Field Force Evolution: Adapting to a New Ecosystem - Pharmaceutical Executive


Field Force Evolution: Adapting to a New Ecosystem

Pharmaceutical Executive

iPads won't save reps

Even if "the most effective selling tool we have is a credible, experienced ­pharmaceutical rep," as Gerry Melillo of PDI puts it, pharma still faces a difficult environment for accessing physicians. Reps are expensive, too, which is making it easier for executives to flirt with new technology; after all, iPads don't pull much of a salary after the initial investment. Most of the first generation, million-dollar physician portals have died quietly online due to physician neglect, but other kinds of non-personal or remote physician engagement are part and parcel of the multi-channel strategy most companies have adopted. Multi-channel engagement is as much about cost savings as it is about serving physician needs. "You're seeing a lot more virtual speaker programs to reduce costs and to reduce travel," in addition to being able to service physicians outside of normal business hours, says Colapietro.

In access-restricted zones like hospital-based networks or academic medical centers, it's important to support other channels for physicians. And for older products at later lifecycle stages, it makes sense to provide basic services digitally; physicians familiar with a product over time don't need a rep coming in again with the same information. But for launch brands and products early in the lifecycle, Melillo says "personal promotion is still what drives [sales]." An Accenture survey from last March found that the top strategic priorities for senior sales and marketing executives in 2013 were, in descending order: reducing costs; mastering multi-channel marketing, improving use and effectiveness of digital marketing; harnessing analytics to drive improved ROI and customer satisfaction; and improving sales force effectiveness.

Ajello says Merck is one of the few companies to successfully build and execute a centralized, closed-loop marketing function based on a technology platform, but he remains unconvinced about the ROI from a "double-digit million dollar investment" in iPads for the entire field force. Gurin says the iPad won't save the rep, "but for the ones who are left, it will probably make them more effective." Not because they can dazzle physicians with interactive promotional materials or let docs self-navigate through a detail, but because companies can push dashboard data out to reps as they sit in the waiting room. That gives reps a chance "to see the latest information on the physician, his patients, his peers, and what he might be interested in," says Gurin. "Companies are moving away from just using iPads as a marketing platform, and are using it more as a business platform to arm reps with the latest business information or relationship information, as opposed to just the e-detail and targeting tool."

As the acronyms start to pile up—ACOs, IDNs, PHOs, etc.—face-to-face access to physicians is expected to decrease even more, as detailed further in the adjoining Quantia/CapGemini study. According to the study's authors, reps will need to become coordinators of information sources, not the predominant providers of it. The technology platforms themselves will take a backseat to the data they generate, and new analytic capabilities allowing headquarters to take a closer look at what's happening everywhere around the world, from the duel perspectives of sales strategy and compliance.

Open Payments upside?

Nothing helps to level the playing field like a new, all-encompassing regulatory requirement. While the cost burden of CMS's recently rebranded Open Payments initiative is significant, it's possible that the law will effectively rein in some of the more excessive "transfers of value" to physicians, many of whom won't like having their names listed next to a pharma company and dollar amount on a public website. If that happens, companies will be pushed even harder to engage physicians and KOLs in ways that don't involve jet setting and haute cuisine. If they succeed, that could be a good thing for the bottom line.

Sales reps, as the first point of pharma contact for many physicians, may serve as whipping boys for potential problems with Open Payments, namely the dispute period, a 45-day dogfight next summer when physicians will be shown their respective dollar amounts prior to publication, and have a chance to dispute them. Colapietro says PwC's clients are trying to figure out ways to "send this information out ahead of time, particularly to their top docs and top teaching hospitals, and to vet that with them outside of the whole dispute process, so they can resolve anything off to the side." In the event that doctors aren't able to resolve a dispute over how much "value" they've received since August 1, the amount will get posted anyway, but it will be posted as being "in dispute."

Colapietro says CMS has "indicated that they're going to monitor companies with an excessive amount of disputes, which could kick off an investigation based on concerns about data accuracy and integrity." In the spirit of controlling costs and doing more with less, sales reps might make a splash with their managers by mitigating disputes beforehand, by explaining the rules and requirements to physicians and addressing any concerns.

Even with a lot of new drugs launching and soon to be launched, sales forces aren't likely to expand very much. But the reps still out there in the field will have to zero in on the key influencers and high-decile docs, and offer them something more, without transferring more value. Relationships, in this context, will matter more than ever.

Ben Comer is Pharm Exec's Senior Editor. He can be reached at


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