The pharma industry has been forced to rethink its sales approach as hospitals, physicians, private practices and more continue to converge into connected networks such as accountable care organizations (ACOs) and integrated delivery networks (IDNs). No longer is pharma just dealing with scattered prescribers, but entire entities with large scale needs.
Key account management (KAM) offers one solution to better serve these new customers. Rather than simply employing sales reps who have experience working with individual physicians, key account managers (or KAMs) can help these larger networks focus on the bigger picture and deliver better value to improve patient outcomes. In the run up to eyeforpharma Barcelona 2015, happening March 24 to 26, PM360 spoke to Niall McConnell, Associate Director of Business Excellence at Celgene in the UK. McConnell, who will be speaking in Barcelona about developing the skills necessary for a customer-oriented KAM approach, explained what it takes to implement a successful KAM strategy in your company.
PM360: At the upcoming conference, you’re going to speak about the strategy for a new customer-centric KAM. Can you explain what you mean by that?
Niall McConnell: We’ve come a long way in KAM, although sometimes it doesn’t feel like it. And it’s been a bit of a journey as opposed to a destination, but every time we deal with even little bit of it, we learn something new.
We started out from the premise that our time with prescribers, decision makers, etc., is being cut. The days of the big field forces are done, so we need a new approach to engage our customers. A lot of this has been quite internally focused on how are we going to change, and that’s not necessarily what’s required. Yes, time with customers is greatly reduced, and we need to make sure that every interaction is as valuable as possible. But that doesn’t mean that you have to change your basics. All the things that made good salespeople still count. That’s still very much an important part of making sure that interaction works. But each interaction, whether it is a one-on-one, one-on-group or group-on-group, must be orientated to your customers’ needs. Because just one interaction like that is worth 20 meetings based on your terms.
That brings us to customer centricity. Customer-centric doesn’t mean we revolve around our customers. It means working in our customers’ best interests and understanding what those interests are—not by what we think they are, but by what they want to achieve. It’s very much Sales 101, but it can have a huge impact.
You said that the basic sales approach is still the same. However, other people say that sometimes a company’s best rep doesn’t necessarily make the best key account manager. Do you find that to be true? What skills do you want in a key account manager?
Some of the best sales reps definitely don’t convert to the KAM approach. However, I don’t believe that’s a skillset question. I believe the skills are very similar—those who were very good sales reps can be excellent KAMs. The difference is the cultural set. And if you aren’t able to adapt to the cultural changes, you won’t succeed in the new KAM environment.
Achieving outcomes, win/win solutions—they’re important for both environments. But what’s different is that old school sales reps purely windowed on sales targets and relationships. They haven’t been able to wrap their heads around the fact that they are being measured in a different way, or that they need to go about planning slightly differently. If you can’t accept change, you won’t succeed in this new environment.
Part of the issue, as you said, is that pharma companies are now being measured in a different way. I know hospital systems in the U.S. are now looking at different metrics to evaluate the value of a drug. They are focused on outcomes. What metrics have you seen that hospitals want from KAMs to demonstrate that their drugs provide more value?
That’s a big question. What hospitals say they want are cost savings. What we need to do is help ourselves and our customers understand what “cost savings” mean.
You have to sit down with them and understand where they are—and what they mean or what they think they mean when talking about cost savings. Initially it will be, “I need you to cut the cost of your drug.” That’s definitely a cost saving. But it should be more than that. For instance, could we achieve more by actually prescribing more of the drug—and keep more patients out of hospital? And will this help drive down the overall cost of care within a community?
Now, that’s quite specific to a UK market space—we’re trying to bring secondary care and primary care closer together, and all costs for a patient are now borne out of a primary care market space.
Some hospital systems want pharma to provide more value in other ways, such as in PR training for their staff, IT upgrades or collaborative efforts to improve adherence. In your experience, what types of extra services interest hospitals?
Now that is an interesting question, because we’ve tried many different ways to offer support. Obviously, we’re quite bound by the code of practice as to what we can and can’t offer. So it’s been along the lines of medication education and grants for an area of interest.
But the area in which we’ve had some of our most surprising success is in just bringing different parties together. In the UK, they have all the skillsets, but what they don’t do is come together. And as the NHS has been changing, we’ve helped bring different parties to the table to talk about how care can be managed in your community. We facilitate the conversations.
So, it doesn’t have to be complicated. It doesn’t have to be big programs. Just facilitating conversations has been a huge win.
Do you have any examples of what comes out of these conversations that you’ve been able to help with?
Organized care pathways. Meaning, if you have a patient with a certain disease type, how is that patient going to be treated right from the point of primary care through to secondary care? That way, everybody at each stage of that pathway knows what they need to do for that patient, and they’re confident in what’s gone before and what will come after.
That process just wasn’t there before—because the different NHS groups rarely talk to each other. A lot of time was lost just reviewing records, and what the patient’s history is, and where should they be, and oh, they’re in the wrong place. It’s a real simple win. Having that clean patient flow makes a big impact on administration burden, on time savings and on just getting a greater number of patients through that much faster.
A lot of the issues you deal with are specific to the UK, but are you familiar with KAM strategies in other countries? Or have you been able to pick up anything from colleagues in other countries that have helped your approach?
I’m quite lucky. In our company, we get together with the big five countries across Europe a couple of times a year. We share what we’re doing and look for synergies across market spaces to see what can we learn from what somebody else is doing.
It’s interesting to see how the different market spaces are set up. Some of that is boiled down to our learnings on what we’ve done well and where we’ve won. Obviously, explaining it to other people helps to solidify your own thinking in some ways. I found that the Spanish market is a particularly interesting one. Their key account managers only deal with payers. It’s really about market access. For us, key account management is split, depending on whether you are in a cancer therapy, which has national market access, or in different markets, where you have to actually employ the market access at a local level or through local funding from the primary care market space.
So you’re a market access person, a hospital specialist and a local primary care specialist. Finding the different skillsets for people who can adapt to all these different areas is obviously quite different to a Spanish model, which has two or three key account managers for the country.
I imagine it can be hard to find one person who can handle all these roles, but how important is it for a KAM to be the sole person or “face of the company” to a customer?
KAM has two theoretical models: The bow tie and the diamond. The bow tie has one account manager on the supply side and one on the customer side, and they deal with everybody else within their respective companies.
In the diamond, four or five different people on the supply side deal with four or five different people on the on the customer side—and they’re all dealing with each other in their own parallels. And for me, again, this is where KAM isn’t necessarily a destination. It’s a bit of a journey. We started off in the bow tie, and we’re now in much more of a diamond. But that didn’t happen overnight. It’s taken almost three years of progression towards that goal.
As more companies implement a diamond approach, is there anything else that you suggest they should be doing to improve their KAM model?
If you’re embarking on this, have a sense of realism and speak from experience. One group we know said, “Well, we’ve done KAM now. We’ve rolled it out. That’s finished.” However, changing the culture to get people to think in a different way takes time—people aren’t going to change their behaviors overnight. One of our early problems was top management support. After we initially rolled out KAM, they thought that was it. Then came the first problem and everybody wanted to revert to type and go back to how they used to work.
So just be realistic about what you can achieve and don’t bite off too much at once. It is important to have a strategy that you know will take a number of years to deliver.