Volatile; Uncertain, Complex, Ambiguous - VUCA Best Describes Pharma Environment Today.

MEDICINMANField Force Excellence
TM
September 2013 | www.medicinman.net
“VUCA”–TheNewNormal.
HowWillPharmaIndustryinIndiaRespond?
Editorial
P
harmaceutical Industry in India has been hit by
turbulence at a pace that can be best described by
the term – VUCA: Volatile, Uncertain, Complex and
Ambiguous. If MNCs operating in India have been hit by
Compulsory Licensing and uncertainty about patent validity,
domestic companies have been no less impacted by the
DPCO and the ensuing stalemate of stocks stuck at various
levels in the distribution chain. FDI in Pharma is an issue
that impacts both MNC and domestic pharma companies.
What the impact of all these VUCA factors will be is hard to
envision. But one thing is certain – not only are business
leaders apprehensive but most new entrants and mid career
pharma professionals are equally apprehensive about their
career prospects.
Against this backdrop, reading about and understanding
VUCA is essential. Harish Manwani, chairman of Hindustan
Unilever, in his AGM address, has spoken of the need for
business leaders to learn to lead in a VUCA environment.
Referring to the volatile change of governments in the
Arab world as well as the bankruptcy of industry leaders
like Kodak, Manwani rightly calls for business leaders
to communicate their vision within and outside their
organisations. Leaders who are not in touch with the reality
and live in denial are likely to face the fate of Kodaks and
Arab rulers.

Editorial: “VUCA” - The New Normal | Anup Soans
Connect with Anup Soans on
LinkedIn | Facebook | Twitter
Visit anupsoans.com.
Meet the Editor
Anup Soans is an
Author, Facilitator
and the Editor of
MedicinMan.
Write in to him:
In an article,“Living and Leading in a
VUCA World”, Paul Kinsinger and Karen
Walch of Thunderbird School of Global
Management suggest 5 practical steps:
1. Create a vision and“make sense
of the world.” Sense-making is more
important now than at any time in
modern history for companies, as we
are not too far away from the time
when the global economy will be truly
“global”: encompassing every country,
in which competitors will emanate
from everywhere.
2. Understand one’s own and others’
values and intentions. Know what
you want to be and where you want to
go at all times, while staying open to
multiple ways to get there.
3. Seek clarity regarding yourself
and seek sustainable relationships
and solutions. Leading in turbulence
demands the ability to utilize all
facets of the human mind. Even the
most impressive cognitive minds will
fall short in the VUCA world - it will
take equal parts cognitive, social,
emotional, spiritual, and physical
intelligence to prevail.
4. Practice agility, adaptability and
buoyancy. Be responsive and resilient
with the ability ride out turbulent
forces that cannot be avoided and
to pivot quickly to seize opportunity
when it presents itself.
5. Develop and engage social
networks. The days of the single“great
leader”are gone. In the VUCA world,
the best leaders are the ones who
harness leadership from everyone.
These 5 steps hold great lessons
not only for business leaders but for
professionals as well. Welcome to
the VUCA world! You can’t stop the
turbulence but you can ride it out and
become the go-to navigator when your
company hits turbulence a la VUCA!
Your career is your responsibility.
Take charge of it and learn to harness
your full potential from the latest
research in neuroscience and other
fields to develop the right mindset and
capabilities. Read the leaders in this
issue of MedicinMan.
K. Hariram’s article effectively
brings out the lack of effective
communication and the creation
silos. Salil Kallianpur once again gives
us clear insight into FDI in Pharma.
We have a very interesting article
by Dr. Anirudh Malpani on what
the Pharma CEO should do to get
the right ROI from the efforts of the
Field Force. Srinivas Pothapagrada
is our new talent; a Medical Rep, he
writes on the importance of career
planning. Dr. Amit Dang, continues his
pharmacology knowledge series on
the important topic of diabetes. Health
2.0 is a great forum spearheaded by
Dinesh Chindharkar and there’s a
report on the recent meet in Mumbai.
There’s a great article on the KAM
experience in the U.K. and lessons
for India on this important emerging
topic. All in all, it’s another value-
packed issue to deal with VUCA. Happy
reading and please pass on the issue to
friends in pharma. - MM
Leadershipforvucatimes

3 | MedicinMan September 2013
MedicinMan Volume 3 Issue 9 | September 2013
Editor and Publisher
Anup Soans
CEO
Chhaya Sankath
COO
Arvind Nair
Chief Mentor
K. Hariram
Advisory Board
Prof. Vivek Hattangadi; Jolly Mathews
Editorial Board
Salil Kallianpur; Dr. Shalini Ratan; Shashin
Bodawala; Prabhakar Shetty; Vardarajan S;
Dr. Mandar Kubal; Dr. Surinder Kumar
International Editorial Board
Hanno Wolfram; Renie McClay
Executive Editor
Joshua Soans
MedicinMan Academy:
Prof. Vivek Hattangaadi, Dean, Professional Skills
Development
Letters to the Editor: anupsoans@medicinman.net
1. FDI in Pharma.......................................................5
Fears about rising costs and predatory tactics of
MNCs are unfounded.
Salil Kallianpur
2. Special Report: Health 2.0 Mumbai.................8
Health 2.0 Mumbai Chapter was attended by
professionals from pharma, healthcare, IT,
diagnostics and others.
MedicinMan Report
3. What the CEO Wants from You..........................9
The CEO wants his Reps to understand the Doctor -
the primary customer - and his needs.
Dr. Aniruddha Malpani
4. Career prospects for Reps in the Pharma
Industry..................................................................11
The opportunities are plenty. Reps must be
prepared for when opportunity presents itself.
Srinivas Pothapragada
5. Careers in Pharma Sales and Marketing........14
Growth areas for Medical Reps in the pharma
industry.
Anup Soans
6. Key Account Management: Lessons from the
UK Experience........................................................15
Four simple steps to KAM excellence.
Ralph Boyce & Tejinder Chandhyoke
7. The High Cost of Operating in Silos................20
Managers who fail to communicate proactively, risk
having to deal reactively with negative emotions
from their team.
K. Hariram
8. Management of Diabetes Mellitus - I..............25
Knowledge for the Field Force Series
Dr. Amit Dang
Contents (Click to navigate)

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                          
                          
                          
                         
FFE & Brand Drift 2014
Advance Announcement:
Encouraged by the overwhelming response for Brand Drift
and FFE 2013, we are happy to announce the following:
1. Brand Drift and FFE will be held on consecutive days in
2014.
2. Dates: 7, 8 February 2014 at Courtyard Marriott, Mumbai.
3. Pharma Service Providers are invited to partner with us for
this event.
CONTACT
arvind@kmv.co.in | +91-987-0201-422

E
FDIin
Pharma
Fears about rising costs and
predatory tactics of MNCs are
unfounded.
Salil Kallianpur
E
arlier this month, a Parliamentary Standing
Committee tabled its recommendations
on Foreign Direct Investment (FDI) in the
pharmaceuticals sector. FDI refers to a foreign individual
or an overseas corporation investing in an Indian
company to expand operations, acquire whole or parts
of the business or build new facilities.
Surprisingly for a country that recently prided itself
for unshackling its economy and pushing pro-growth
reforms, the Committee recommended a blanket ban
on FDI in brownfield projects which means it doesn’t
want foreign pharmaceutical companies to invest in
existing Indian ones.
INDIA ALLOWS 100% FDI INTO GREENFIELD
PROJECTS
To be fair, India allows 100% FDI into greenfield projects,
which means foreign corporations can begin operations
in India, build factories, invest in R&D set-ups and create
jobs for Indian citizens. If it is as good as it sounds,
why aren’t foreign companies investing in greenfield
projects? This is because while India supports greenfield
projects in letter (through a policy document), it does
not support it in the spirit.
Setting up such projects requires land, labour and
capital. You must have seen the tussle that companies
like Arcelor Mittal (owned by an NRI, L.N. Mittal),
Vedanta (Anil Aggarwal), another NRI) and Posco (South
Korean steel company) are going through to acquire
land to set up factories in Orissa. You will also remember
the infamous Tata Nano factory ruckus in Singur, West
Bengal. India’s labour laws are archaic and pro-labour.
Salil Kallianpur is
Commercial Head - Classic Brands
Center of Excellence, GSK. He is a
well-known pharma blogger and
social media enthusiast.
salilkallianpur.wordpress.com

FDI in Pharma: A Foolish Proposition | Salil Kallianpur
While this is good to protect the poor labourer, more
often than not it creates incentives for local politicians
to control labour bodies (unions). The government
hardly intervenes for fear of upsetting their vote-
banks (eg: labour unrest at Honda and Maruti-Suzuki
factories in Gurgaon). As far as capital is concerned,
one only needs to recall the horror that Vodafone
went through when tax laws were amended ad-hoc
to suit the government’s need. I will not even delve
into other areas such as India’s lack of commitment
to R&D, acute shortage of skilled scientists to employ
in R&D facilities and the uncertainty created by
draconian regulations in the Clinical Trials sector. This
very broadly explains why foreign companies are not
interested in greenfield projects.
RECOMMENDED BAN ON FDI IN
BROWNFIELD PROJECTS
In this context, the ban on investments into
brownfield projects (existing companies) is surprising
for two reasons. First, this is the sector that the global
industry is attracted towards and FDI can bring in the
much required foreign exchange into India which
will reduce the ballooning Current Account Deficit
(CAD). This deficit occurs when India pays more for
goods and services that it imports than it earns from
those that it exports. In simple terms, India spends
more than it earns and this is bad for the economy.
So, if foreign companies invest in India, it brings in
much needed revenue. Second, the recommendation
comes from a legitimate body (a Parliamentary
Standing Committee) that is mandated to think
rationally and rule in the best interests of the Indian
people. What is shocking is that this committee
seemed more driven by public perception and chose
to value Bollywood actor Aamir Khan’s judgement
over those of veteran economists!
FOREIGN COMPANIES WILL STOP MAKING
AFFORDABLE GENERIC MEDICINES
The argument central to the recommendation is
that FDI poses a direct threat to the access and
affordability of medicines and threatens to elbow out
our domestic pharmaceutical industry. This line of
argument shows a complete lack of understanding of
how the global pharmaceutical industry operates.
Foreign firms are not acquiring Indian generic
companies to stop generic medicines. With a huge
number of products going off-patent globally,
pharmaceutical companies are building their
capabilities to sell generic drugs. They are acquiring
Indian companies for their strength in generics,
Foreign firms are
not acquiring
Indian generic
companies to
stop generic
medicines. With a
huge number of
products going
off-patent globally,
pharmaceutical
companies are
building their
capabilities to sell
generic drugs.
“
”

FDI in Pharma: A Foolish Proposition | Salil Kallianpur
not to obliterate them. Hence, the concern that India’s
pharmaceutical industry will die if foreign companies invest
here is silly. Why would Mylan – a global generic company
spend $1.6 billion to kill Agila Technologies (the sterile
injectibles arm of Strides Arcolab)?
Another argument (more moral than rational) is that FDI in
the sector will hamper Indian medicine exports. Currently,
India exports drugs to more than 200 countries and
vaccines and bio-pharma products to about 151 countries.
The export growth rate is around 10 percent per annum.
And the major chunk of exports relate to generic drugs.
A third argument is that prices of medicines will rise in
India due to FDI inflows. This despite a recent study by
India’s own Department of Pharmaceuticals that found
domestic drug prices to be immune to acquisitions. It is
also interesting to point out here that the largest critics of
the recent Drugs Price Control Order (DPCO) were Indian
companies and not foreign firms. Indian companies were
also guilty of over-charging Indian patients, an accusation
levied against foreign firms. While the intention is not to
paint foreign firms as angels in pristine white clothing, the
economic merits of the argument are lost in this worthless
rhetoric.
If anything, economic literature suggests that inefficient
firms will lose market share due to foreign competition,
which in the long run should increase the overall efficiency
of the Indian economy. If foreign firms set up shop through
acquiring the existing operations of Indian companies,
would they willingly kill a market as lucrative as India by
stopping production of medicines, increasing prices to
satisfy their capitalistic greed or stop the poor from buying
their products? Does this even make business sense?
The Standing Committee recommends a ban despite the
government’s conditions that foreign companies after
acquisitions in India will continue manufacturing at current
level for 5 years, invest in R&D and not stop making generic
medicines. This is hardly the way a nation with a crumbling
economy, desperate to prove its investor-friendly
environment can afford to behave.
It is very clear that a FDI inflow into the pharmaceutical
sector is only beneficial for India and its citizens.
Foreign firms can be expected to bring in new products,
technologies and governance standards. If India opens
its markets to them, the government can begin to lure
them into investing in PPPs that are key to building much
needed health infrastructure.
If universal health coverage of Indian citizens is indeed
on the mind of the government, paying heed to sound
economics is a much better way of deciding what is good
for the nation and its citizens rather than letting foolish
emotions destroy our country. -SK
If anything, economic
literature suggests that
inefficient firms will lose
market share due to foreign
competition, which in the
long run should increase
the overall efficiency of
the Indian economy. If
foreign firms set up shop
through acquiring the
existing operations of
Indian companies, would
they willingly kill a market
as lucrative as India by
stopping production of
medicines, increasing prices
to satisfy their capitalistic
greed or stop the poor from
buying their products? Does
this even make business
sense?
”
“

E
Special Report | Health 2.0 Mumbai
Health 2.0 Mumbai
‘Be the change you want to see’. This was the motto behind
an informal and unconventional setting that marked the
commencement of the recent meet-up of Health 2.0 Mumbai
chapter held on 23rd
August 2013.
Health 2.0 a global entity, has been providing a common
platform to promote and harbor innovations and ideas for
improving healthcare. Being true to the Health 2.0 global
culture, the meet up captured in its essence novel health ideas
and health innovations to discuss patient-centered healthcare
through the use of digital & social media and leveraging
technology.
Organised by Dinesh Chindarkar, Health 2.0 Mumbai Chapter
leader, the event was attended by professionals from pharma,
healthcare, IT, diagnostics etc. James Mathews, Chairman –
Health 2.0 India, spoke about how Health 2.0 is evolving in the
country and making difference in patient’s lives across India’s
population from rich to the poor. Amrita Naimpally, Global
Business Development Lead at Medtronics, mentioned that the
main goal of healthcare is to empower patients and described in
details about their Adivasi initiatives which they are conducting.
Mr. Ravi Desai CMO, Metropolis Lab – one of the largest chains of
diagnostic labs in the country, expressed the need of diagnostics
to emerge as a strong pillar for healthcare in India. He also
proposed on thoughts on implementing preventive healthcare
in India. This was followed by panel discussion by delegates from
across the healthcare industry - Mr. Salil Kallianpur from GSK,
Dr. Malpani MD at H.E.L.P., Mrs. Priti Mohile from Mediamedic
Communications and Erin Little, Founder – Sucre Blue gave the
audience a varied perspective on preventive healthcare and
connected the varied dots within.
Shreekant Pawar, co-founder Farasbee & Dr. Yogesh Patil co-
founder of Biosense– demonstrated their start up product
– Diabeto & uCheck respectively.‘Diabeto’– is a device which
helps connect glucometers to smart phones and relay data;
whereas uCheck does urine analysis on 10 different parameters.
Both being interesting ventures to empower patients in taking
care of their health.
A lot of interaction with the audience made the Health 2.0
Mumbai chapter meet-up a productive one; that will help the
community to grow rapidly and provide unique solutions to the
changing healthcare scenario within India. -MM

What the CEO
wants from You
T
he business strategist, Ram Charan, has written an excel-
lent book called - What the CEO Wants You to Know: Using
Your Business Acumen to Understand How Your Company
Really Works. If you want to progress through the ranks, you need
to know how your boss, his boss, and your boss’boss – the CEO -
thinks , so you can deliver what they want from you.
A major problem with many companies is the lack of communica-
tion between employees and managers; and if you are not aware
of the“big picture”and what the company is trying to accomplish,
you are likely to be left behind when it’s time for promotions!
Let’s start from the basics! If I were your CEO, what would I want
you to do, to help our company to excel?
The primary job of a CEO is to maximize profits, and as a pharma-
ceutical company CEO , the best way of doing this is to maximize
the number of prescriptions of my drugs.
The CEO wants his Reps to understand the Doctor - the
primary customer - and his needs.
Part - I
Dr. Aniruddha Malpani
Dr. Aniruddha Malpani, MD
is the Medical Director at
Malpani Infertility Clinic in
Mumbai.
E

“
”
Since the people who write the prescriptions ( the influencers
and the decision-makers ) are doctors , like any sensible CEO,
we will need to spend a lot of our energy in convincing doctors
to prescribe our drugs. This is what the Pharma industry has
done for many years, using advertising and marketing and an
army of medical reps in order to create relationships with doc-
tors, so that doctors will prescribe their brands.
However, this is a broken model. For one, it’s very expensive
and cost ineffective. This is a very competitive field, because
all pharma companies are vying with each other to occupy the
same limited“top of the mind”space in the doctor’s head. This
means that it is no longer cost effective to continue to use this
technique - and it’s only because of inertia that companies con-
tinue to do so. This doesn’t mean that medical reps are going to
become obsolete – but we are going to have to reinvent their
role! This is both a challenge and an opportunity!
Governments worldwide are exerting regulatory pressure in
order to crackdown on the doctor - pharma nexus, as this has
been one of the reasons drugs have become so expensive and
cause healthcare costs to spiral out of control. Since providing
financial gratification to doctors has become illegal in India,
this is now being done under the table, as a result of which it
becomes that much harder to crack! Sadly, many companies
merrily continue using inducements (such as funding overseas
trips to medical conferences) in order to manipulate doctors.
Until the Indian government makes an example of erring doc-
tors and the companies who indulge in these malpractices, this
is unlikely to change in the near future. The tragedy is that it is
the senior, influential doctors (who have the most clout), who
are part of this nexus. And because they benefit the most from
these sponsorships, it will have to be an outsider who will need
to clean the system. The good news is that principled doctors
are refusing to be manipulated by Pharma companies. They are
no longer willing to spend their time seeing medical represen-
tatives without a clear return on their time invested. So the old
fashioned route of influencing a doctor based on his relation-
ship with the company reps is going to die a natural death.
So what is the alternative? We still need to influence doctors,
and if we refuse to do this unethically, what are my options?
The answer is simple – we need to make the doctor’s life as
productive as possible. If we can solve doctors’pain points, they
will be obliged to us, and the first principle of exerting influ-
ence is that of reciprocity. Doctors whom we can help would be
much more willing to prescribe our drugs (and we know their
quality is good – most drugs today have similar bioequivalence,
no matter who manufactures them!)
So what are the doctor’s pain points which we can help to solve
in a cost effective manner? We will look at this in the second
part of the article in the October issue. - AM
Why Great Strategy Often Fails | Prof. Vivek Hattangadi
We still need to
influence doctors, and
if we refuse to do this
unethically, what are
my options? The answer
is simple – we need to
make the doctor’s life as
productive as possible.
If we can solve doctors’
pain points, they will be
obliged to us, and the
first principle of exerting
influence is that of
reciprocity.

11 | MedicinMan June 2013
Career
prospects
for Reps in
the Pharma
Industry
T
he job of a Medical Rep is very challenging and
also at the same time very exciting. Medical Reps
communicate and get in touch with a plethora
of genres of people having different backgrounds and
upbringing. A successful Medical Rep has a“Go Getter”
attitude. Medical Reps have to manage each and every
aspect of sales of their products. Right from the supplier
to the distributor; to the Doctor and the chemist till it
reaches the patient. Their job involves lot of physical
and mental stress, and they have to sacrifice their
personal life in order to achieve targets.
There are many Medical Reps who take up the job out
of their own“interest or passion”. But there are also a
considerable number of people who consider this job
as a“first-step”for their career or as a“part-time job”
until they get a better job. Some take up this profession
casually, thinking this profession to be an additional
source of income, apart from their already established
business. And there are others, who take up this job
because they want to join management courses which
demand work experience. The mental, physical and
emotional stress and strain experienced in the job
cannot be handled by all. There are many Medical Reps
who take up another profession even after 10 to 12
years!
Apart from those who are really interested and
passionate about this profession, there are many who
want to leave the profession for many reasons. The
reasons may vary from health and age related factors,
to interests and career preferences. But the world
outside of pharma is also not easy. Generally, a Medical
Srinivas Pothapragada
Srinivas Pothapragada is
a front-line professional
at a leading Pharma
company.
E

Career Prospects for Reps in the Pharma Industry | Srinivas Pothapragada
12 | MedicinMan June 2013
Rep is accepted only in the sales roles of another company
or other sectors like insurance or automobiles, and there
they have to face the same situation. The Pharmaceutical
Industry itself has plenty of opportunities to explore and
excel. So why go somewhere else? Unless Medical Reps
have some“back-up plans”to settle down in life, in some
other profession of their own interest, it’s very difficult
to get a job whose profile caters their personal and
professional needs.
In this article, I offer some tips on Back-Up Plans which
would really help them to excel in their desired career.
These plans must implemented while justifying the present
job as a Medical Rep
1. Always follow your interest - Have an ambition and give
your 100 per cent to achieve it. Never become complacent
and never compromise. If you are a Medical Rep, then it’s
not the end of the world. You are fortunate to experience
the life of a Medical Rep. It teaches you many things. If you
want to get into Product Management, then make it your
goal and work on it.
2. Do NOT change your career goals - If you keep
changing your career goals, it will get you nowhere. If you
are good at doing sales analysis, then you will have good
opportunities of getting into Sales Force Effectiveness.
3. Work on your career goals - Do something which
shows that you are good in that particular area. For
example, if you are good at scientific knowledge and
you are good at communicating the same, then practice
presenting them; and you can get into the Learning and
Development team.
4. Show-off whatever you do Show-off your
achievements to your peers and superiors. Let them
know that you are interested to work in that area because
you have the talent and skill. For example, if you are good
at Branding and Marketing activities, participate in events
pro-actively, conduct events and CMEs with your doctors
and make an impact. Make an analysis of the changes
which took place before and after your efforts to establish
the brand in the market. Brand yourself to get into the
Marketing team.
5. Half knowledge is dangerous - If you feel that you are
not aware of some things related to the domain in which
you want to make your career, enroll in a course to learn
more about it. For example, if you are interested to get
into the Logistics team, and you don’t know much about
logistics, then your chances are very slim. Many universities
offer part-time or distance courses which allow you to work
and study.
6. Correlate your academics to your interest and career
goals - After spending lot of money on your academics, if
you are feeling that you are not able to use your academics
in your job, think again. You will be able to explore lot of

Career Prospects for Reps in the Pharma Industry | Srinivas Pothapragada
opportunities if you correlate your academics, interests, and
career goals. For example, if you are a life sciences graduate
or a post-graduate, then you can get into Clinical Research
or Pharmacovigilance. Or if you have done your bachelors
or masters in law, you can also get into the Compliance
Team. If you are good at numbers, Finance is another
option.
Missing something important?
You can access all past issues of MedicinMan at: http://medicinman.net/archives.
Be sure to Subscribe on our website (top-right corner: www.medicinman.net)
to stay up-to-date with us.

HardKnocks for the GreenHorn | Anup Soans
Anup Soans
“Cave dwellers froze to death on beds of coal. Coal was right
under their feet, but they could not see it, did not know about
it, and, therefore, could not mine it or use it.”
The moral of the story: Ignorance is not bliss. Knowledge
gives you power to change the course of your career and life.
Thousands of graduates, both men and women, are
unemployed, underemployed, or do not have long-term
career goals. They are not fully aware of the opportunities
available to them. They land up in a job by chance, somehow
manage to go on month after month and year after year,
and end up frustrated, disgruntled and disappointed. What
happens to these once-bright sparks? Where does their
enthusiasm go? Why do they stop dreaming and pursuing
their goals?
HardKnocks for the GreenHorn is designed to inform
and equip young graduates with Survival Skills in a hyper-
competitive sector.
Understanding the background in which an industry
operates is essential for anyone desiring to make a decent
career. Every town in India with a population of over
one lakh has openings for qualified people (graduates,
preferably in life sciences) to join the pharmaceutical
industry as Professional Service Representatives (PSRs).
They are also known as Medical Representatives, Territory
Sales Officers, Business Managers, and such other titles as
appropriate to the recruiting company's strategy and goals.
Every company desires to have dynamic, hardworking and
knowledgeable PSRs in their employment to further their
business goals. Most PSRs are well paid and well trained, as
they are the critical link in the pharmaceutical industry's
business operations. The PSRs are responsible for achieving
the company's sales targets on a monthly, quarterly and
annual basis. Their Area Managers assist them in this task
by regular supervision and guidance. Regional Managers,
Product Managers and others also contribute to the PSRs'
success, and a clear understanding of the company's
objectives and sales process is essential for a PSR to succeed,
excel and grow.
The aim of this book is to equip the PSR with the necessary
Attitude, Skills and Knowledge. These facets will equip him
with a distinct personality and differentiate him from his
peers in the marketplace as a professional who performs his
functions competently. The effective PSR can look forward
to a rewarding career, which will enable him to earn well and
grow professionally.
The performing PSR must aim to be promoted within three
to five years to the position of an Area Manager in his own
company or wherever opportunity beckons. The more
ambitious PSRs must earn a diploma or degree in marketing
in order to qualify as Product Executives.
The main streams of career advancement for PSRs are:
1) As a territory and people manager responsible for
achieving the sales targets of his team and territory 2)
As a product and promotions manager responsible for
developing and executing the marketing strategies of his
company, and 3) Other health career related service sectors.
All these streams are challenging, and one must pursue the
opportunities best suited to one's skills and inclinations
or make the most of opportunities as they come. There
is a dearth of talent for newer avenues like international
marketing. There are openings too for the posts of training
manager, sales administration manager and distribution
manager. More avenues will open up in pharmaceutical-
support fields such as Health Care Advertising,
Health Care PR, Health Care Market Research, Health Care
Publishing, and a host of allied industries that cater to the
growing pharmaceutical and health care industry.
The pharmaceutical industry is full of top-level executives,
including CEOs, who have been promoted from the ranks
of PSRs. These were men and, nowadays, women with drive
and attitude who acquired knowledge and skills and grew
from one level to the next unmindful of the hardships and
adversities they encountered along the way while moving
themselves and their families to different situations and
cities. They were always willing to adapt and learn new skills
and face challenging situations on a daily basis in order to
achieve their career goals. What is important is that one
must make a beginning towards a fruitful career, and the
role of a PSR is the ideal starting point even for IIM or
other MBA graduates desiring to make useful careers in the
growing health care sector. - AS
Careers in Pharma Sales and Marketing
Adapted from the
book HardKnocks
for the GreenHorn
by Anup Soans.
Available at a Special
Price. See page 19
for details.
E

E
A
t present in the UK, Key Account Management
(KAM) is the flavour of the day. This is because
recent changes to both the structure and man-
agement of the NHS (The National Health Service) have
changed the way many Pharmaceutical organisations seek
to interact with NHS stakeholders, moving from direct sell-
ing approaches to account and key account management.
Due to this, Pharma organisations in the UK now have
several years’experience in applying KAM across our in-
dustry and have made and corrected many mistakes in the
process.
From discussions with our international colleagues, it seems
that a number of other markets may, in the future, follow
the path to KAM albeit for many different reasons.
One of the first learning’s was the necessity for new KAM
teams set out to describe their vision of KAM as a complete
business function, incorporating operational methodology.
This minimises the potential for uncoordinated implemen-
tation and inherent waste.
Using an industrial engineering paradigm, we might define
KAM in terms of 4 integrated process cycles.
1. The Management Cycle
2. The Operations Cycle
3. The Account Planning Cycle
4. The Opportunity Cycle
KeyAccount
Management
Lessonsfromthe
UKExperiencefor
IndianPharma
Ralph Boyce & Tejinder Chandhyoke
Ralph Boyce is a Director of Pharma-
ceutical Management Intelligence Ltd.
(Pharma MI).
Tejinder Chandhyoke is a Key Account
Manager with Pfizer who previously
worked as an Account Manager in India
for a number of years.

Key Account Management: Lessons from the UK Experience | Ralph Boyce & Tejinder Chandhyoke
By designing and following these 4 KAM Process Cycles you
can turn a Mission into a Vision and finally into a successful
Operation.
1. The Management Cycle
The management cycle seeks to describe an approach, where-
by the organisation can achieve best management practice in
its operation of KAM. The Management Process cycle is based
on generally accepted principles and techniques, such as Peter
Ducker’s Management by Objectives, and those of other like-
minded individuals, complemented by in-house expertise, ex-
perience and best practice. This model operates on the basis of
Mission, Vision, Objectives, Organisation, Communications and
Performance. Effectively, these headings are translated into
meaningful Management functions, which are linked together
to form the management process designed to suit the mission.
In the main these management functions and their associated
management and leadership techniques are well understood
within our industry.
2. The Operations Cycle
As a first step we need to identify the actual Key Accounts
which require to be effectively managed within the teams Key
Account Management Operation.
We would need to undertake some basic research in order to
ensure that we have a genuine understanding of what actually
makes up an Account. A good example of this in the UK Hospi-
tal market would be whether we identified individual Hospitals
as Key Accounts, or whether we identified Hospital Groups
which combine smaller Hospitals into bigger Key Accounts.
Then we would seek to design and refine the KAM organisa-
tion, to ensure that it comprises all the necessary resources to
permit effective Key Account Management.
The Indian pharmaceutical industry is on a strong growth path
with the total value expected to reach almost $50 Billion by
2015-2016.Secondary Care (Institutional Business) constitutes
about 7% of Pharma sales in India. Institutions can buy from
appointed stockists and directly from the company.
Key Account Management requires the segmentation of large
multi bed hospitals as KEY Accounts on the basis of its affili-
ations to either a Medical college or, a well-established chain
(Fortis, Appollo etc.) Whereas smaller district hospitals, local
dispensaries etc. will be treated as TRANSACTIONAL (Non-Key)
accounts.
As regards the Key Accounts, The KAM will map the key stake-
holders in these accounts who have the authority to procure
either directly from the company and or through the appoint-
ed stockists through tendering. Well established relationship
engagement is essential to secure regular business.
Fig. 1: The KAM Management Cycle
Fig. 2: KAM Operations

Customer-Centric Interaction for the MR | Ralph Boyce & Tejinder Chandhyoke
As regards Primary Care (Community Pharmacy Business)
there are approximately 600K pharmacies in India and of
these only 3% are part of organised Pharmacy chains, the
remainder of 97% is independent, and they can only pro-
cure their stock from Pharma Company appointed stockists
(wholesale distributors).
The KAM, in this part of the business, has to work very closely
with the appointed stockists in order to procure regular busi-
ness. In these circumstances a primary opportunity is to drive
stock (stock sold to the stockist from their Pharma company.)
from the stockists to the wide number of retail pharmacies
month on month. The KAM’s ability to influence these sales
will earn creditability and future business from the stockist.
There are currently over 2500 large appointed/recognised
stockists in India, and some of the retail pharmacies some-
times have the potential (high turnover) to be categorised as
the KEY account. The rest of the pharmacies are designated as
transactional accounts (Non-Key) on the insight/knowledge
of the KAM.
3. The Account planning cycle
Key Account Management is often driven through Account
Plans, although in more sophisticated Implementations, the
Account Plan Process is complimented by the Opportunity
Process.
The Account Plan Process itself consists of Designing and
Developing and Operating in accordance with an agreed
Account Plan specifically designed for each Key Account. This
becomes the responsibility of the KAM in question.
The Key Account Manager is seeking at this level to identify
the objectives and priorities of both the Key Account Man-
ager and their Key Account Contact. This would permit an
understanding of the particular accounts budgetary situation
and processes, and allow the KAM to identify the objectives
and priorities of the Key Account, which can be turned into
individual opportunities. The KAM is also seeking to develop
a full understanding of the account level stakeholder map,
which consists of the major stake holders from within the Key
Account’s Management organisation as well as interested col-
leagues from the KAM’s own organisation. Once this has been
completed, the KAM seeks to identify a Primary Opportunity
to progress for the benefit of both organisations.
4. The Opportunity Cycle
This leads us to the Opportunity Management itself which
most Key Account Managers would consider is the primary
driver of success. The opportunity process is initiated by
clarifying the full circumstances surrounding the previously
identified primary opportunity with the KAM’s primary con-
tact. The KAM would seek to agree exactly what is of interest
Fig. 3: Account Plan Management

Customer-Centric Interaction for the MR | Ralph Boyce & Tejinder Chandhyoke
to them, and how that can be turned into a Solution, and
subsequently driven through as an Opportunity.
The KAM should next seek to obtain a joint agreement be-
tween the KAM and their primary contact that the opportunity
is worth pursuing from both of their perspectives. They would
jointly define a Solution, and in the process identify the Deci-
sion Making Unit i.e. those individuals responsible for making
the decision. Once the DMU has been documented, the KAM
would identify and then constantly monitor the position of
the DMU as regards whether it is‘For’or‘Against’the proposed
solution. Then, when the DMU has a majority in favour, the
KAM would seek to close the Opportunity with agreement to
implement. Once the Opportunity is closed, either successfully
or not, the KAM could move back to the Account Plan Process
in order to seek a new primary Opportunity, and so the process
continues to cycle. - RB & TC
Fig. 4: Opportunity Management
Abdul Basit Khan
Ajay Kumar Dua
Amlesh Ranjan
Amrutha Bhavthankar
Andris A. Zoltners
Anthony Lobo
Aparna Sharma
Arvind Nair
Atish Mukherjee
B. Ramanathan
Chayya Sankath
Craig Dixon
Devanand Chenuri
Venkat
Dinesh Chindarkar
Dr. Amit Dang
Dr. Aniruddha
Malpani
Dr. Hemant Mittal
Dr. Neelesh Bhandari
Dr. S. Srinivasan
Dr. Shalini Ratan
Dr. Surinder Kumar
Sharma
Dr. Ulhas Ganu
Geetha G H
H. J. Badrinarayana
Hakeem Adebiyi
Hanno Wolfram
Hitendra Kansal
Iyer Gopalkrishna
Jasvinder Singh
Banga
Javed Shaikh
Jitendra Singh
John Gwillim
Jolly Mathews
Joshua Mensch
K Hariram
K. Satya Mahesh
Ken Boyce
Mahendra Rai
Mala Raj
Manoj Kumar
Mayank Saigal
Milan Sinha
Mohan Lal Gupta
Neelesh Bhandari
Neha Ansa
Nishkarsh Likhar
Noumaan Qureshi
Parveen Gandhi
Pinaki Ghosh
PK Sinha
Prabhakar Shetty
Vivek Hattangadi
Rachana Narayan
Rajesh Rangarajan
Ralph Boyce
Renie McClay
Richa Goyel
Richard Ilsley
RM Saravanan
Sagar S. Pawar
Salil Kallianpur
Salil Kallianpur
Sally E. Lorimer
Sandhya Pramanik
Sanjay Munshi
Shafaq Shaikh
Shalini Ratan
Sharad Virmani
Shiv Bhasin
Spring Sudhakar
Subba Rao Chaganti
Sudhakar Madhavan
Tony O’Connor
V. Srinivasan
Varadharajan K.
Vijaya Shetty
Vishal V. Bhaiyya
Vishal Verma
Vivek Hattangadi
William Fernandez
Our Authors
MedicinMan invites contributions from Pharma professionals on topics related to Field Force
Excellence. See: www.medicinman.net/author-guidelines for more information.

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I
n one of my recent visits to my Orthopedician’s
clinic, as I was waiting to meet the doctor, I hap-
pened to see a couple of pharma MRs waiting to
make the call.
I overheard a conversation amongst themselves.
One MR in a complaining tone was sharing that
though the wage settlement was signed couple of
months ago, there was no further communication
about the implementation of the revised wages
plus the fate of retrospective payments.
The effort to seek clarification by the field team had
not met with any response across the hierarchy
of sales management including HR. the standard
answer was‘ it will happen’or a vague response.
Other MRs surrounding him were giving their
opinion, suggestions and also some ideas. Most of
those were negative or reactive.
Though it sounds very familiar and oft repeated
scenario, it rang a bell in my mind with unanswered
questions:
Why does this happen time and again?
Why is this allowed to happen?
Whom should the MR seek clarification from - re-
sponsible insiders or disconnected outsiders?
Is the management ignorant of the consequences
or is it‘ don’t care’attitude towards the sales people
who are the GOLDEN GOOSE and their positive
mental framework leads to GOLDEN EGG (revenue
E
K. Hariram is the former MD
(retd.) at Galderma India. He is
Chief Mentor at MedicinMan
and a regular contributor.
khariram25@yahoo.com
TheHighCostof
operatinginSilos
E

Prepare to Promote | K. Hariram
generation) every day, even braving the extreme weather
conditions and all sorts of customers attrition?
If the management cannot provide a satisfactory response,
is it the fault of MR, if he seeks solace and guidance from
external sources?
Silos...silos and silos.
It all boils down to one thing - the organisational culture
driven from the top.
If the decisions taken are going to affect people who matter,
then why this chasm?
The big question - what will be the frame of mind of these
Complaining MRs when they enter a Doctor’s chamber to
make a call? How effective will the call be?
Should there be no timely and appropriate communication
at all levels of management percolating to all levels?
How does one close the loop Very simple and obvious solu-
tion is to communicate, communicate and communicate.
Information is power. Effective management teams must
know that if they want their team members to have the
power to achieve organisational objectives, they need to
have the appropriate information.
So always communicate 3 important things:
1. What is happening?
2. What is in the offing? At least those that affect the
concerned people.
3. How they are doing?
In general it is important that openness and transparency
with appropriate discretion makes all the difference. Of
course, no hidden agenda, please.
Having run an organisation for 13 years and a religious
practitioner of‘openness and transparency’in matters that
affect people I was feeling sorry that there are still‘old archa-
ic approaches’in dealing with sales people. I even ensured
that the annual salary structure with modalities and criteria
was shared in sales meetings and hence people knew what
they would receive and also why.
An effective leadership and efficient management should
utilise such situations as great opportunities to foster the
sense of belonging. It will also shield the organisation from
the influence of unwanted external forces (who have no
stake at all). -KH

Empower Your Field Force
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MEDICINMAN

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iSharpenMMy Success is My Responsibiliti

A
s mentioned in the last section of Diabetes
Mellitus (DM), the acute symptoms and chron-
ic complications of DM can be controlled by
lifestyle modifications (diet, exercise, weight reduction)
and/or medication. The lifestyle modifications can help
in improving the control of DM by decreasing the insulin
resistance (insulin resistance means that different tissues
like muscle, fat, and liver cells do not respond properly
to insulin and thus cannot easily absorb glucose from
the bloodstream). From the list of drugs available for
treating DM, we’ll firstly discuss Insulin and its analogs.
The high blood glucose levels stimulate the release of
insulin from the pancreas and then insulin maintains
the blood glucose levels in the normal range. Insulin
is involved in utilization and storage of glucose in the
body. For patients with type 1 DM, insulin therapy is
necessary to sustain life. Those with type 2 DM general-
ly don’t require insulin for sustaining life, but they can
have a better control of blood glucose levels if these are
uncontrolled with oral anti-diabetic drugs.
The Insulin preparations available are the human insulin
i.e. their source is human and not animal, as it used to
be few years back. Insulin is not administered orally as
it is degraded in the gastrointestinal tract. Generally, it
is administered subcutaneously except in emergency
conditions, regular insulin is given intravenously. Insulin
preparations have been divided into categories depend-
ing upon the onset and duration of action. The catego-
ries are:
1. Rapid and short acting insulins
a. Insulin lispro
b. Insulin aspart
c. Insulin glulisine
d. Regular insulin
2. Intermediate acting insulins
a. Neutral Protamine Hagedorn (NPH) insulin
b. Neutral Protamine lispro (NPL)
c. Neutral Protamine Aspart (NPA)
3. Long acting insulins
a. Insulin glargine
b. Insulin detemir
4. Insulin combinations
a. NPH insulin and regular insulin (in the ratio of
70% /30% or 50%/50%)
b. NPL insulin and insulin lispro (50%/50%; 75%/25%)
c. NPA insulin and insulin aspart (70%/ 30%)
The rapid acting insulins have a quick onset, short du-
ration of action and less chance of hypoglycemia. These
insulins mimic the pattern of release of insulin from
pancreas in response to food intake. Generally used with
long acting insulins so as to have proper glucose control.
All of these can be given intravenously, but regular
insulin is most commonly used. NPH insulin should be
given only subcutaneously. It has intermediate duration
of action because of its delayed absorption. NPH insulin
is used along with regular or insulin lispro one to two
times daily. The long acting insulins have a slow onset
and prolonged action. The standard mode of insulin
therapy is subcutaneous injections using disposable
needles and syringes. The other delivery methods are
portable pen injectors or continuous subcutaneous insu-
lin infusion devices.
Adverse reactions to insulin include symptoms of
hypoglycemia (which can be severe even); weight gain,
lipodystrophy (i.e. destruction or overgrowth of local
adipose tissue at the site of injection), headache, anxiety,
vertigo and allergic reactions etc.
The next section will cover the oral antidiabetic agents.
- AD
E
Managementof
DiabetesMellitus-I
Knowledge
Series for
the FF
Dr. Amit Dang is Director at Geronimo
Healthcare Solutions Private Limited.
E

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