2. Executive Summary | At the Health Experience Project, we
believe the right experience can change everything.
Every day, the Health Experience Project explores the
experiences that are changing outcomes for people, for
professionals, and for brands. In this report, we’ve curated
some of our most important findings from the frontlines.
Inside, you’ll find the big trends that are changing
pharmaceutical sales and the new best practices and
opportunities those trends are inspiring.
3. INSIDE THIS PERSPECTIVE
Designing the Pharma Rep Experience for 2015 brings together research from the Health
Experience Project, GSW, and other experts across our industry.
SECONDARY RESEARCH FROM:
Manhattan Research, ZS
Associates, PwC, Booz Allen
Hamilton, Accenture, Hay
Group, INSEAD, IBM, Deloitte
Special thanks to our core contributors: Alex
Brock, Bill Robinson, Dawn Marinacci, Joy
Hart, Kevin Coleman, Leigh Householder, Matt
Cash, Michael Krohn, Nick Bartlett, Ritesh
Patel, Ryan Deshazer, Tyler Durbin
HANDS ON EXPERIENCES WITH:
RepLab: Exclusive think tank that brings
together field reps from our contract sales team
with iQ, our product development lab
Rep rides: Accumulated experience from over
100 rep rides around the world
Global digital collaborative: 62 specialists
from across our global network committed to
innovation
To discuss this report live or request a presentation, please contact Leigh
Householder at 614-543-6496 or leigh.householder@gsw-w.com.
5. NEW GLOBAL
CENTER IN
ASIA-PAC
DOCTORS LESS
CENTRAL IN
HEALTH
GLOBAL
SYSTEMS
IN CRISIS
PAYERS
FIRMLY
IN CONTROL
1 2 3 4
CUSTOMER
NEAR
UNIVERSAL IPAD
ACCESS
HIRING
THE
COMPETITION
FEAR
OF THE
CLOSING DOOR
5 6 7
TRENDS OVERVIEW
TALENT
STRATEGY
THE NEW
REP-RELIANT
BLOCKBUSTER
DISCONNECTED
DIGITAL
TOOL SET
DETAILING
FOR THE
DOUBLE YES
WORKING
WITH NEW
PREFERENCES
8 9 10 11
6. The Asia-Pacific region, including China, Japan, India, Australia and
Korea, is projected to be the single largest contributor (46%) to global
pharmaceutical market growth through 2015. But the shift won’t come
without new challenges.
Without the margins to support large sales forces in the long-term, Asia will be
where we crack the code on remote selling.
1
80,000
90%
Number of sales reps in China, making it the
largest pharma sales force in the world
Level of deep discounts imposed by some
governments on healthcare products
Pharmafocus, Mark Mallon, regional vice president Asia-Pacific and president China, AstraZeneca, 2012
NEW GLOBAL CENTER OF
OPPORTUNITY IN ASIA-PAC
7. DOCTORS BECOMING LESS
CENTRAL TO HEALTHCARE
2
We’re about to double the number of people in so-called rich countries who
are 65 or older. There simply won’t be enough doctors to treat them. Teams of
caregivers will close the gap.
Detailing this diverse workforce will require deep understanding of each
organization’s specific care model and competency in building connections
within it.
New roles beyond nurse
practitioners
America developed the roles of NPs
and PAs. Their next innovation:
diagnostic medical
sonographers, These 2-year degree
careers are expected to grow by 44%
between 2010 and 2020.
India is the critical
first mover
Britain has 27.4 doctors for every
10,000 patients. India has just 6
doctors. To make it work, they’ve
developed true medical
homes, forcing each professional to
only work at the top of his skill set.
Bureau of Labor Statistics, 2013; The Economist, Squeezing Out the Doctor, 2012
8. GLOBAL HEALTHCARE
SYSTEMS IN CRISIS
3
Reps will increasingly be selling into healthcare systems experiencing new
levels of crisis and looking for lifeboats
• Rising toll of chronic disease worldwide
• Aging model not built for new needs in healthcare
• Cost pressures from all sides
Administrators and practice leadership will be looking for partnership in
identifying solutions that reduce total costs.
Lancet, McKinsey, 2011
Long the envy of the world, even Japan’s kaihoken is struggling
Japanese people see doctors twice as often as Europeans and take more life-enhancing
drugs. They stay longer in hospitals and have one of the lowest infant mortality rates in the
world. Yet Japanese healthcare costs are a mere 8.5% of GDP. Still, the country's universal
payer system is embattled. Since it was established in 1961, the proportion of people over 65
has quadrupled to 23%; by 2050 it will be two-fifths of a population that will have fallen by 30
million. Experts say it’s beginning to fail under the pressure.
9. PAYERS FIRMLY IN CONTROL4
The next 3 years have been described as the perfect payer storm.
Empowered, frustrated insurers are using all their tools to put new demands
on manufacturers and practices.
The opportunity to help practices effectively navigate the new landscape and
get patients access to their preferred medications will fall to reps and their
support organizations.
Pricing controls: Like Germany’s new required 16% rebate
Outcomes expectations: Like value-based systems in Sweden, Singapore & Canada
Generic push: Including India’s generics-only drug list for prescribers
Prescription limitations: In the US, 16 states have monthly Medicaid drug limits
Coverage denials: NICE (UK) rejected reimbursement for 9:10 end-of-life cancer drugs
PharmaExec, 2012
10. The 10-year tradition of digital detailing finally has the tools to deliver the
experience we always imagined. Today most reps are armed with the
touchscreen tablets:
Use and adoption remain uneven in part because opportunities still include
improving the experience for reps and doctors by reducing fragmentation and
innovating interactions.
NEAR-UNIVERSAL IPAD ACCESS5
Manhattan Research, Cognizant: How to Properly Deploy the iPad Within the Pharma Sales Force, 2013
8:1066% 76%
Of the reps US
doctors see in a week
are using a tablet
Of “Big 10” global
pharma are using or
rolling out iPads
Of doctors are
satisfied or very
satisfied with those
iPad interactions
11. If you’ve launched one diabetes drug, why not another? By far, manufacturers
are hiring from their competitors' field sales forces, only infrequently tapping
other departments within the company or sales professionals outside the
industry.
Pharma sales are vulnerable to big innovation from outsiders.
HIRING THE COMPETITION6
INNOVATIONACCESS
They’re counting on "years of
pharma industry sales
experience" to deliver lots of
positive existing relationships.
But will organizations be able to evolve
when only 40% rely on interpersonal
competencies to inform their hiring
decisions and 20% factor in business
acumen or scientific expertise?
Hay Group, 2013
12. High no-see rates have
made reps cautious
about protecting the
access they
have, ultimately limiting
how aggressively they
pitch existing contacts
and how frequently they
knock on new doors.
There’s untapped
opportunity to foster
bolder closing behaviors.
FEAR OF THE CLOSED DOOR7
45%
2x
2/3s
Of prescribers restrict sales
reps' access
As many as the number that
fenced off their practices in
2008
Of oncologists have
"moderate to severe" rules
governing rep visits. Even
the best reps visit
oncologists just once per
month
ZS Associates, 2013
13. Marketing was the major driver behind the last generation of mass-market,
mass-scale blockbusters. But the new generation of highly specialized,
highly expensive drugs requires more individualized selling and learning.
The conventional wisdom about the selling mix is about to change.
A NEW PARADIGM: THE
REP-RELIANT BLOCKBUSTER
8
Biologics are taking
the lead
Designed for very
targeted patient
populations with few
treatment alternatives
Biosimilars changed
the conversation
New choices in old
categories will require
reps to deliver subtle
value props
New incentives will
shift focus
Incentives will be
weighted to these life-
long, higher-cost
drugs
14. Reps tell us that the tools they have at their fingertips are more
sophisticated than ever. They’re tracking their weekly sales goals in real
time, sharing 3D models with doctors, and learning about new
opportunities all on one screen—well, one screen with 15 different
programs and passwords. Reps are hoping for a more singular dashboard
and more flexible learning tools.
DISCONNECTED DIGITAL TOOL SET9
Personal dashboard: All their individual numbers and product news in one place
Dr-involved detailing: Over half of US docs have already taken iPads out of reps’ hands
Digital leave behinds: In-detail tools to email or text desired information to a doctor
On-the-go learning: Their downtime is in the car; why does training require a screen?
Manhattan Research, RepLab, 2013
15. We’re watching a major shift in risk and responsibility from payer to patient.
That’s creating new challenges for doctors and manufacturers alike.
Reps will need to foster transparency into the real world behavior, asking
doctors to not only write the Rx but help ensure it gets filled.
DETAILING FOR THE DOUBLE YES10
Avoiding a surprise when they get there
In Spain, the central payer now requires
patients to pay the full price for 450
prescription medicines. Around the world,
pharmacists are incented to swap branded
drugs for cheaper generics.
Getting patients to the
pharmacy counter
24% of patients given a new
medication by their doctor
never fill the prescription.
PharmaExec, 2012; CVS, Harvard, 2011
16. Many physicians are changing their preferences for how they work with
manufacturers, mixing up when and where they want to interact with
reps, peers, and on-demand education.
That’s going to require more flexible approaches in communication and
more compelling reasons to spend time live.
WORKING WITH NEW
PHYSICIAN PREFERENCES
11
DIGiTAL
???s
Many physicians report a preference for digital
marketing and education, citing limits in their time and
availability as key reasons why
Physicians in Europe, particularly, are also
concerned about improper promotions
or even the appearance thereof
Wall Street Journal, Lilly Plans to Lay Off 30% of Its Sales Reps, April 2013
18. All the
answers
(in best-fit
media)
Influencer call
plans and
content
Flexible
contact model
Reconnect
marketing
and sales
Feature-rich
engagements
REP EXPERIENCE 2015 BEST PRACTICES
Tools, experiences, and expectations
designed to stand out in a crowded
marketplace—or even just a crowded
waiting room
19. FEATURE-RICH ENGAGEMENTS
The best iPad details don’t center on a
long, sequential brand story.
Instead, they’re a collection of
shareworthy features that compel
people to lean into the little screen:
• Novel illustrations
• 3D models
• Interactive tools
• Participatory inquiry
Learn-from example: Medtronic
Medtronic used scored, simulated surgery tools to
increase the number of doctors willing to schedule
cases or educational events with the brand.
We all learn more when we participate.
Get healthcare professionals more
actively involved in the discussion by
handing over the screen and
providing them with content they
can navigate or—even better—play
with.
20. RECONNECT MARKETING AND
SALES
One of the biggest complaints we hear from reps about CRM is they don’t get anything
out of it. Their contact notes pass collected insight up the chain, but in the field, the most
they get is a reminder of what they last talked to a doctor about. CRM should do more:
Learn from industry: Automotive
Big CRM initiatives score leads for local dealers and
pass opportunities back up the chain for new launches.
Warm leads from the marketing suite: Alert a rep when a local doctor has interacted
with the product website or a direct marketing initiative to open a new door
Prompts for new offers/engagements: Automatically show a rep when new content or
a local event are available for his doctors. Request a direct send in one click.
Report back what works: Use a simple dashboard to show what content or news is
working for other reps and is making an impact in direct or digital marketing
21. DELIVER ALL THE ANSWERS
(IN THE BEST-FIT MEDIA)
Learn from outsider: Zappos
Zappos call center reps are empowered to solve almost
any challenge a customer can bring their way, making them
one of the most loved and trusted brands in shoes.
Increasingly the rep will be the main
service point for the healthcare
professional – asked for insight on
everything from access to a medical
specialist to navigation in a complex
reimbursement environment.
That’s a whole new battlefield. One that
requires innovative new tool sets. All
built in a flexible system that allows
immediate ―leave behinds‖ via
email, SMS, or even Bluetooth printing.
Formulary
model
Patient
tracker
MSL
video
connect
Best
practice
briefs
Workflow
tools
Training
guides
22. INFLUENCER CALL PLANS—
AND, CONTENT!
Although the specific titles and roles vary by country, the
medical home model is drastically changing medicine
across regions. Today, decision making in the practice is
fragmented and typically not at all on the same page. Reps
need to consider every professional in the mix.
Strategist
Medical
specialist
Primary
support
Nurses and
techs
Practice
manager
All office call
connect:
Lunch and learns and
other cross-office calls
will connect
conversations and foster
synergy in prescribing.
Personal tools
activate:
More custom
interactions with HCPs
who are below the
specialist will earn
deeper conversation
and lasting loyalty.
23. FLEXIBLE CONTACT MODELS
Learn from example: Pfizer
Pfizer Pro offers members easy access to connect
with their rep, request samples (for personal or
drop-ship delivery) or launch on-demand education
Reps need to be able to connect with each
healthcare professional on her own terms.
That means a more flexible detailing
suite, one that works as seamlessly when
they’re together at the office or on other
sides of the city:
• Feature-rich, in-person tools
• Turnkey web and video conference
platforms
• Easily shared, self-guided modules with
self diagnostics and one-click follow-up
THE DETAILING SUITE
In person
Remote/virtual
Self-guided
26. ON-THE-GO LEARNING
Learn from outsider: Cracker Barrel
You can’t get more outside of healthcare than Cracker
Barrel, but the exit-ramp chain knows how to support travelers
with borrow-anywhere, return-anywhere audio books.
The downtime our reps have is in
their cars, often when they’re
covering larger and larger
territories. But the training tools
we provide require screen time
(or even paper reading).
The new opportunity will be
developing real on-the-go
learning modules that integrate
new training—from data
translation to segmentation—into
busy schedules with better media.
DM download: An auto-synced, podcast-style
broadcast that reps can play on their iPads
(syncing through Bluetooth to play through the
cars’ stereo systems)
Monthly magazine: 60 Minutes-style
audiobook with coverage across the
organization
Special segments: Quick download
―chapters‖ on critical segments or selling
strategies
27. AFFILIATE LABS
Learn from outsider: United Way
This massive nonprofit credits most of its successful
national programs with cultivation at a very local level.
The affiliates are chiefly responsible for trial and refinement.
Today’s pharmaceutical franchises have multiple centers of power, with tens of
thousands of reps in global centers like China, western Europe, and the United
States. Each of these major affiliates—and many of their smaller siblings—are a
proving ground for new ideas and approaches. No more will the best strategy
come from the global team; instead, it will be discovered by that team.
Ad hoc competition will deliver proven
approaches for global rollout
The data from the success of the affiliate
programs will be the go-to business case
for broader rollout and refinement.
Global teams will become
Opportunity Spotters
Watching for high-potential
programs and ideas being
―piloted‖ in the local affiliates.
28. DYNAMIC CONTENT AND CALL
ROUTES
Combine the geolocation features in a
rep’s iPad with the deep data from a
company CRM to get more efficiency
and deeper personalization.
Cognizant, How to Properly Deploy the iPad Within the Pharma Sales Force, 2013
Know the rep:
Show real-time call activity and
dynamically reroute reps based
on proximity to opportunity, recent
calls/cancelations, even traffic
patterns.
Know the healthcare professional:
Recommend relevant content for the call or prompt new learning modules with
just-in-time relevance. Follow up with quick requests for rep ratings and feedback.
29. MAKING THE PACKAGE SALE
A number of converging trends—from more personalized medicine to more
commoditized categories—will prompt a more packaged selling system, one that
combines a diagnostic tool with a proven support system to both identify a
patient and help him or her succeed on a given Rx.
Diagnostic + Product + Support
[more personalized medicines] [more successful patients]
More medical knowledge for
reps, ability to give live
demonstrations, and do
hands-on training with staff
New kinds of research and
data that prove the outcomes-
based value of patient support
programs
30. NAVIGATORS OF NEW DATA
The shift to more outcomes-driven reimbursement is changing the kind of data doctors
want. But that doesn’t mean the skills to use it—or challenge it—will be there.
Reps will be the field guides who help use EHR to power investigator-initiated
mini trials:
From: The results of big, multi-
phase, clinical trials
To: Experience and data about patient
populations like theirs
• Working with physicians in large practices
to pilot new drugs/indications with small
numbers of patients
• Mining/comparing/rationalizing the data
• Empowering entirely new kinds of
KOLs, ones driven by numbers, relevant to
small groups of peers, and connected
across digital networks
31. TALK TO US
To discuss this report live or request a presentation of
trends, please contact Leigh Householder at 614-543-6496 or
leigh.householder@gsw-w.com.
Visit us at GSW-W.com
Or HealthExperienceProject.com