the ultimate arbiters of pricing and value, reimbursement and prescribing decisions.

There will have to be a stronger link between marketing and R&D, according to PwC. For many years, pharma firms have more or less ignored the payer’s perspective when developing medicines, with the result that just eight of the 27 new therapies launched in 2007 were the first of their kind. However, this is already beginning to change, as indicated by Novartis’ recent deal with NICE to pay the agency a consultancy fee for advising on the design of a Phase III trial to measure the efficacy and cost-effectiveness of a new drug. GlaxoSmithKline also recently took the step of giving government officials in the UK, France, Spain and Italy a say in deciding which of its pipeline compounds to progress.

The often contentious relationship and competing agendas that have long existed among pharma companies, payers and providers will end as pay-for-performance and comparative effectiveness analysis force them to work together for the common goal of improving health outcomes for the patient and demonstrating value for money. Pay-for-performance is already evident in the UK, in such reimbursement schemes as those employed by Johnson & Johnson for Velcade and Novartis for Lucentis. There are also now plans to extend this approach with a flexible pricing system that will better reflect the value of medicines.

 

Product portfolio to change

The current blockbuster model was designed to promote mass-market treatment of common diseases such as hypertension, diabetes, high cholesterol to primary care physicians. Sixty-five percent of these drugs are now sold generically in the US and 70% in Central and Eastern Europe. In the next ten years, only drugs considered truly innovative will be financially rewarded with a premium price.

Good medicines will no longer be enough in isolation. As the balance of power shifts to payers and patients, qualitative criteria – such as the extent to which a treatment makes a patient feel better, whether it allows them to return to work or reduces the cost of caring for them – will become increasingly important. Pharma companies will therefore have to collaborate with others in the healthcare arena to provide a range of products and services from which patients can pick, both to differentiate their offerings and preserve the value of their drugs. These may include services such as health screenings, compliance programmes, exercise facilities and nutritional advice.

Pharma companies that choose to focus on specialised medicines will gradually shift their product mix to include more biologics and medicines that are targeted to specific and more complex disease states.

Science is leading the pharma industry toward specialist medicine – highly effective therapies developed for specific complex conditions, developed in small doses and in need of refrigerated handling and storage. Specialised drugs are significantly more expensive, in some cases costing thousands for a single dosage or treatment. The global market for specialised medicines, which accounted for 44% of worldwide prescription drug spending in 2008, could be twice the size of the current market for all prescription drugs by 2020, according to PwC.

This change in focus to specialist therapies will require significant cultural and organisational changes. As these drugs are prescribed by specialists, rather than GPs, sales and marketing executives will need considerable scientific knowledge, as well as a clear grasp of the health economics involved, since the drugs will attract greater regulatory scrutiny due to their expense. A pharma company promoting these products will have to offer complimentary diagnostic and support services, appoint a smaller salesforce with greater knowledge and invest in patient education. However, the rewards will be a longer period of exclusivity and greater customer loyalty.

Regulatory harmonisation

The FDA and other leading regulatory agencies are exploring various new methods for assessing, approving and monitoring innovative medicines. While a single global regulatory body is unlikely, there may well be a common regulatory regime across pharmaceuticals, medical devices and diagnostics. Plus, more global regulatory harmony will make simultaneously multi-country launches routine.

By 2020, the launch of a new drug will become much more incremental. The big bang, big budget blockbuster launch will be replaced by a process in which clinical outcomes information is continuously disseminated in a series of much smaller waves. New medicines will be launched with ‘live licenses’, conditional on further in-life testing to substantiate their safety and efficacy in larger/different populations.

According to PwC, the future sales and marketing process must master each of these dynamics and synthethise them into a new system. Pharma companies will need to restructure their marketing functions accordingly, with the appointment of key account managers who will be responsible for collaborating with healthcare payers to shape the information doctors receive and provide hard proof that a product really is safer, more effective or more economical than its rivals before they add it to the formulary.

The shift to specialist medicines will require a greater focus on brand management to improve the longevity and value of products, closer working between sales and marketing and R&D, more use of professional networking sites to engage with patients and health professionals, and improved collection and sharing of information through ETM systems.

Simon Friend, global pharmaceutical and life sciences leader at PricewaterhouseCoopers, concluded: “In the past, the sales and marketing function shouted loud and jumped high to sell products. Soon, the imperative will be who can add the most value, not who can sell the most pills. The pharmaceutical companies that succeed in demonstrating value will be rewarded with a longer period of exclusivity, stronger financial health and greater loyalty to its brand. The challenge for pharmaceutical companies will be managing through the changes in their business model as the shift from blockbuster to specialised evolves over the next ten years.”

The report Pharma 2020: Marketing the Future is available at: www.pwc.co.uk/eng/publications/pharma_2020_marketing_the_future.html

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