PM360 April 2011

PM360 THINK TANK: The Evolving Sales Model

How do you distinguish your brand and influence its adoption by prescribers? The arsenal of sales tools is ever growing. Are you exploiting every avenue? Our experts detail their strategies in the new healthcare environment.

Tom Campbell
Executive Vice President Product Management and Development Healthy Advice Networks
tcampbell@healthyadvice.com

Time-crunched doctors are increasingly becoming “hard-to-see” and “no-see” docs. In fact, according to a recent study, about two out of three physicians are now restricting rep access and almost one in four are refusing to see reps at all. And while getting face time with the doctor is still a key objective for pharma brands, quality face time is becoming a thing of the past, with the average detail lasting less than two minutes and only one in four details being conducted directly with the physician. And don’t count on immediately reaching the doctor through professional journals. Research shows that 50% of physicians need three or more weeks to get to the latest issue of their favorite journal. Time spent with journals has dropped 32% during the past two decades.

NEW TOOLS
Despite all this, brands still need to gain share of mind among targeted doctors. But we need to find new tools to reach doctors where they are rather than where they used to be. According to Manhattan Research, 64% of physicians have a smartphone, and that number is expected to grow to more than 80% by 2012. Physicians are spending eight hours per week on the Internet for professional purposes, more than triple the time spent in 2002. Healthy Advice doctors confirmed physicians access information differently today with their immediate acceptance of PracticeWire—a medical news and information service that integrates these two rapidly growing information sources. Utilizing digital technology to deliver real-time medical news and brand messages into the clinical back office, PracticeWire gives physicians instant information where they work. Adding online, mobile applications, and mobile device access and information is now literally available whenever and wherever physicians want it.

Mark Calabrese
VP and General Manager, Marketing Solutions
Cegedim Relationship Management
Mark.Calabrese@cegedim.com

What are the trends in reaching hard-to-see and no-see physicians? With sales forces being down- sized and more and more physicians’ offices either not allowing representative calls or limiting calls to by-appointment only, maximizing your most precious personal marketing resource has become increasingly challenging. A March 2011 study by SK&A on U.S. Physician Access indicated that while across specialties 77.1% of physicians still permit access, upwards of two-thirds require appointments. The percentage of offices with no access varies greatly by specialty and geography.

CORE CONCEPTS
So how do you reach these important prescribers if they are part of your target prescribing universe for your brand? Understanding these customers, including their attitudes and prescribing usage of your brand and therapeutic category, is at the core of how to address them. What size patient practices do they have? Are they part of a group practice? Do they have nurse practitioners or physician assistants in their practices? Are they early adopters or brand loyalists? Are they online users or do they prefer to be reached via telephone? Understanding these customers’ channel preferences will help guide how you should reach them.
Tactics which territory representatives can personalize and deploy directly from their CRM systems are effective tools for follow-up, and when integrated into database marketing technology, allow marketers to segment and refine their marketing to these customers. While traditional sampling mail programs are still being delivered, online portals are increasingly being leveraged so that prescribers can access on their own time and choose to receive product samples, download patient co-pay savings cards and patient literature, as well as receive a product e-detail.

EXTENDING YOUR REACH
Do not underestimate the influence that nurse practitioners and physician assistants can have on your target physicians. Extending reach to the NPs and PAs who are associated with your no-see physicians can provide incremental prescription volume in many therapeutic categories.

Richard P. Micali
Senior Vice President, Sales Services
PDI
RMicali@pdi-inc.com

There is no denying physician access is at an all-time low and continues to worsen. However, the ubiquity of technology and its escalating embrace by physicians offers us a real opportunity to break through.

CUSTOMIZED OUTREACH
The trend toward multi-channel promotion is changing the role of reps, who must now leverage digital tools as part of their outreach strategy. Fortunately, digital promotion has enabled us to build robust databases on physician messaging and channel and timing preferences, giving reps the ability to tailor their messaging approach to be more effective. This can be especially helpful with hard-to-see physicians to make the most out of a rare in-person visit.

By tapping databases for preferences, the rep can put together a program that best suits the target profile. By using customized digital presentations as an introduction, the rep will be able to drive interest in subsequent personal or video presentations. More than likely these will be before or after hours as set by the physician’s schedule.

In the case of no-see physicians, digital channels offer an alternate way to reach them via e-detailing, web portals, and the like. In some cases, these channels can even help connect no-see physicians and reps. For example, physicians who are no-see due to office access policies or geography may still be able to connect with a rep after hours via a video detail they initiate.

DELIVERING VALUE
An important lesson from the past few years is that physicians now shape the conversation. We must be continually delivering value to physicians and their patients. If we want to be successful in promoting a brand important to their practice, we must deliver messaging how, when, and where physicians want it. A high level of brand adoption requires a multi-channel approach of personal and non-personal promotion, including digital.

Chris Dowd
Senior Vice President, Market and Product Development
PSKW
cdowd@pskw.com

There are two ways to approach the challenge of hard-to-see and no-see physicians, and both are common in today’s pressurized marketing/sales environment. The first is to keep faith in your sales team! Most “no-see” doctors still see some reps (just not your rep). Great organizations help their representatives find new ways to create in-person access. As former VP of Sales at Pfizer, as well as at start-up and specialty companies, I found that this typically requires more than just great marketing materials; it’s also a function of training more thoroughly, managing more effectively, and guiding the team to a true belief in the life-changing value of the products. The second is to implement a multi-channel mix of non-personal promotional tactics tailored to your situation. This could include a range of online tactics along with tele-reps, video reps, mail, fax, etc.

MEANINGFUL DIFFERENCES AND VALIDATION
Distinguishing a product is a function of its indications, pricing, managed markets position, clinical data, marketing strategy and tactics, etc. Ultimately, we distinguish a brand in the minds of prescribers by providing discriminative information; information highlighting the meaningful differences between our product and the competition. On the other hand, influencing adoption is much more difficult. While information-focused marketing tactics create aware- ness and knowledge, they are not highly effective in persuading an individual to adopt. To “close the deal,” we need to move beyond information to validation. Prescribers validate a new choice using two primary methods. First, they validate a new product through shared experiences of peers. Thus, well- executed peer education programs increase adoption. But the most important method of validation is successful trial with patients. Successful marketers create multiple opportunities for targeted prescribers to try a product. And of course, a crucial part of any trial strategy is a creative sampling strategy, including co-pay cards, vouchers, and other easy-to-use trial incentives.

Daryl Gaugler
Senior Vice President, Commercialization
Quintiles

The pharmaceutical marketplace has changed tremendously over the past few years. Not only is the competition fierce for share of voice across a breadth of therapy areas and among key stakeholders, increasing numbers of prescribers will not see sales representatives. Succeeding in this challenging market landscape requires innovative approaches, strategic solutions, and an array of new technologies. The marketplace calls for breadth, agility, expertise, and a deep understanding of the diverse, global stakeholder landscape—payers, prescribers, and patients. Strategic planning and flexibility are key.

While the number of prescribers who will not see sales representatives is increasing, there are still opportunities for interaction with those prescribers. There’s a plethora of communication channels and innovative methods for delivering product differentiating messages regardless of accessibility, such as remote detailing, call centers, e-detailing, education programs, market access programs, medical communication programs, patient-centric solutions, research and analytics, and sales teams.

Just because there are prescribers who won’t see sales reps doesn’t mean that companies should walk away from a sales model. Again, the key is strategic planning. More than 50% of prescribers see sales reps, so it’s even more important to reach out to that audience strategically and effectively. It’s important to remember that the sales interaction can only improve if the knowledge, information, and exchange factors in the needs of stakeholders. Some of the options include:

• medical science liaisons to work with physicians to speed diagnosis and improve treatment
• key account managers to improve relationships with top prescribers
• call centers to increase market reach
• service specialists to cost-effectively support a sampling program
• therapeutic specialists to add brand credibility
• hot-spot teams to test and support specific geographies, new
  strategies, and precise physicians and healthcare channels

In this new health landscape, where shifting stakeholder power and expectations are making an even more complex and less predictable environment, the growing influence of payers offers a tremendous opportunity for product differentiation. Pharma companies that can demonstrate improved patient outcomes together with economic benefits will be the marketplace winners. Planning for market access and commercial success should start early in clinical development—effectively aligning commercial marketing and clinical product development— what we call convergence.

Todd Courcy
Senior Vice President
Physicians World
A Division of KnowledgePoint360 Group
todd.courcy@physiciansworld.com

Although hospital regulations, healthcare system rules, and group practice policies make communicating with physicians more difficult, the need to effectively communicate with physicians continues to be critical. Old-style promotional activities are less effective; having a strategy to provide physicians with added value is an increasingly important marketing objective.

Physicians World, a division of KnowledgePoint360, offers a fundamental shift away from static web-based platforms with the development of an integrated relationship marketing platform. This platform, iCampus, links physicians with brand attributes and the field force. The technology provides true value by allowing physicians to customize their learning opportunities and quickly find information of most immediate interest. These opinion leader–endorsed sites allow physicians to access clinical data, disease information, patient materials, and other information relevant to their practice.

Interactions on this relationship marketing platform also provide marketing teams the opportunity to integrate other marketing initiatives that may be of interest to physicians, such as access to live meetings and peer-to-peer forums. Physicians can request a meeting with a medical science liaison or a sales representative. These features close a specific gap by creating access where none previously existed.

This technology platform yields measurable outcomes such as utilization rates, duration of site visits, and types of information most often accessed and requested; it can strengthen pharmaceutical companies’ long-term relationships with physicians by providing relevant, real-time information on changes in product information and product pipeline developments. Accessed from desktop and mobile devices, such platforms expand access to physicians by allowing them to create and maintain a long-term learning environment that they customize to their individual information needs and schedules.

The opinions expressed by the authors in the Think Tank section are their own and do not necessarily reflect those of their affiliated companies or organizations.