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Healthy Skepticism Library item: 19636

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Electronic Source

Taylor P
Don't write off the sales rep just yet 2011 Oct 5


Traditional sales reps can still play vital roles in the transition to KAM. Phil Taylor reports

Full text:

With key account management a hot topic in the pharmaceutical industry, what future does the traditional sales representative have in the new selling paradigm?

One often-repeated story when reporting on KAM in pharma is that its adoption has become something of a necessity, thanks in no small part to the shift in the prescribing power base from doctors to primary care trusts and healthcare consortia.

The contention is that the selling function in a pharmaceutical company needs to operate at a higher level, with KAMs cultivating high-level relationships with the new payers, adding to the value proposition they offer in order to get their products onto formularies and into the new prescribing process.

But is that viewpoint too simplistic?

The shift in the payer landscape remains incomplete in many countries, including the National Health Service in the UK, according to David Wrightdirector of customer management consultancy Imonic.

“In some areas, such as oncology, for example, clinicians remain powerful decision-makers,” he says.

“They sometimes prescribe on the limits of formulary hierarchy, backed up with clinical justifications and often without referral, once a product is approved.”

Variations in payer activity

In primary care and routine hospital settings, however, the buying system has taken precedence and payers and medicines managers are the more powerful people in the mix, particularly where you have a high-complying organization, such as a primary care trust.

That variation in payer activity is one reason why KAM uptake has been relatively slow in pharma, and why there is still a role for the traditional sales rep within a KAM setting, according to Wright.

KAM is about saying, ‘Let’s work with fewer customers, but in a deeper way,‘” Wright explains.

“But pharma has been concerned that, in the current environment, that may not be optimal.”

As a result, the sector has started to work a little bit deeper with its customers, with more planning and segmentation

While it’s a long way from a true KAM approach, it is a reasonable position to take, given the pace of change in healthcare systems across Europe.

Bernard Quancard, president and CEO of the Strategic Account Manager Association (SAMA), agrees that there will continue to be traditional sales rep in a KAM-oriented team.

For example, even in cases where a hospital consortium wields a great deal of power in medium-term decisions on patient care, smaller members of the grouping will likely need follow-up to execute the centralized decision.

“Traditional reps can fulfil that compliance-assuring role,” says Quancard. “However, they will be in dramatically lower numbers than today.”

Many sales reps will have to redeploy, either as a KAM—assuming they have the right competencies—or into a supporting role within KAM-oriented organizations.

In many industries, KAM and traditional sales models co-exist, according to Quancard.

The KAM approach is applied to big stakeholders and very high-value accounts, while at the other end of the spectrum you get mass sales via the Internet.

In between is the third model involving sales that go through wholesalers and other intermediaries, with sales reps providing support to those non-selling channel partners.

“Eventually, perhaps in 15 to 20 years, those sales will also go through the Internet and the third tier will become much smaller,” says Quancard.

Lifecycle management

While the diffuse nature of the pharmaceutical payer market preserves a role for sales reps, the lifecycle of a pharmaceutical also has a bearing.

In the early stages of a product’s lifecycle, when a lot of work has been undertaken to get guidance and approvals, there is a need for more fundamental communication work, and the traditional sales rep is suited to this awareness-raising role.

Once that initial profile-raising effort is completed, the product lifecycle management approach moves onto winning the endorsement of the primary care trust or consortium, particularly those that take a more proscriptive formulary approach.

“At that point, you no longer need an army of ‘verbal commercials,‘” notes Wright.

Building sales in a compliant formulary system requires work to increase a product’s position and breadth within the system, through new indications, for example.

PCTs in the UK differ greatly in their degree of formulary compliance.

In less-compliant cases, clinicians can have greater leeway to break out of the system, and these can be good contacts for traditional salespeople to cultivate.

Other industries, such as fast-moving consumer goods (FMCG), have been earlier adopters of the KAM approach, and some drug makers—notably Pfizer and AstraZeneca—have imported talent from them.

However, the majority of companies have tried to develop KAM programs by internal advancement of sales staff.

“It’s not a transition that sales reps can’t make, but there is a sizeable body of reps within the industry that have become almost hard-wired to follow the traditional process and don’t want to do anything else,” says Quancard.

For the time being, at least, it looks like the archetypal rep still has a role to play in the pharmaceutical industry.


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