Is sales still a factor of sell?

Is “Sales” still a factor of “sell”?

The Pharma industry has really come a long way. There was a time when number of players in the market was few, more time with physician was available, simple and basic selling strategy worked. With time, the scenario changed. Time with physician has been enormously scarce, sales force effectiveness has come in the limelight and companies, to align themselves with the trend, spent millions of dollars on technologies and consulting to increase or retain their share of the pie. Was all this worth? Yes – without this, established players would have faded away. Think about a market leader being complacent and not meeting the doctors for a while and allowing their products to be out of the pen habit. No one who has some basic sense of sales and marketing will do that.

This strategy of ethical marketing worked and will work. But if you take a closer look, it is like a situation where a bunch of hungry people fighting for a small piece of cake. The cake size is limited and they are ready to pay more to get one more piece of it. Within a short distance, there lies another big piece of cake but people are so busy fighting for this piece are not even looking at that. Sounds little infeasible, isn’t it ? Yes – but this is true. Pharma companies, focusing very highly on physicians or KOL / KAM are increasingly overlooking another big channel of business – Patients!

Lets take an example of 2 big multinational giants trying to convince a doctor on one life saving medicine used for chronic treatment. Finally one of them wins – the doctor is convinced and he prescribes the medicine to one of his patients. The patient starts taking the medicine however, drops after a certain period of time. The medicine, if used for prolonged period (say 3 years), could have generated 200 $ of revenue. But since the treatment has stopped at half a year, the revenue will now be one-sixth i.e. 33$. All effort that was spent on convincing the doctor generated revenue – but 17% of what was desired.

But don’t you think the rest of the 83% was assured money? Yes – but what did the company do to ensure that 83%? Nothing! The entire exercise stops right at the physician prescription. This is one big area that is untapped to a very large extent and will be in the focus in the next decade.

One of the reports I read few days back mentioned “pharma globally loses $350bn a year due to non-adherence which is more than 1/3 the total market size”. That should be enough to be an eye – opener.

Pharma companies need to invest in this area to ensure that prescription switching does not happen and patients adhere to the medication guideline as suggested by the physician. A patient who needs to have long term medication will ensure his / her own long life by adhering, so this has a social cause associated with it. Doctors will get benefited by associating themselves with the improved healthcare of the society. Pharma companies will be a part of this improvement and will generate more revenue at the same time. So, it is win – win for all.

What is needed is a robust program to ensure patient adherence. It may be in numerous form – text message at periodic interval to remind patients of their medication, next visit date, test etc; Free health check up after certain interval for their progress checked by the physicians; bond with the Pharma companies to avoid prescription switching and availability of the “bond”ed medicines at a lower cost, mobile games that help to increase patient awareness. There are many ways and the industry has just started.

Of course this will have challenges – economical, political, social. Some of the companies will utilize more liberalization in the rules to promote their medicines through emails, brochures and messages directly to the patient, availability of incorrect, misleading information and wrong interpretation will also be more likely. That requires tighter regulations, stricter control. But you can’t miss the forest for the trees, right?

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Beyond Therapy: Four Dimensions

Every day we talk about rapidly changing business dynamics, increasing disposable income, growing middle class, internet, more knowledge, info available at fingertip. Every industry does its impact analysis and changes its positioning, marketing strategy, pricing. Change is inevitable and the options are clear – change or perish. However, there is one such industry where this change is very much required yet not happening with that pace. That is – medical industry. I will clarify my statement here – the change is happening but at a slower pace. Let me give some practical examples here.

A patient is detected with an indication and he visits a doctor. What factors determine that if he will come out of the doctor’s chamber satisfied or stressed? What can the doctor do in those 10-15 minutes to satisfy his customer?

We need to understand that when a patient comes to a doctor, he comes for a treatment – to get relieved of the problem he is suffering from. Therefore, the first thing required is listening and assurance. The doctor should first listen to the patient carefully irrespective of how nonsense he talks. Every human being is different and the way of expression of each individual is different too. Some patients will spend more time describing their sufferings than others. Doctor needs to take the crux out of it without spending too much of time. But a doctor that interrupts the anxious patient in between creates a feeling in the mind of the patient that he could not explain his problem to the doctor and therefore the treatment might not be correct. So, the assurance which is needed most by the patient is now no longer there. The patient is still anxious and feels dissatisfied with the first meeting.

Assurance is a big thing indeed. Think about a doctor that tells you “Don’t worry; I have understood your problem. It happens with many people. If you take your medicines regularly, you will be fine in 2 weeks”. And then think about another doctor who tells you “Take this medicine for 2 weeks and come after that”. Sounds different? Yes, they are. In the second part, the assurance is missing.

The next part is communication. Patients are told to take their antibiotics but patients are not told that if they miss one dose in between – what will be the impact and what should be the corrective measures. There are plenty of studies in the market that shows that dose compliance is often poor because the communication is not clear. Which medicine to take is important but how to take the medicine is important too. Preparation of syrups where the medicine is to be mixed with water requires guidance. The gap in communication leading to poor drug compliance is also supported by a study conducted by WHO.

We need to understand that assurance, communication and listening are also part of the treatment. A patient with a great mental strength is much more able to fight the disease compared to a patient who has lost the hope.

The fourth dimension is information. Many patients search in the internet about their symptoms and come to a possible conclusion before they come to the doctor. I will not say this is always a good practice because internet often mentions possibilities that are good enough to scare the patient even more. But my point was availability of information. These patients expect the doctor to explain what has happened to them. Doctors also need to understand this and spend some time explaining about the symptom, its cause and possible treatment. A doctor not entertaining this information availability often creates confusion in the patient’s mind. Instead, discussion on the topic and few trends often creates respect in the mind of the patient about the doctor and also helps to develop relationship.

My intention is not to blame anyone here but to emphasize that the change is now very much required. The medical fraternity understands this and there are doctors who have implemented these best practices. But to ensure it across all places, I believe what is required most is education. There should ideally be a mandatory subject on patient handling or how to deal with the emotional side of the patients. I don’t have enough information on if such course or subject already exists and this is absolutely my personal opinion to get this soft skills instilled mandatorily in each medical student. However, I strongly believe that with these four dimensions implemented in real life practice, wellness will be much more beyond therapy.

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CRM : Selling Old Stuff In New Package

The word “CRM” is in the light for quite a few years now. Companies across industries spend millions of dollars on their CRM system implementation. But is CRM a new concept or is it existing for years and just more organized version of the same old trick? Let’s take a closer look.

What are three essential components of CRM? First, capturing the customer data and transactions. You capture all possible data about the customer – starting from general information such as age, religion, name, gender, telephone numbers to preference of the customer such as his inclination towards a particular product category or brand segment or his interests in different areas. All transactions are captured because you want to keep a track of what the customer wanted, what is his need, how he reacted to your product or service, what can be done better to satisfy him etc. Second, you consolidate the data at one single place to complete the 360 degree view of the customer. You may interact with the same customer across multiple channels. But to appear as a single face, you must consolidate the data received through different channels at one database. Third, Analyze the data to find out the patterns, habits, likings, opportunities etc so that you can take informative decisions on basis of that………………

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Sales Force Effectiveness : Right Focus?

You ask any Pharma professional around the world – what is the best way of promoting Pharma products? I bet 99% of them will say “detailing products to the medical fraternity by face to face calls”. This practice is well established across the world. From the global leader to a small new comer in the market, every company counts how many calls you made per day, which product you have detailed, what message you have delivered, how did the doctor react to it et al. I am not challenging them – that’s how medicines are sold. We are not talking about OTC products here. Drugs which can only be marketed by “information dissemination” to the doctors and nurses are sold through detailing. But how effective is the 5 min that is spent inside the doctor’s chamber? Let’s take a closer look.

I will take few examples in Indian context here. Majority of the doctors do not have a specific time dedicated for the MRs. Representatives coax the attendant to get entry in to the chamber when the doctor is busy seeing his patients. Sometimes he enters the chamber when the patient is also inside. The doctor looks at his face once and concentrates on the patient again. How does the rep handle it? Since he cannot come back and knows that waiting is pointless, he starts detailing his product. Does he use the visual aid? In most of such cases, no. He takes the name of the product, few key features, take the sample out, keep it on the doctor’s table, bow and come out. One call is gone. He will be back after 1-2 weeks may be.

The other situation can be when the doctor is seeing the MR when no patient is inside. This is comparatively better as the rep will get the attention. He details the product, shows the visual aid, talks about the features and benefits, delivers the sample. I have seen numerous such detailing where text written in the visual aid is seldom used. The conversation is like this “Doctor, nothing new to say about our product X. You have been prescribing our product X for long – will ask for some more support. This month has a high target doctor. Please prescribe. Thank you”. The doctor keeps listening, sometimes looks at his face, sometimes at the visual aid or the sample, sometimes at his own writing pad. The call ends. At the end of the day, many such calls happen. Does the doctor retain all of the products that have been detailed to him? No.

The other situation is for the doctors who provide dedicated time to the MRs after seeing all his patients. He has now seen 30 patients and is tired. 15 reps are waiting outside. When the first rep enters, doctor has already started counting how many reps are there and even if he provides 5 minutes each, more than 1 hr is gone. He is least interested and want them to go fast. The moment the rep starts talking about the features and benefits, the doctor reacts “I know all this”. The rep hurries and the call ends in form of just reminders. 15 reps detail 75 products. The doctor retains 10-15.

All of the above mentioned situations are true and they raise a question about the effectiveness of the calls made. At the end of the month, when we compare our prescription against calls, we don’t find much correlation and accuse the rep of not knowing what he is doing. But do we really see these challenges? Do we train our reps on how to handle such situations? Do we update our communication strategies on basis of these situations? Not really.

When everyone is talking about differentiation and the market place is more crowded than a fish bazaar, investing in IT alone will not help. The way of detailing must be customized to make it more effective. How do we do that? That’s the topic of another column.

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Chemist Influence : opportunities missed ?

Global pharma market dynamics are changing rapidly and so is the business model. Traditional method of sales is no longer the sole method of survival. Companies are looking for newer avenues  of reaching out to the customers and new “type” of customers are being emerged. Key Opinion Leaders, Stakeholder management, key accounts, alternative trade channels – these are the buzz words in the market these days. In this context, one group of people (read customers) that is gaining focus is the chemist community in India.

Let us look at the normal process of how a medicine is sold. Sales rep details a product, the doctor prescribes it, the patient goes to the chemist shop, the chemist serves the medicine. Well, this scenario is true but not for all situations. Let’s look at situations where it may be different.

1.       A very large percentage of Indian people go to the chemist shop first for treating their symptoms. Going to the doctor at the very first go for minor symptoms is still considered as an additional and unnecessary expense. How many people go to the doctor for common cold? Patients utilize the money which they would otherwise spend on doctor’s fees for buying the medicines. Here comes the role of a chemist. The patient does not go and tell him the name of the medicines, but tell him the symptoms instead. The chemist, based on his experience and knowledge, sell a strip of medicines to the patient. Now let’s assume that a chemist earns more profit by selling product A than product B and both are used for the same symptoms. Will he ever push Product B in this situation?

2.       OTC drugs are anyway perfect examples where chemist plays an important role. I go to purchase Eno, the chemist says “Eno is not available these days, they have some poor supply, there is a new product that has been launched for the same purpose, it costs slightly less but even more powerful. What do I do? I go to another shop or I buy the alternative? In some cases, I will check in another outlet, but in majority of the cases, I buy the alternate product.

3.       Patient – chemist relationship is an important factor for getting a medicine sold. Normally, people have the habit of purchasing from the same medicine shop everytime. This retailer loyalty costs thousands of rupees to one owner and earns thousands for the other. We trust the people from whom we purchase the medicines. If he says a product is not nice, we tend not to purchase it and if he says something is good, we tend to believe. Crores of Indians get a credit facility from the medicine shop they purchase from – scope of belief and dependency is obviously much more.

4.       A doctor’s prescription does not always guarantee the same medicine sold. If the chemist says this product is not available and has a poor supply, we call the doctor for suggestion of an alternative. The doctor utters a name which majority of us don’t understand. What do we do? We don’t hand the mobile phone over to the chemist, we instead ask what will be the best alternative.

5.       In rural India, the number of chemist shop itself is very limited. There may be just one shop for 5-6 villages. If that does not keep whisper or stayfree just because they are expensive and keep a local low cost alternative – will customers travel few miles to get a sanitary pad?

So, we see they are important. Pharma companies in India are yet to react on it. Since the chemists are not registered medical practitioners, sales rep cannot go and detail a product to the chemist. It will have legal implications and will face protest from the medical fraternity as well – understood! We don’t want the chemist to alter the doctor’s prescriptions. But what about the other situations?

·         Sales force should spend more time with the chemists. The interaction should just not be limited on checking the availability of stocks or number of prescriptions received from the nearby doctors. We need to talk to them about the profit margin, the recent advertisement (if applicable), the company profile, the quality standards, the features and benefits. Chemist does not have a pen habit, but let your product be at the top of his mind. They are busy in the morning and evening – so utilize your lazy afternoon for meeting them.

·         Occasional events can be organized with the chemist group. All pharma companies organize events but with the doctors and nurses only. Event with chemist does not get approval because of  legal reasons and there is no readymade data to show the ROI. But a small event once in a quarter will serve the purpose – you don’t have to organize it in a five star hotel, just a small gathering with knowledge dissemination focus will do wonder. In my early career, I have seen a company doing this and I will not name it here.

Focus on distribution in rural India. Let the chemist keep your stock even if it is not frequently sold. Give him the credit and get the money only when it gets sold. That will increase your reach at least – we are fine with extending credit facility, but surely not fine with a customer looking for my product and buying an alternative just because mine is not available.

Well, this is what I think. Your comments are most welcome!

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