Detailing Gets Personal

August 1, 2003
Ronald Branning

Ronald Branning is the vice president of corporate quality assurance at Gilead Sciences, Inc.

Pharmaceutical Executive

Pharmaceutical Executive, Pharmaceutical Executive-08-01-2003,

As pharma sales forces grow and their productivity declines, the question on everyone's mind is, "Has the traditional detail lost its punch?" The answer is unequivocally no. The sales force is still the best medium for forging valued and trusted relationships with targeted physicians.

As pharma sales forces grow and their productivity declines, the question on everyone's mind is, "Has the traditional detail lost its punch?" The answer is unequivocally no. The sales force is still the best medium for forging valued and trusted relationships with targeted physicians. But industry's current focus on volumetric measures-the high number of sales reps and frequency of sales calls-rather than the effectiveness of those calls is causing a growing number of doctors to close their doors against detailers.

Reversing that trend requires a "repersonalization" of the selling process. Integrated physician segmentation, a predictive model that allows pharma companies to better target doctors and make each interaction more valuable to them, aims to do that by understanding and satisfying individual doctors' needs.

Instead of categorizing-and targeting-physicians by the volume of prescriptions they write, integrated segmentation analyzes individual prescribing behaviors, demographics, and psychographics (attitudes, beliefs, and values) to fine-tune sales targets. For a particular product, for example, one segment might consist of price-sensitive physicians, another might include doctors loyal to a given manufacturer's brand, and a third may include those unfriendly toward reps.

This article shows how pharma companies can capitalize on integrated segmentation by creating and implementing more personalized brand messages and strategies that resonate more strongly with targeted physicians, leading to more positive doctor rep interactions and increased access.

The Psyche

In other industries such as automotive and finance, integrated segmentation has a proven track record. Whether it's BMW seeking prospects who value driving performance, Volvo pursuing the safety-minded, or Mercedes looking for "prestige" buyers, those companies use psychographic knowledge as a marketing mainstay.

Integrated segmentation can drive more effective pharma marketing and sales strategies in the same way. Some pharma companies, like Atlanta-based UCB Pharma, have already bought in.

UCB recently worked on an integrated segmentation project for its anti-epileptic drug Keppra (levetiracetam) and now plans to launch the program throughout the company. (See "UCB's Pilot Project," page 68.)

Steve Banet, UCB Pharma's director of market research, says, "This program enables our reps to customize their approach to physicians, providing greater value and better meeting their needs. I expect continued success as we roll this out throughout UCB."

It's a Process

There are four steps to designing and implementing integrated segmentation strategies: discovery, design, analysis, and application. (See "Segmenting, Step by Step.")

Before beginning, pharma companies must explain the project's objectives to all key internal stakeholders from marketing, sales, and sales training. In the initial phase of discovery, those stakeholders help companies, and the consultants they hire, assess the product environment, set goals, identify problem areas, and determine the project's scope. (See "Checklist for Success," page 70.)

The second phase, design, defines the project. At that stage, companies employ diverse data sources and analytic techniques to determine how to accurately allocate market and sales strategies for targeted brands. The necessary data include physicians' prescribing behaviors, demographics, attitudes-such as how they feel about managed care-values, and lifestyle factors that may affect their prescribing activity.

Executives then compile secondary research, such as de-identified longitudinal patient measures that provide insights into physicians' behavior relative to switching, titration, new therapy starts, new patient starts, and concomitant therapies as well as more traditional research, such as physician prescribing and overall promotional data, to create a complete understanding of physicians. The more extensive the knowledge and data that companies factor into the front end of the integrated segmentation process, the more accurate the predictive modeling will be.

Much of the secondary research and demographic information companies use in that phase already exist, and it can be drawn from current databases. However, pharma companies can survey a sample of physicians to collect additional details about their attitudes, values, and lifestyles. The survey might include, but is not limited to, physicians'

  • approach to patient treatment (specific to disease state)

  • clinical concerns such as efficacy, safety, side effects, and drug interactions

  • ease of titration

  • formulation preference

  • cost sensitivity

  • brand sensitivity

  • conservatism versus willingness to try new things

  • degree of technological savvy

  • reliance on sales reps for information

  • social skills

  • association of products with key attributes.

Because the results and the ensuing interpretation are only as good as the quality of the initial survey, prior input from all internal stakeholders and pre-testing the questionnaire with doctors to fine-tune it are critical. It is a good idea to survey several hundred physicians, including some who prescribe the company's product and others who do not.

Using a variety of statistical methods, including decision tree algorithms, self-organizing maps, and latent class analysis, marketers can marry the responses with the physicians' demographic data and prescribing behaviors and identify the variables that cause greatest differentiation. Out of dozens of variables, typically the top four or five variables as identified by the segmentation technique determine the segment physicians will fall into. As one might expect, that segmentation differs from product to product, depending on the characteristics of the therapeutic category and the drug in question.

During the analysis phase, executives profile and name the segments to begin building a predictive model. Some physicians might fall into a segment described as "product innovator" and "rep friendly," others into "product conservative" and "rep unfriendly." (See "A Closer Look," page 70.) Once the segments are defined, secondary information, such as prescribing behavior data, managed care influences, and group practice membership help shape the predictive model that projects the segments all doctors within the target market will fall into. And once companies assign physicians to segments, they can automatically deduce their psychographics and attitudes because the segments were initially developed with primary, representative research on those variables.

Analysis is Not Enough

Definition and analsis of segments, and the ability to project psychographics and attitudes, are meaningless unless they are used to transform a pharma company's marketing and sales processes.

In the application phase, the internal stakeholders agree on the marketing messages, as well as the sales and media mixes for each physician segment. To develop marketing strategies, the team revisits the responses to survey questions that helped determine physician segments in the first place. For example, do physicians in a particular segment find sales reps useful in keeping them informed of the latest treatments? In prescribing new therapies, do doctors base their decisions on who the manufacturer is? Does a particular segment enjoy socializing with, and is it influenced by, leaders in its field? The survey also produces significant information regarding how, in doctors' minds, the product is competitively positioned within the market, based on critical attributes such as efficacy, tolerability, and side effects.

Factoring in all such data, pharma executives can develop marketing and sales approaches for each segment. During that process, marketers need to take a hard look at all current promotional materials. Some may still be usable, while new collateral material may need to be created. Marketers may even determine that sales reps shouldn't visit some segments, even those that contain high prescribers, if they are unreceptive to detailing or if the possibility of those physicians prescribing the company's drug is very low. As an alternative to an in-person detail, companies may find that using direct mail or e-detailing is more productive and cost-efficient for those groups.

For segments that sales reps should concentrate on, the promotional plan will indicate

  • detail frequency

  • messages to support the product and messages to counter physicians' objections

  • what materials to exclude

  • what other promotional tools-such as e-letters, thought leadership and peer influence programs, and programs for fellows/clinical liaison and medical information scientists, should supplement the detail.

"The result of the segmentation process can't be academic," says UCB Pharma's Banet. "If you use the word 'psychographic' with a sales rep, he or she will immediately tune you out. They want to know how to be more effective. Is this physician interested in clinical data? Is he or she influenced by peers?

"The final product must have real-world implications for interacting with doctors. When a rep identifies a doctor as a 'segment number six,' that rep should immediately be able to paint a picture of what that doctor's characteristics and needs are and be able to customize their message accordingly. At the end of the day, we need something that's not only strategic, but tactical and implementable."

Piloting Pays Off

Before completely rolling out such a program, companies should implement a pilot involving a small percentage of the sales staff. It's important to ensure that participating reps are appropriately compensated, no matter how the effort turns out.

To make the assessment valid, executives must carefully choose test and control territories. Companies that quantify the effectiveness of the integrated segmentation approach by tracking and measuring results help gain assurance that it works before the full roll-out. In addition, assuming the results are positive, the rest of the sales force subsequently will be more willing to adopt the concept when companies implement it companywide.

To further strengthen sales rep buy-in, marketers should share how they developed the segments and administer exercises that engage reps in the process. Role playing, in which reps interact with mock physicians, can also teach reps how to best employ the recommended strategies and counter physician arguments against product positioning. No predictive model is 100 percent accurate. However, integrated segmentation can predict the correct segment for any given doctor with 75 80 percent accuracy.

For the rest, sales reps are armed with one or two questions to ask physicians or their staff that will tease out the appropriate segment membership. The response to "How concerned are you about managing your patients' pain?," for example, can confirm whether a doctor has been accurately placed in a segment or whether he or she should be moved into an adjacent one.

Finally, no pharma company using an integrated segmentation approach can afford to be satisfied with a single study at one point in time. Doctors and markets are constantly evolving. Marketers should review segments and the physicians within them annually or after every major new development.

In most cases, the segment characteristics will remain stable, but individual doctors should change segments as the sales and marketing approach moves them into higher-prescribing segments, which is the goal of the segmentation and targeting strategy. However, if a major market event occurs, such as the introduction of a new product or generic, companies may find it appropriate to conduct a new segmentation study.

To optimize their value, pharma companies must transform hard-core quantitative data into more qualitative human factors that marketing departments and sales reps can use effectively. Pharma companies usually outsource that whole process to incorporate the most diverse data sources and technical resources.

But regardless of how companies get the study done, a robust understanding of physicians as human beings, with distinct sets of attitudes and values, can better position companies to listen and respond to their needs with highly targeted information, such as thought leader testimonials for those who are most influenced by their peers.

As insiders and outsiders alike continue to scrutinize pharma's sales forces, the industry needs to undertake new approaches that will make this critical medium more effective. Integrated segmentation promises not only to increase prescribing volumes but also to generate a positive shift in doctors' perception of reps' value. And that's a critical step in harnessing the full potential of industry's sales forces.

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