sales force empowerment: closed doors and opened windows?

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Sales Force Empowerment: Closed Doors and Opened Windows?

Today’s healthcare landscape is changing. From the ACA to the digital economy to EHRs and beyond,

pharmaceutical companies are being challenged to navigate this new world across their entire value chain,

including the sales model. While reps remain the primary means to deliver product information, a recent report

indicates that it’s becoming harder and harder for reps to access HCP offices, with 49% of physicians placing

moderate to severe restrictions on sales reps (up from 45% in 2013). 1 As this access declines, something must

change in the traditional sales model to enable the commercial team to successfully sell their product.

Why is access continuing to drop?

A number of factors are driving this trend:

First, physicians are just plain busier – they have less time available, whether it’s from needing to see more

patients in a day, dealing with payer reimbursement issues or entering notes into their new EHR system

that the Affordable Care Act is requiring.

Second, the concept of an independent physician is going away – many physicians are now part of larger,

integrated healthcare systems and oftentimes these systems set access rules in order to gain efficiencies to

improve their business model.

Third, with the implementation of the Affordable Care Act, healthcare is shifting from a fee-per-service

model to a values/outcomes based model. The way reps detail a product and interact with the system will

need to change accordingly.

Fourth, with the implementation of the Sunshine Act, there is generally more awareness of the financial

relationship between pharma companies and physicians – and this may lead to a more restrictive access

policy.2 In particular, for those physicians that were accustomed to being paid speaker fees, they may be

more keenly impacted by this new law and move away from relationships where there could be an

appearance of conflict of interest.

Finally, physicians (especially younger ones) prefer to receive information through the convenience of

digital and mobile channels.

1 http://www.zsassociates.com/Publications/Articles/AccessMonitor-2014-Executive-Summary

2 http://www.physicianspractice.com/blog/sunshine-act-shedding-light-physician-pharma-rep-relations

http://www.physicianspractice.com/blog/sunshine-act-shedding-light-physician-pharma-rep-relations


How can reps overcome these barriers?

Successful reps already know that the days of doing a two to three minute “stand-up detail” are long over. Today,

reps must be prepared to:

Make a “total office call.”

Reps must work with not only the physician, but the entire office staff to ensure patient issues are being

addressed, such as reimbursement, REMs requirements or clinical trial enrollment assistance.

Be more in tune with the needs of the doctor and delivering to those needs.

For example, what is his preferred communication channel (e-detailing, dinner programs, email, webinars,

reprints, etc.)? What is the physician interested in learning more about? Enabling this requires the rep to work

with the marketing team to ensure these channels are delivering content specifically tailored to each HCP. In

short, reps must optimize and manage each customer experience in a unique way – something they may not

have had to do as deliberately in the past.

Understand that more physicians are part of health care systems.

These systems not only control rep access, but in the case of Affordable Care Organizations or Integrated

Delivery Networks, drug choice. This means reps must be savvy enough to realize they are selling more than a

pill and be able to speak to the economic and clinical value of the medicine, while knowing how their drug fits

into payer reimbursement. Reps may need to liaise across multiple components of the ACO, hospital or health

system, map the influencers and decision makers in an organization, and sell to these stakeholders.

Leverage new data when it becomes available.

Particularly for new drugs, physicians are more receptive to reps when they can offer fresh insights and

information. That said, the door only remains open for a limited time – it was found that oncologists were

more likely to meet with a rep about a new drug during its first six months post-launch.3

3 http://www.policymed.com/2013/10/nearly-half-of-us-physicians-restrict-access-by-manufacturer-sales-reps-new-strategies-

to-reach-physicians.html

http://www.policymed.com/2013/10/nearly-half-of-us-physicians-restrict-access-by-manufacturer-sales-reps-new-strategies-to-reach-physicians.html

http://www.policymed.com/2013/10/nearly-half-of-us-physicians-restrict-access-by-manufacturer-sales-reps-new-strategies-to-reach-physicians.html

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Be prepared to work and be measured as one, customer-facing team.

Given the impact of the ACA on healthcare, reps will need to work closely with their Managed Markets Account

Manager, Key Account Manager and other reps assigned to the account to ensure all components of the

system are receiving the appropriate amount of unified attention. As one example, GSK recently changed its

compensation scheme from the traditional, individual sales target to one based upon technical knowledge,

quality of service and overall business performance across the sales team.4

Utilize their tablets to enhance details when they do get to meet with the physician

face-to-face.

54% of physicians believe tablets make meetings more valuable.5 Doing so, however, requires knowing the

appropriate time to use them, such as when to show an eye-catching MOA animation or other engaging video.

Understand that access (i.e. call frequency) is not the only metric.

According to a recent survey, overall physician engagement should also be measured.6 This metric should not

only include rep details, but how often the HCP interacts with the company through other channels, such as

opening an email or attending a dinner program. Again, ideally, it is the rep managing these various

interactions.

It’s not just the rep…

With so many demands on today’s reps, the home office must step up its support level as well and make the life of

the rep as easy as possible. A mixture of old and new strategies can go a long way in allowing the rep to spend his

time on what counts - selling. They include:

Rigorously train the rep in pre and post-call planning.

With so many variables now in the mix, pre-call planning cannot be left to the five minutes in the parking lot

prior to making the call. Providing tips on how to navigate these new systems, conduct stakeholder mapping

and leverage counterparts and tools (from NAMs to digital marketing campaigns) enable rep success. After the

detail, the rep must be diligent in responding to what was learned in the total office call.

4 http://social.eyeforpharma.com/sales-marketing/gsk%E2%80%99s-new-incentive-structure-risky-business-or-industry-

leading 5 http://worldofdtcmarketing.com/physicians-expect-more-from-pharma%E2%80%AC/marketing-to-health-care-professionals/

6 http://www.zsassociates.com/Publications/Articles/AccessMonitor-2014-Executive-Summary

http://social.eyeforpharma.com/sales-marketing/gsk%E2%80%99s-new-incentive-structure-risky-business-or-industry-leading

http://social.eyeforpharma.com/sales-marketing/gsk%E2%80%99s-new-incentive-structure-risky-business-or-industry-leading


Have everything at the rep’s fingertips.

Many organizations still provide their reps KPIs and HCP profile information via separate spreadsheets or on

multiple SFA screens. While home office intentions are good, reps don’t have time to search for insights and

performance metrics. Having everything consolidated in one spot, with detailed insights already provided, goes

a long way in making the rep’s life easier and increasing sales effectiveness. It’s important to configure these

support solutions around the rep’s daily process; for example, providing dynamic maps of nearby

accounts/offices can make rerouting simpler should a rep encounter a no-see physician.

Support the sales rep across all channels.

Today, it’s not enough to drop samples and invite physicians to dinner programs. As mentioned, more and

more doctors expect to utilize the spectrum of digital channels to learn about pharmaceuticals – this means

having a digital strategy in place that includes webinars, email campaigns, web resources and e-detailing.

Interestingly, even today, only 10% of physician interactions are digital.7 It also means having the Closed Loop

Marketing capabilities to track these touch points and measure how and when the HCP is engaging with the

company. Arming the rep with this information will allow for more productive, targeted sales calls.

Case Study

A leading pharmaceutical company needed to launch a specialty oncology drug and time was running short.

Knowing that the first six months of the launch were critical to getting their message out, they asked Verix for a

quick-to-deploy, integrated solution, which would provide an in-depth, up-to-date status report of launch

performance.

Within a few months, Verix delivered a comprehensive solution that enabled the team to track performance and be

alerted of any business change or issue that required attention.

The solution Verix provided the client encompassed much more than a typical dashboard or sales report. Of

course, the standard sales and payer information were included; however, many more capabilities were built into

the solution.

For home-office management, executives could see:

Aggregated performance in such key areas as performance-to-forecast, prescriber behavior (new,

continuing, KOLs) and geography analyses. Seeing top level trends allowed the team to drill down to areas

of concern and take action.

7 http://blogs.wsj.com/corporate-intelligence/2014/03/13/the-pharmaceutical-sales-rep-lives-to-fight-another-day/

http://blogs.wsj.com/corporate-intelligence/2014/03/13/the-pharmaceutical-sales-rep-lives-to-fight-another-day/

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Specialty pharmacy statistics – what were average drug dispense times? How long did it take an SP to

obtain reimbursement? Did below average SPs need assistance? Being able to see metrics across SPs (and

compare them) allowed the home office to resolve issues and get the drug to the patient.

Marketing programs metrics – using Closed Loop Marketing, these initiatives (such as Speaker Programs)

were tracked from participants to program cost to ROI. Were the programs impacting sales?

Closed Loop Marketing – see HCP program attendance (left) and Sales change post program (right)

Payer trends – who were the top payers? Could the company improve formulary status with a given payer

or initiate a pull-through campaign?

Call Activity – was the team reaching its call plan goals?

See targets reached launch-to-date


Reps were empowered as well, with the capability to:

Be more patient-centric. They could track patient therapy enrollment, treatment progress and any

reimbursement issues. Doing so allowed the rep to ensure that patients were continuing along in their

treatment path and be alerted to any patients that may have discontinued the drug or were having

reimbursement issues. Reps could also review how many patients were being placed on the drug by

account and see which accounts were part of integrated systems.

Anonymized Patient data allows reps to see where patients are in treatment process – and help mitigate any issues.

Know the status of their treatment centers. For radiology products, reps could see where locations were in

the registration process. They could answer vital questions such as, has the hospital applied? Is it

licensed? Is it patient ready? Does it have product? If not, the rep could take initiative to step in and help

clear any roadblocks.

Forecast their business more accurately. By seeing both scheduled and planned treatments in aggregate,

they received a good barometer of futures sales. They knew when business was falling off or picking up,

and could act accordingly.

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Reps can track patient treatments, completed and planned – essentially creating a sales pipeline.

See how patients were being diagnosed via ICD-9 codes, helpful for tailoring details. This information was

also useful to the brand team as they developed on-label marketing materials.

Be automatically alerted to what was working – and not working so well – in the territory. These

“HotSpots” put the power of analytics in the hands of the rep. For example, reps could see physicians who

had patients with treatment gaps.

HotSpots help the rep easily see how he can impact performance.

Analyze their business from multiple angles. Reps were able to view what doses were being used the most,

or how these medications were being paid for - commercial payer or Patient Assistance Program.


As Dr. Bridget Duffy, Chief Medical Officer at Vocera said, “the single most broken thing in healthcare is

communication.” This statement could be applied across the board, reflecting the communication between various

instances: practitioners, healthcare systems, physicians, and more. With so much information competing for

analysis and attention, providing sales teams with the right insights and tools to succeed is paramount. Armed with

a 360-degree view of the business, from patients to doctors, the rep can have a much more meaningful and

focused interaction with his customers.

While the trend of diminishing access to physicians may be disappointing to the pharmaceutical industry, the

physician may be opening a window as he closes the door. This window provides an exciting opportunity for the

commercial team that didn’t exist in the past – the opportunity to communicate with the doctor in new ways and

manage this relationship across multiple channels.

By empowering the sales team with easily digestible and actionable information, the industry will be able to

provide more value to physician – which ultimately benefits the patient and the bottom line.


About the Author

Greg Barlow is a veteran of the pharmaceutical industry. Before joining Verix, Greg led business analytics for Gilead

Sciences and CV Therapeutics. In his present position as Senior Director of Product Marketing and Business

Development at Verix, he brings an extensive background in strategic management, positioning Verix as the

business analytics solution for Life Sciences.

sales force empowerment: closed doors and opened windows?

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