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Sales strategies for a changing environment

Published on 24/07/09 at 05:48pm

Over the last two years the UK pharma industry's established product sales strategies have begun to change. The industry's primary sales strategy has been to employ large numbers of company representatives who specialise in the primary or secondary care markets and whose function is to promote their products to healthcare professionals through direct interaction.

But this model has been increasingly compromised. Lack of market access is one issue. Physicians in GP clinics and hospitals are exceptional busy people and often refuse to see corporate representatives in their working day. This problem is compounded by NHS directives severely limiting the time the potential customer can set aside for representative meetings.

Meanwhile clinical guidelines keep getting stricter. Increasingly physicians can only prescribe those products that appear on their own, or national clinical guidelines (NICE, SMC).

The last few years have also seen a tightening up of self-regulation. Taking the example of the UK, the ABPI's Code of Practice has long dictated that sales representatives cannot discuss pre-launch products with customers. But in 2005 the industry body unveiled a range of new requirements and restrictions on its members, with public 'naming and shaming' for any company found guilty of the most serious breaches of the rules on marketing and communication.

Against this backdrop there is the sales representative 'knowledge gap' to condent with. As pharmaceutical products and bio-active agents become more technical in their modes of action and functions it is becoming progressively difficult for sales representatives to adequately discuss and sell these products to specialists given their limited training. But what to do?

One answer: change sales roles

To enable pharmaceutical companies to communicate pre-launch products to customers, two functional roles, which are based on a US model, have been developed and whose activities are acceptable to the ABPI.

The first is the Medical Science Liaison (MSL), a highly trained individual commonly with either a medical/pharmacy degree or a PhD. Their primary function is to discuss, without bias, the scientific background to pre-launch products with secondary care physicians and other specialist healthcare workers. The second is the Healthcare Manager. They often have a secondary care sales background and their function is to discuss and communicate issues such as pricing arrangement and economic data to NHS officials key to regional formulary inclusion (hospital pharmacists, prescribing advisors and NHS managers).

But their effectiveness can be limited

However, poor strategic direction and training - or even its absence - can easily compromise the MSL role. Often there is no cohesion in terms of what objectives are set and no way to measure effectiveness (that is, the number and quality of potential key opinion leaders that will become product advocates on launch). Moreover, the MSL is a scientist (quite often recruited straight from university or with an academic background) and untrained in customer interfacing.

When comes to the Healthcare Manager role, problems often arise from a lack of in-depth knowledge. Healthcare Managers are often ex-sales personnel and may be educationally ill-equipped to discuss in-depth technical scientific and health economic data with the key stakeholders who are their primary customers.

Furthermore, the familiar spectre of the internal communication breakdown can all too easily raise its ugly head. Without good internal communication between sales, healthcare and MSL functions, designing a coordinated, comprehensive strategy to achieve total market access is very difficult. Particularly as each function generally works independently to access their own customers without input or support from other functions. Worse, a bunker mentality will often exist, where mistrust is felt from the sales force towards the specialist functions regarding their use and worth. They feel that their territory is being encroached upon and their customer relationships compromised.

There is therefore a clear need within the industry to re-evaluate and put into practice in-field product management to facilitate coordinated, cross-functional use of specialist personnel. Any move toward this goal will inevitably drive sales and will therefore be appealing to the pharmaceutical corporation.

Medical communications for a changing environment

Following the success of the US model of Continuing Medical Education, the UK NHS is establishing statutory requirements for it for healthcare providers - primary and secondary care physicians, nurses, pharmacists and support workers. To ensure that continuing education is maintained, a credit system will be employed, whereby participants must accrue a certain amount of Continuing Medical Education (CME) credits per year (based on completing accredited courses). Much of the progressive educational requirements focus on the knowledge of mode of action, function and use of pharmaceutical drugs and bio-active reagents. Therefore there is a significant opportunity for the pharmaceutical industry to provide accredited, educational material on the use of its drugs and contemporary information on the condition they are designed to treat. This presents a significant opportunity for the industry in two ways.

First there is the chance to be at the forefront of the evolving CME initiatives - industry-based pathogenic research is at the forefront of developing new, technically-advanced agents based on advanced knowledge of metabolic processes, as well as gene and protein mechanics. The continuing education of physicians will be largely based on knowledge of these agents and mode of action. The industry is best placed, therefore, to provide this education.

Although the educational material must of course be scientifically and clinically unbiased, its provision represents an as yet unexploited marketing opportunity, allowable under current ABPI guidelines.

Secondly, in addition to CME-accredited education, there is a need within the industry for innovative ways to communicate the attributes of products to healthcare workers and, importantly, patients. The methods and delivery systems in which physicians optimally receive ongoing education has been extensively researched and implemented by the author. Time-critical knowledge transfer of information may be best achieved by a mixture of innovative, interactive electronic means and traditional didactic paper-based materials (including peer-review publications).

As discussed above, one of the limitations of the current industry sales model is that the primary and secondary sales force and Healthcare Managers may be educationally ill-equipped to effectively communicate the technical attributes of their products to their highly specialised customers. This severely affects the credibility of both the representative and the product. There is therefore a need within the industry for improved educational materials and training processes that are functionally specific for sales and healthcare functions. Indeed, comprehensive representative education has long been implemented in the US with significant positive impact on sales. In addition, there is a requirement for improved materials and preparation expertise when directly interfacing with the NHS, crucially for example, to provide product information for regional and national guidelines and formulary submissions.

Reacting to the changing environment

There is a real need for the pharmaceutical industry in the UK to react to a changing market access environment and to recognise opportunities and take the lead in educational communications.

Product Management is undergoing a strategic change in our industry. The brand management and marketing of new products must reflect the changes in the customer environment and the requirements of the marketplace. There must be a holistic approach to marketing and gaining product awareness that draws from a cross-functional approach and use of new functional personnel.

With the development of newer, mechanistically more complex products we must ensure that internal education is sufficient for staff to be able to best communicate the brand messages and that our educational materials fit the need for progressive education within the healthcare community.

Alan Crofts is managing director of Integrated Consultants. For more information visit: or email

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