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

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1. FDI in Indian Pharma by Salil Kallianpur …

1. FDI in Indian Pharma by Salil Kallianpur

Fears about rising costs and predatory tactics of MNCs are unfounded.

2. Special Report: Health 2.0 Mumbai by MedicinMan

Health 2.0 Mumbai Chapter was attended by professionals from pharma, healthcare, IT, diagnostics and others.

3. What the CEO Wants from You by Dr. Aniruddha Malpani

The CEO wants his Reps to understand the Doctor - the primary customer - and his needs.

4. Career Prospects for Reps in the Pharma Industry by Srinivas Pothapragada

The opportunities are plenty. Reps must be prepared for when opportunity presents itself.

5. Careers in Pharma Sales and Marketing by Anup Soans

Growth areas for Medical Reps in the Pharma industry.

6. Key Account Management: Lessons from the UK Experience by Ralph Boyce & Tejinder Chandhyoke

Four simple steps to KAM excellence.

7. The High Cost of Operating in Silos by K. Hariram

Managers who fail to communicate proactively, risk having to deal reactively with negative emotions from their team.

8. Management of Diabetes Mellitus - I by Dr. Amit Dang

A "Knowledge for the Field Force" initiative from MedicinMan.

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  • 1. 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.
  • 2. 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. 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)
  • 4. 4 | MedicinMan September 2013 xxx | yyy E                                                                                                                                                                                                                                                                                                                                                                      å                                                                                                                                                                                                                                                                                                                                                                                                               å                                                                                                                                                                                                                                                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
  • 5. E 5 | MedicinMan September 2013 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
  • 6. FDI in Pharma: A Foolish Proposition | Salil Kallianpur 6 | MedicinMan September 2013 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. “ ”
  • 7. 7 | MedicinMan September 2013 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? ” “
  • 8. E 8 | MedicinMan September 2013 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
  • 9. 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 9 | MedicinMan September 2013 Dr. Aniruddha Malpani, MD is the Medical Director at Malpani Infertility Clinic in Mumbai. E
  • 10. “ ” 10 | MedicinMan September 2013 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. 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
  • 12. 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
  • 13. 13 | MedicinMan September 2013 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.
  • 14. 14 | MedicinMan September 2013 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
  • 15. E 15 | MedicinMan September 2013 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.
  • 16. Key Account Management: Lessons from the UK Experience | Ralph Boyce & Tejinder Chandhyoke 16 | MedicinMan September 2013 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
  • 17. Customer-Centric Interaction for the MR | Ralph Boyce & Tejinder Chandhyoke 17 | MedicinMan September 2013 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
  • 18. Customer-Centric Interaction for the MR | Ralph Boyce & Tejinder Chandhyoke 18 | MedicinMan September 2013 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.
  • 19. w100/- MRP Rs. 799/- MRP Rs. 599/- *Exclusive corporate offer. Contact anupsoans@gmail.com | +91-93422-32949 for more details. Field Force Productivity Tools now at only inr 100*.
  • 20. 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 20 | MedicinMan September 2013 E
  • 21. 21 | MedicinMan September 2013 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
  • 22. Empower Your Field Force KA$H=CASH Repeat Rx Pharma-specific Training: Medical Representatives Field Sales Managers Senior Managers Learning and Development Programs from the Leaders in Pharma Field Force Excellence Signature Programs for Medical Representatives Constructed on the fundamental premise that a Medical Representative’s success depends on his Knowledge, Attitudes, Skills and Habits (KA$H). Representatives seek success in their personal and professional lives but look for it in the wrong places leaving them frustrated. Companies and bottom-lines suffer when the front-line is not ful- ly engaged. KA$H=CASH is a high-engagement module for customer-facing employees. Repeat Rx is an advanced module for customer-facing Representatives based on the book by Anup Soans. Repeat Rx focuses on building lasting relationships with Doctors by creating value through a process of Calling Connecting Consulting Collaborating with the Doctor. At each stage of this Four Stage process the Represen- tative acquires measurable skills and competencies that enable him to add value in the Doctor’s chamber. Repeat Rx comes with detailed evaluation tools. In Any Profession, More KA$H = More Cash Knowledge  Attitudes  Skills  Habits MEDICINMAN
  • 23. SuperVision for the SuperWiser Front-line Manager. Why Should Any- one Follow You? The Half-Time Coach anupsoans@gmail.com | +91-934-2232-949 | www.medicinman.net Signature Programs for Front-line Managers Signature Programs for Second-line and Senior Managers Based on the best-selling book by Anup Soans, this program is for new and experienced Front-line Managers who would like to get breakthrough performance from their teams. SuperVision for the SuperWiser Front-line Manager focus- es on topics such as Team Building, Emotional Intelligence, Situational Leadership, Coaching and more. VALUE ADD: Psychometric Assessment* The Half-Time Coach is based on the concept of half-time in football. If half-time is so crucial in a game that last only 90 minutes, how much more important in a career that last a life time. The Half-Time Coach is a learning-by-reflection program with a focus on Coaching Skills for senior managers. Mod- ules also cover Self Awareness, Emotional Intelligence, Em- ployee Engagement and Sales Change Management. VALUE ADD: Psychometric Assessment* A walk-the-talk program for cross-functional senior managers to understand the process of employee engagement, creating trust and building relation- ships to build and sustain high-performance teams. VALUE ADD: Psychometric Assessment* *Psychometrics assessments give in-depth insights into one’s personality preferences and its impact on interpersonal relationships and teamwork.
  • 24. anupsoans@gmail.com | +91-934-2232-949 | www.medicinman.net Methodology Webinars and E-Learning All programs are fully customizable. A pre-program questionnaire is used to capture the needs and expectations of the participants. Company’s may request a demonstration of a particular module at no expense (except conveyance to venue). Programs incorporate the principles of adult learning and are highly participative, audio-vi- sual and activity-based. Important truths are conveyed through games, stories and videos. Companies are advised to give participants the books on which the programs are based for continued learning and development. The same may be procured from the author at a discount. Company’s may choose to deliver a program as a webi- nar - giving the advantage of scale and lowering costs. Audiences are kept engaged using visually stimulating slides and powerful delivery. Emphasis is placed on taking charge of one’s success, even in the absence of oversight. Most recently 1,000 reps of a leading MNC were trained over four webinars with excellent feedback. Customized issues of MedicinMan, with inputs from the company can be given to the Field Force for their continuous learning and development. MedicinMan currently reaches 60,000 pharma professionals. Interactive Classroom Training Management Games Audio/Visual Learning-by-reflectionSimulation Case Studies iSharpenMMy Success is My Responsibiliti
  • 25. 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 25 | MedicinMan September 2013 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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