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2015 Pharmaceutical Sales Rep Experience


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A perspective on the big trends that are changing pharmaceutical sales and the new best practices and opportunities those trends inspire.

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2015 Pharmaceutical Sales Rep Experience

  2. 2. Executive Summary | At the Health Experience Project, we believe the right experience can change everything. Every day, the Health Experience Project explores the experiences that are changing outcomes for people, for professionals, and for brands. In this report, we’ve curated some of our most important findings from the frontlines. Inside, you’ll find the big trends that are changing pharmaceutical sales and the new best practices and opportunities those trends are inspiring.
  3. 3. INSIDE THIS PERSPECTIVE Designing the Pharma Rep Experience for 2015 brings together research from the Health Experience Project, GSW, and other experts across our industry. SECONDARY RESEARCH FROM: Manhattan Research, ZS Associates, PwC, Booz Allen Hamilton, Accenture, Hay Group, INSEAD, IBM, Deloitte Special thanks to our core contributors: Alex Brock, Bill Robinson, Dawn Marinacci, Joy Hart, Kevin Coleman, Leigh Householder, Matt Cash, Michael Krohn, Nick Bartlett, Ritesh Patel, Ryan Deshazer, Tyler Durbin HANDS ON EXPERIENCES WITH: RepLab: Exclusive think tank that brings together field reps from our contract sales team with iQ, our product development lab Rep rides: Accumulated experience from over 100 rep rides around the world Global digital collaborative: 62 specialists from across our global network committed to innovation To discuss this report live or request a presentation, please contact Leigh Householder at 614-543-6496 or
  4. 4. 11 TRENDS What’s changing pharmaceutical sales, and how will it impact expectations?
  6. 6. The Asia-Pacific region, including China, Japan, India, Australia and Korea, is projected to be the single largest contributor (46%) to global pharmaceutical market growth through 2015. But the shift won’t come without new challenges. Without the margins to support large sales forces in the long-term, Asia will be where we crack the code on remote selling. 1 80,000 90% Number of sales reps in China, making it the largest pharma sales force in the world Level of deep discounts imposed by some governments on healthcare products Pharmafocus, Mark Mallon, regional vice president Asia-Pacific and president China, AstraZeneca, 2012 NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA-PAC
  7. 7. DOCTORS BECOMING LESS CENTRAL TO HEALTHCARE 2 We’re about to double the number of people in so-called rich countries who are 65 or older. There simply won’t be enough doctors to treat them. Teams of caregivers will close the gap. Detailing this diverse workforce will require deep understanding of each organization’s specific care model and competency in building connections within it. New roles beyond nurse practitioners America developed the roles of NPs and PAs. Their next innovation: diagnostic medical sonographers, These 2-year degree careers are expected to grow by 44% between 2010 and 2020. India is the critical first mover Britain has 27.4 doctors for every 10,000 patients. India has just 6 doctors. To make it work, they’ve developed true medical homes, forcing each professional to only work at the top of his skill set. Bureau of Labor Statistics, 2013; The Economist, Squeezing Out the Doctor, 2012
  8. 8. GLOBAL HEALTHCARE SYSTEMS IN CRISIS 3 Reps will increasingly be selling into healthcare systems experiencing new levels of crisis and looking for lifeboats • Rising toll of chronic disease worldwide • Aging model not built for new needs in healthcare • Cost pressures from all sides Administrators and practice leadership will be looking for partnership in identifying solutions that reduce total costs. Lancet, McKinsey, 2011 Long the envy of the world, even Japan’s kaihoken is struggling Japanese people see doctors twice as often as Europeans and take more life-enhancing drugs. They stay longer in hospitals and have one of the lowest infant mortality rates in the world. Yet Japanese healthcare costs are a mere 8.5% of GDP. Still, the country's universal payer system is embattled. Since it was established in 1961, the proportion of people over 65 has quadrupled to 23%; by 2050 it will be two-fifths of a population that will have fallen by 30 million. Experts say it’s beginning to fail under the pressure.
  9. 9. PAYERS FIRMLY IN CONTROL4 The next 3 years have been described as the perfect payer storm. Empowered, frustrated insurers are using all their tools to put new demands on manufacturers and practices. The opportunity to help practices effectively navigate the new landscape and get patients access to their preferred medications will fall to reps and their support organizations. Pricing controls: Like Germany’s new required 16% rebate Outcomes expectations: Like value-based systems in Sweden, Singapore & Canada Generic push: Including India’s generics-only drug list for prescribers Prescription limitations: In the US, 16 states have monthly Medicaid drug limits Coverage denials: NICE (UK) rejected reimbursement for 9:10 end-of-life cancer drugs PharmaExec, 2012
  10. 10. The 10-year tradition of digital detailing finally has the tools to deliver the experience we always imagined. Today most reps are armed with the touchscreen tablets: Use and adoption remain uneven in part because opportunities still include improving the experience for reps and doctors by reducing fragmentation and innovating interactions. NEAR-UNIVERSAL IPAD ACCESS5 Manhattan Research, Cognizant: How to Properly Deploy the iPad Within the Pharma Sales Force, 2013 8:1066% 76% Of the reps US doctors see in a week are using a tablet Of “Big 10” global pharma are using or rolling out iPads Of doctors are satisfied or very satisfied with those iPad interactions
  11. 11. If you’ve launched one diabetes drug, why not another? By far, manufacturers are hiring from their competitors' field sales forces, only infrequently tapping other departments within the company or sales professionals outside the industry. Pharma sales are vulnerable to big innovation from outsiders. HIRING THE COMPETITION6 INNOVATIONACCESS They’re counting on "years of pharma industry sales experience" to deliver lots of positive existing relationships. But will organizations be able to evolve when only 40% rely on interpersonal competencies to inform their hiring decisions and 20% factor in business acumen or scientific expertise? Hay Group, 2013
  12. 12. High no-see rates have made reps cautious about protecting the access they have, ultimately limiting how aggressively they pitch existing contacts and how frequently they knock on new doors. There’s untapped opportunity to foster bolder closing behaviors. FEAR OF THE CLOSED DOOR7 45% 2x 2/3s Of prescribers restrict sales reps' access As many as the number that fenced off their practices in 2008 Of oncologists have "moderate to severe" rules governing rep visits. Even the best reps visit oncologists just once per month ZS Associates, 2013
  13. 13. Marketing was the major driver behind the last generation of mass-market, mass-scale blockbusters. But the new generation of highly specialized, highly expensive drugs requires more individualized selling and learning. The conventional wisdom about the selling mix is about to change. A NEW PARADIGM: THE REP-RELIANT BLOCKBUSTER 8 Biologics are taking the lead Designed for very targeted patient populations with few treatment alternatives Biosimilars changed the conversation New choices in old categories will require reps to deliver subtle value props New incentives will shift focus Incentives will be weighted to these life- long, higher-cost drugs
  14. 14. Reps tell us that the tools they have at their fingertips are more sophisticated than ever. They’re tracking their weekly sales goals in real time, sharing 3D models with doctors, and learning about new opportunities all on one screen—well, one screen with 15 different programs and passwords. Reps are hoping for a more singular dashboard and more flexible learning tools. DISCONNECTED DIGITAL TOOL SET9 Personal dashboard: All their individual numbers and product news in one place Dr-involved detailing: Over half of US docs have already taken iPads out of reps’ hands Digital leave behinds: In-detail tools to email or text desired information to a doctor On-the-go learning: Their downtime is in the car; why does training require a screen? Manhattan Research, RepLab, 2013
  15. 15. We’re watching a major shift in risk and responsibility from payer to patient. That’s creating new challenges for doctors and manufacturers alike. Reps will need to foster transparency into the real world behavior, asking doctors to not only write the Rx but help ensure it gets filled. DETAILING FOR THE DOUBLE YES10 Avoiding a surprise when they get there In Spain, the central payer now requires patients to pay the full price for 450 prescription medicines. Around the world, pharmacists are incented to swap branded drugs for cheaper generics. Getting patients to the pharmacy counter 24% of patients given a new medication by their doctor never fill the prescription. PharmaExec, 2012; CVS, Harvard, 2011
  16. 16. Many physicians are changing their preferences for how they work with manufacturers, mixing up when and where they want to interact with reps, peers, and on-demand education. That’s going to require more flexible approaches in communication and more compelling reasons to spend time live. WORKING WITH NEW PHYSICIAN PREFERENCES 11 DIGiTAL ???s Many physicians report a preference for digital marketing and education, citing limits in their time and availability as key reasons why Physicians in Europe, particularly, are also concerned about improper promotions or even the appearance thereof Wall Street Journal, Lilly Plans to Lay Off 30% of Its Sales Reps, April 2013
  17. 17. NEW BEST PRACTICES World-class sales tools and training
  18. 18. All the answers (in best-fit media) Influencer call plans and content Flexible contact model Reconnect marketing and sales Feature-rich engagements REP EXPERIENCE 2015 BEST PRACTICES Tools, experiences, and expectations designed to stand out in a crowded marketplace—or even just a crowded waiting room
  19. 19. FEATURE-RICH ENGAGEMENTS The best iPad details don’t center on a long, sequential brand story. Instead, they’re a collection of shareworthy features that compel people to lean into the little screen: • Novel illustrations • 3D models • Interactive tools • Participatory inquiry Learn-from example: Medtronic Medtronic used scored, simulated surgery tools to increase the number of doctors willing to schedule cases or educational events with the brand. We all learn more when we participate. Get healthcare professionals more actively involved in the discussion by handing over the screen and providing them with content they can navigate or—even better—play with.
  20. 20. RECONNECT MARKETING AND SALES One of the biggest complaints we hear from reps about CRM is they don’t get anything out of it. Their contact notes pass collected insight up the chain, but in the field, the most they get is a reminder of what they last talked to a doctor about. CRM should do more: Learn from industry: Automotive Big CRM initiatives score leads for local dealers and pass opportunities back up the chain for new launches. Warm leads from the marketing suite: Alert a rep when a local doctor has interacted with the product website or a direct marketing initiative to open a new door Prompts for new offers/engagements: Automatically show a rep when new content or a local event are available for his doctors. Request a direct send in one click. Report back what works: Use a simple dashboard to show what content or news is working for other reps and is making an impact in direct or digital marketing
  21. 21. DELIVER ALL THE ANSWERS (IN THE BEST-FIT MEDIA) Learn from outsider: Zappos Zappos call center reps are empowered to solve almost any challenge a customer can bring their way, making them one of the most loved and trusted brands in shoes. Increasingly the rep will be the main service point for the healthcare professional – asked for insight on everything from access to a medical specialist to navigation in a complex reimbursement environment. That’s a whole new battlefield. One that requires innovative new tool sets. All built in a flexible system that allows immediate ―leave behinds‖ via email, SMS, or even Bluetooth printing. Formulary model Patient tracker MSL video connect Best practice briefs Workflow tools Training guides
  22. 22. INFLUENCER CALL PLANS— AND, CONTENT! Although the specific titles and roles vary by country, the medical home model is drastically changing medicine across regions. Today, decision making in the practice is fragmented and typically not at all on the same page. Reps need to consider every professional in the mix. Strategist Medical specialist Primary support Nurses and techs Practice manager All office call connect: Lunch and learns and other cross-office calls will connect conversations and foster synergy in prescribing. Personal tools activate: More custom interactions with HCPs who are below the specialist will earn deeper conversation and lasting loyalty.
  23. 23. FLEXIBLE CONTACT MODELS Learn from example: Pfizer Pfizer Pro offers members easy access to connect with their rep, request samples (for personal or drop-ship delivery) or launch on-demand education Reps need to be able to connect with each healthcare professional on her own terms. That means a more flexible detailing suite, one that works as seamlessly when they’re together at the office or on other sides of the city: • Feature-rich, in-person tools • Turnkey web and video conference platforms • Easily shared, self-guided modules with self diagnostics and one-click follow-up THE DETAILING SUITE In person Remote/virtual Self-guided
  24. 24. EMERGING OPPORTUNITIES What experiences should we build next?
  25. 25. Package sale Dynamic calls Affiliate “labs” 2013/142015/beyond On-the-go learning Navigators of new data NEW OPPORTUNITIES FOR REP EXPERIENCE The new, compelling experiences we can build position reps as quick-access experts and leverage our individual affiliates to improve global strategy.
  26. 26. ON-THE-GO LEARNING Learn from outsider: Cracker Barrel You can’t get more outside of healthcare than Cracker Barrel, but the exit-ramp chain knows how to support travelers with borrow-anywhere, return-anywhere audio books. The downtime our reps have is in their cars, often when they’re covering larger and larger territories. But the training tools we provide require screen time (or even paper reading). The new opportunity will be developing real on-the-go learning modules that integrate new training—from data translation to segmentation—into busy schedules with better media. DM download: An auto-synced, podcast-style broadcast that reps can play on their iPads (syncing through Bluetooth to play through the cars’ stereo systems) Monthly magazine: 60 Minutes-style audiobook with coverage across the organization Special segments: Quick download ―chapters‖ on critical segments or selling strategies
  27. 27. AFFILIATE LABS Learn from outsider: United Way This massive nonprofit credits most of its successful national programs with cultivation at a very local level. The affiliates are chiefly responsible for trial and refinement. Today’s pharmaceutical franchises have multiple centers of power, with tens of thousands of reps in global centers like China, western Europe, and the United States. Each of these major affiliates—and many of their smaller siblings—are a proving ground for new ideas and approaches. No more will the best strategy come from the global team; instead, it will be discovered by that team. Ad hoc competition will deliver proven approaches for global rollout The data from the success of the affiliate programs will be the go-to business case for broader rollout and refinement. Global teams will become Opportunity Spotters Watching for high-potential programs and ideas being ―piloted‖ in the local affiliates.
  28. 28. DYNAMIC CONTENT AND CALL ROUTES Combine the geolocation features in a rep’s iPad with the deep data from a company CRM to get more efficiency and deeper personalization. Cognizant, How to Properly Deploy the iPad Within the Pharma Sales Force, 2013 Know the rep: Show real-time call activity and dynamically reroute reps based on proximity to opportunity, recent calls/cancelations, even traffic patterns. Know the healthcare professional: Recommend relevant content for the call or prompt new learning modules with just-in-time relevance. Follow up with quick requests for rep ratings and feedback.
  29. 29. MAKING THE PACKAGE SALE A number of converging trends—from more personalized medicine to more commoditized categories—will prompt a more packaged selling system, one that combines a diagnostic tool with a proven support system to both identify a patient and help him or her succeed on a given Rx. Diagnostic + Product + Support [more personalized medicines] [more successful patients] More medical knowledge for reps, ability to give live demonstrations, and do hands-on training with staff New kinds of research and data that prove the outcomes- based value of patient support programs
  30. 30. NAVIGATORS OF NEW DATA The shift to more outcomes-driven reimbursement is changing the kind of data doctors want. But that doesn’t mean the skills to use it—or challenge it—will be there. Reps will be the field guides who help use EHR to power investigator-initiated mini trials: From: The results of big, multi- phase, clinical trials To: Experience and data about patient populations like theirs • Working with physicians in large practices to pilot new drugs/indications with small numbers of patients • Mining/comparing/rationalizing the data • Empowering entirely new kinds of KOLs, ones driven by numbers, relevant to small groups of peers, and connected across digital networks
  31. 31. TALK TO US To discuss this report live or request a presentation of trends, please contact Leigh Householder at 614-543-6496 or Visit us at Or
  32. 32. SPECIAL THANKS To artist David Wink for the custom illustration on the cover of this report