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Healthy Skepticism Library item: 20582

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

Burns M
HxP seeks out ways to better arm salesforces
PharmaLive 2013

Full text:

The Health Experience Project, also known as HxP and sponsored by GSW, has launched a new report that uncovered 11 healthcare trends that are changing the world of pharma sales. Leigh Householder, who edits HxP and is also a member of GSW’s innovation strategy team, got together with a team to answer the question, “If we really got close to the trends changing the salesforce, what new experiences and new best practices could we uncover?”

The team worked with colleagues from around the world to address the trends that are leading to change within the realm of pharma sales. These trends include physicians becoming less central to healthcare to a new global center of opportunity in Asia-Pac to evolving multi-media expectations from doctors.

“The challenge in Asia-Pac is the deep discounts that some governments are requiring of pharma innovators who sell in the region,” Householder told Med Ad News Daily. “In China, for example, the government imposes a 90 percent discount on some products through a tendering process. According to Yahoo! Finance’s industry summary, the largest average profit margin for major drug manufacturers is at 18.4 percent. This group includes Pfizer, AstraZeneca and Bristol-Myers Squibb. For the ‘other drug manufacturers’ category, which includes Teva Pharmaceutical Industries and Allergan, the average margin drops to 12.2 percent. Although the margin required will vary by company, few or none could reasonably make it work in the long term in an environment of such deep discounting. Marketers around the world are testing remote marketing solutions that pair doctors with dedicated reps and key opinion leaders through texting, video conferencing, and online events. As these tools mature, they may become the go-to in price sensitive markets like those in Asia-Pac.”

According to the report, the next three years are considered as the perfect payer storm. “The biggest U.S. trend that is factored into that perfect storm payer story is the big shift to outcomes-based reimbursement, which has its roots in the Affordable Care Act,” says Householder. “Pharma companies can do two things immediately to help navigate the new landscape: Create greater transparency so that there’s never a surprise at the pharmacy (pages 15 and 21) and demonstrate why these products are worth fighting for by helping doctors share data across diverse care teams, use predictive modeling to figure out which patients are at higher risk for adherence or tolerance challenges, and generally get smarter about how the specific Rx impacts personal outcomes.”

Pharma sales are vulnerable to big innovation from outsiders, but that is not necessarily something to curtail, Householder told Med Ad News Daily. “For a whole range of good and bad reasons, healthcare in general – and pharma in particular – have made incredible, life-changing strides in our labs (for our products), but innovated only incrementally in the experience around them,” she says. “It’s possible that innovation from outsiders will challenge us in ways that help us all achieve more – for both the people we serve and the brands we represent. I say, don’t fight it, learn from it.”

High no-see rates have made reps cautious about protecting the access that they have, however, this course of action limits how aggressively they pitch existing contacts and how often they knock on new doors, according to the report. To tackle this, reps can “Change who’s knocking through a return to more expert (veteran HCP) sales teams and new kinds of KOL initiatives that leverage our medical teams to start new conversations,” says Householder. “Group learning opportunities seem to make an impact, too, in Europe particularly.”

To prepare for selling within this new paradigm, reps need to become experts. “Be the person the doctor looks forward to talking to because you know so much about the trends and context changing the industry, about the debates that divide physicians, and ultimately about the examples and stories that make the case in a much more personal way,” Householder told Med Ad News Daily.

In some cases, doctors have literally taken iPads away from reps during detailing. “Initially it was reps in our Rep Lab who told us that doctors would literally take the iPad out of their hands to look more closely at a topic that intrigued them,” says Householder. “The latest Manhattan numbers confirmed the trend – a full 50 percent of doctor’s report holding the iPad at some point during the call.”

In addition, reps will need to foster into real world behavior by not only asking physicians to write prescriptions, but helping ensure that it is filled. “Reps can help by creating transparency to real-world behavior,” Householder told Med Ad News Daily. “Remember, many of our doctors still believe that patients do what they say. If we can show them the percent of their patients who aren’t even making it to that initial fill, we can also credibly offer them programs, tools, and advice on how to improve that conversion they prescribed.”

As reps learn to adapt to new physician preferences and implement flexible communication, this means that they will need to think about communication in three ways, according to Householder. “How could it be delivered in person (by a rep, by a peer, by a patient)?” she told Med Ad News Daily. “How could someone use it to learn on their own (by reading, watching or trying)? How could it be used in the practice (with a care team, at the point of care, in their daily workflow)?”

The report mentions that sales and marketing need to reconnect, but this is not exactly the same as a lack of understanding the difference between the two. “A bigger challenge could be that we haven’t learned enough from the broader world of B2B marketing,” Householder says. “We’re lobbing tools to reps and they’re pitching data back, but we’re not making it all work together to create something bigger and more powerful. These tactics are table stakes for people selling hard drives, but we don’t put them to work to sell life-changing medication. Why?”

Reps will need to consider every healthcare professional within the mix. “We’ve definitely seen that non-physician prescribers aren’t always following the lead of the physicians in the practice – they’re writing their own way,” Householder Med Ad News Daily. “So, detailing them could actually create an opportunity for connection. Reps learn what’s working for Non-physician prescribers and can share that knowledge with non-physician prescribers outside the practice or other healthcare providers within, bridging critical gaps and connections and conversations. If sales teams aren’t already detailing non-physician prescribers, they’re missing out an important prescriber population plus this ability to create connection.”

As the shift to a more outcomes-driven reimbursement changes the type of data that doctors seek, it is not a guarantee that the skills to use it or challenge it will be present, according to the report. When an entirely new kind of key opinion leader become empowered and are driven by numbers that are relevant to small groups of peers in addition to being connected across digital networks is one way in which reps can navigate new data. “In the case of real world data, the #1 advantage is uncovering a second tier of key opinion leaders who are likely making digital connections (ex. Doximity) with other people in practices very similar to theirs,” Householder says. “You can understand what data or population characteristics influenced their decisions and know who their influencing – potentially helping elevate their voice, the way we do with traditional key opinion leaders.”


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