Transforming The Sales and Marketing Model
Sales reps have been a fixture of the pharmaceutical industry since the 1940s. Originally known as “detail men,” the rep was perceived by doctors as a trusted colleague who provided valuable information about pharmaceuticals, information unavailable elsewhere. Reps were so trusted that in a 1959 survey of doctors, more than 95% of the doctors said they “strongly disapproved” of physicians who wouldn’t speak with sales reps!1
Fast forward to 2016: The number of physicians willing to see reps has dropped to less 50% and most doctors have restrictions on when they will see pharmaceutical reps.2 Today, the typical length of a detail call is less than 3 minutes (and in fact may be only a minute or so). On a given day, reps are lucky if they can call on 5 or 6 physicians, spending the majority of their working hours waiting and driving. While some, typically older, physicians still believe that reps provide valuable information about their drugs, most doctors are receiving drug information from multiple sources. Physicians are more often today working in institutions or for groups that have policies barring reps; many medical schools are teaching new medical students to be skeptical of pharmaceutical reps.3 The times have changed, and radically.
Yet the commercial model of pharmaceutical companies remains relatively unchanged. Companies still compensate reps based on prescriptions written, GSK notwithstanding; they deploy their sales teams to the field (albeit in smaller numbers than in the high-flying 1990s), and expect that the brands will be launched, sustained and reinforced against competitive forces based on the same sales strategies that have been used for the past 75 years. True, there are now brand websites, impersonal promotional programs, and alternative channels for delivering samples, but these marketing tactics are still seen as subordinate to the job of the sales force. They are planned and implemented in silos apart from the work and the tools of the rep. The orthodoxy still stands: if you want to market your brand, you need a sales force.
Last year, the consulting firm PWC surveyed 150 pharmaceutical sales and marketing executives on how the commercial model in their company was changing to meet the realities of a highly restrictive customer environment.4 It’s not that novel models aren’t being piloted, but almost 75% conceded there were no transformational changes and that most new approaches were a refashioning of the traditional sales and marketing models. Of the more innovative approaches, two judged to be among the most successful were the Clinical Specialist Model and the Service Rep Model. Clinical Specialists involves deploying an elite team of highly trained reps who have substantial medical knowledge. The Service Rep Model is an approach where lower cost resources (without clinical expertise) are deployed to the customer site to deliver the marketing support tools, including samples.
The Service Rep and Clinical Specialists divide the traditional sales force role of clinical expertise and service support in half. Conceptually this makes sense, as it allows brands to reestablish their value as a source of high quality pharmacological information, and at the same time provide better customer service with a broad reach at a more affordable cost. However, making this pairing work requires a new choreography of brand sales and marketing efforts. To explain, let’s explore why the traditional rep role has worked in the past: The sales rep arrives at the office, armed with samples. He or she is shown back to the sample closet to refill the shelves, and then (if the stars align), crosses paths with the doctor (who is running between patients). In this instance, the rep presses the doctor for a valuable minute, whereupon the doctor agrees (often only grudgingly) and the rep quickly delivers the detail. The rep thus created a “clinical moment” in the busy workday of the doctor where one didn’t exist before.
If we deconstruct the traditional model, allocating the roles between clinical and service, we lose the opportunity for happenstance encounters. This means that in order for Clinical Specialists to make themselves available to physicians, they need to be scheduled (as they are far too valuable of a resource). Whether the Clinical Specialist’s detail is 10, 15 or 20 minutes in length, it is no longer just a stolen minute, shoehorned between patients. Instead, there needs to be coordination that both optimizes the Clinical Specialists time and is scheduled for the convenience of the physician.
Some companies have experimented with a flexible model of deploying some Clinical Specialists to the field to service their key accounts, while other specialists are retained inside, delivering details through videoconferencing. Video details may be more effective than live ones as they force participants to stay focused and maximize time. Moreover, a well-coordinated scheduling approach can result in a throughput of more than dozen impactful and engaging clinical details in the course of the day. These details can be scheduled for off-hours, don’t impinge on the clinic’s workflow of seeing patients, and usually do not conflict with institutional policies barring sales reps.
The role of the Service Rep also needs to be remodeled to reflect the realities of the continual reduction of access to customers. In addition, fewer promoted drugs are offering patient samples, so brands need to take a fresh look at what customer service means, providing heightened value beyond filling and organizing the sample closet. Sales managers need to widen the customer service lens and look beyond the physician to the needs of the nurses and the entire office staff. Some pioneering brands have scanned other B2B industries beyond the life sciences to generate new concepts of service. They have also adopted measures of service performance, utilizing tools such as the NetPromoter score to assess how well they are doing at meeting customer needs.5
In a healthcare environment that has closed the door to reps, brands need to convey their customer presence in new ways. One successful approach that is being used by some forward thinking companies is the use of inside Service Reps. Teams of phone-based Service Reps create and maintain relationships with office managers, reaching them using chat, email, and phone. While they can’t physically open a box of samples and place them on the shelf, they can continually ensure that the office has available brand resources, providing both reach and frequency at a cost that field based Service Reps can’t match.
Of course the inside Service Rep model provides a natural opportunity for choreography and scheduling of the Clinical Specialists. With each touch, the Service Rep can offer in-person or video details. And by offering details that are topically varied, with broader clinical value, prescribers will deem them of value to the entire clinical staff.
This choreography between the inside Service Rep and the Clinical Specialist needs to be maintained utilizing a flexible digital infrastructure that manages customer relationships. The approach needs to be multi-channel, incorporating digital micro-sites for scheduling, emails and direct mail that reinforce brand value, and content that continually provides a heightened sense of brand presence and customer support. Unlike one-off marketing campaigns or other limited tactics, the sales and marketing approach required for the new commercial environment is one of total integration. Brand messaging and support needs to work hand-in-hand with the effort of Service Reps and Clinical Specialists.
Piloting and building this new approach is not easy, although many companies have taken steps to move in this direction. There are numerous factors that have kept the old commercial sales model is place (sales compensation models are probably the biggest reason). However, it is clear that with the emergence of outcomes based medicine, personalized medicine, and a shift towards more specialty medications and drugs with complex pharmacology, the transition is occurring.
The biopharmaceutical industry must change to be relevant in a world where drug information is available through multiple channels. It must change to be acceptable in a healthcare environment that has become skeptical, if not hostile to the industry. The traditional rep relationship has already changed, but the industry needs to recognize that it needs to transform how it provides value to customers. To do to this it will have to change the way that it touches customers from unplanned face-to-face visits, to a highly choreographed multichannel approach where touches are coordinated to support both service needs and educational needs.