key challenges and priorities in sales transformation indonesia prespective
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KEY CHALLENGES AND PRIORITIES IN SALES TRANSFORMATION INDONESIA PRESPECTIVE
UNDERSTANDING THE MAJOR TRENDS TO 2016 GLOBAL PRESPECTIVE
Mature markets facing low growth more cost containment
Pharmerging markets to have high growth with mixed fortunes for Originators
On patent brand sales to decline as generics aspire to +- 80 dispensed prescriptions
Growth will come from specialist driven markets particularly biologics but with biosimilars making little impact to 2016
Europe is under pressure with severe hospital debt and austerity measures
Consolidation within the industry and diversification by originators changing the playing field
Global Pharmaceutical Market and Generics IMS Kyoto presentation
MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020
Copyright copy 2014 Evaluate Ltd All rights reserved
WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)
Copyright copy 2014 Evaluate Ltd All rights reserved
GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018
comSource EvaluatePharmaTM June 2013
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
UNDERSTANDING THE MAJOR TRENDS TO 2016 GLOBAL PRESPECTIVE
Mature markets facing low growth more cost containment
Pharmerging markets to have high growth with mixed fortunes for Originators
On patent brand sales to decline as generics aspire to +- 80 dispensed prescriptions
Growth will come from specialist driven markets particularly biologics but with biosimilars making little impact to 2016
Europe is under pressure with severe hospital debt and austerity measures
Consolidation within the industry and diversification by originators changing the playing field
Global Pharmaceutical Market and Generics IMS Kyoto presentation
MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020
Copyright copy 2014 Evaluate Ltd All rights reserved
WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)
Copyright copy 2014 Evaluate Ltd All rights reserved
GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018
comSource EvaluatePharmaTM June 2013
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020
Copyright copy 2014 Evaluate Ltd All rights reserved
WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)
Copyright copy 2014 Evaluate Ltd All rights reserved
GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018
comSource EvaluatePharmaTM June 2013
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)
Copyright copy 2014 Evaluate Ltd All rights reserved
GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018
comSource EvaluatePharmaTM June 2013
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018
comSource EvaluatePharmaTM June 2013
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION
Data from World Bank 2011 (latest available)
605 million people
Average age lt 27yo
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
0
5
10
15
20
25
30
35
40
45
50
200
7
200
8
200
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
201
8
201
9
202
0
202
1
202
2
202
3
Pharmaceutical Sales In South East Asia (USDbn)
Indonesia
Thailand
Vietnam
Philippines
BruneiCambodiaMyanmarSingapore
Laos
CAGR = compound annual growth rate Source BMI
84 CAGR
64 CAGR
141 CAGR
64 CAGR
71 CAGR119 CAGR94 CAGR
144 CAGR88 CAGR
Malaysia 78 CAGR
REGIONAL MARKET FORECAST
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
REGIONAL OUTLOOK ASIA
Health and pharma spending growth rapid but
slower Pharma expected to rise faster than overall
healthcare spending
Expansion will be driven largely by China thanks to
the rollout of public health programmes
By 2016 Chinarsquos pharmaceutical market will be
bigger than that of Japan where growth will be
minimal owing to rising use of generics and market
competition
India Indonesia Malaysia South Korea and
Thailand will also see double-digit growth despite
efforts to bolster cheap local production and reduce
drug prices
Global outlook Healthcare March 2014 The Economist intellegent unit
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC
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 wonrsquot 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
80000
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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE EVOLVING STAKEHOLDER LANDSCAPE
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
DECLINING CONTRIBUTION FROM OTC DRUG SALES
175 175 179 184 193 199 204
377 394 400 405 411 416 421
448 431 421 411 397 385 375
2009 2010 2011 2012 2013 2014 2015F
Patented drug Generic drug OTC
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
BARRIERS TO GROWTH
Kpmgcom
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INTRODUCTION INDONESIA
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
Investment Gateway into Indonesia Deloitte
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
RISING CONSUMPTION
wwwtomcatfuturistcom
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)
Source WHO
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE
Source Frost amp Sullivan
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
LARGE POPULATION
Source Frost amp Sullivan
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013
Source World Bank and OECD
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER
Source httpukreuterscom Frost amp Sullivan
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS
Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)
Public Healthcare Coverage in Asia
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE
Source Frost amp Sullivan
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
IMPROVED ACCESS TO HEALTHCARE
Source MOH Indonesia BPJS Frost amp Sullivan
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP
(2012)
764 m
30coverage
(2014)
142m
56 coverage
(Aug2015) 150m
63 coverage
(2019)
270m 100 coverage
Source Roadmap to National Health Insurance 2012-2019 DBS Vickers
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED
Source Standard Chartered 2014 Frost amp Sullivan
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME
Source Frost amp Sullivan
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INDONESIA HOSPITAL BEDS CLASSIFICATION 2010
Hospital (General and Specialty)
Public Hospital
Class A (gt400 beds)Extensive specialist medical services +
extensive sub specialist
Class B (100-400 beds)Extensive specialist
medical services + limited sub specialist
Class C (50-100 beds)Has minimum of 4 basic
specialist medical services
Class D (lt50 beds)Provides basic medical
facilities
Private Hospital
PriorityGeneral medical services
+ specialist and sub-specialist
MadyaMinimum 4 specialists
medical services
Pratama General medical service
Journal of Hospital Administration 2013 Vol 2 No1
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)
43 56 56 60
217 256 295 344
447631
742901
251
416
517473
761
724618 684
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
A B C D N Class
h1048597 psirsbukdepkesgoid
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)
1371 1608 1718 1935
348 475 510 527
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015
General Hospital Specific Hospital
h1048597 psirsbukdepkesgoid
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)
Source Ministry of Health DBS Vickers
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP
Private 6140Govt
(provincialdistrictmunicipal) 2870
Ministry of Health amp other
ministries 170
Military amp Police 680 State-owned 260
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INTRODUCTION OF UHC TIMELINE
All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so
Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
FACT 2015
httpwwwbpjs-kesehatangoidbpjsindexphphome
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS
Source KKI 2008
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)
Source Negative investment list mdash Presidential Regulation No 392014
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES
Source BPJS PhilHealth WHO
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)
Source Ministry of Health (see Appendix H) Future need EY rough estimate
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)
Source Ministry of Health
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE
Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme
The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies
Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
KEY 20152016 HEALTHCARE MARKET PREDICTIONS
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT
Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE SALES FORCE SYSTEM FRAMEWORK
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY
Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)
5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY
Key strategic choices
Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE
copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
UNDERSTANDING WHAT PHYSICIANS VALUE
Physician Prescribing Trend
What Doctors expect from Medical Sales Reps
httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE WINDOW IS EVER SHORTER
Today only 7 of sales calls are longer than 2 minutes
Your opportunity will end in
Based on Canadian Study ArcusBC Medical Association 2011
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)
102000 REPS IN 2007
75000 REPS IN 2012
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
What level of face-to-face calls from field based specialists do you expect in order to develop and grow
regional-level thought leader relationships (per year)
N=28
1-8 calls per year32
8-10 calls per year25
10-12 calls per year11
13-14 calls per year14
15-18 calls per year3
19-26 calls per year11
More than 26 calls per year
4
68 call no more than1 time per month
DEVELOPING RELATIONSHIPS
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
PERSISTENCE
Over 30 of leads are never contacted at all
By just making a few more call attempts sales reps can experience up to a
70 increase in contact rates
Source Insidesalescom
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
FIRST THINGS FIRST
Rumors of the death of the sales force have been vastly over exaggerated
50-75 of physicians prefer to have some contact with reps
Thatrsquos right They want to be detailed
Knowledge Networks and Physicians Consulting Network 2011
Business Insights LTD 2009
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE
copy Copyright 2001 by ZS Associates All Rights Reserved
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE
copy Copyright 2001 by ZS Associates All Rights Reserved
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE
Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHAT PHYSICIANS WANT AND NEED FROM PHARMA
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo
httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
BUYER BEHAVIOR MODEL
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY
In younger smaller organizations with few products KOL management should be very hands-on as an
organization grows and the number of therapeutic areas increases clinical and commercial leaders
employ more strategic approaches
KOL Function Maturity
KO
L M
anagem
ent
Sophis
tication
New Bio-Pharma
Medical amp clinical leaders collaborate with commercial to develop KOL strategy
Identify Key Opinion Leaders for Therapy
Develop excellent relationships with National KOLs
Develop regional KOLs
Leverage relationships to educate providers on disease and therapy
Maintain and improve KOL relationships for existing and developing therapies
Mid-Cap Bio-Pharma
Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies
Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas
Develop and improve systems for tracking all company interactions with KOLs
Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area
Conduct periodic reviews to identify and approach new KOLs
Large Bio-Pharma
Continue cross-functional collaboration to ensure KOL strategies remain current
Periodic refinements to KOL management structures based on experience and changing therapeutic needs
Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact
Continue periodic reviews to identify and approach new KOLs
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
Intangibles
WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards
and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values
Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)
44 46 48 50 52 54 56 58 60
Being on the cutting edge Involvement in changing science Clinical studies participation
Innovative products Engaging Peers Chance to Give Advice Ability to contribute
Rewards and
Benefits
Contribution and
Involvement
0
Integrity Ethics Patient Focus Honesty
Transparency Service orientation Brand value
Support for research
Sponsorship Honoraria Ability
to publish CV building business
perks
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
INNOVATION DIFFUSION CURVE AMONG PHYSICIANS
D
C
A
Cautious Majority
Laggards
Late Adopters
Innovators
B
E
Early Adopters
Target First Movers With Tailored CME
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
VALUE INNOVATION
Product
benefits
Brand
benefits
Service
benefits
Acquisition
costs
Customer Value-surplus
Costs of
- buying
-production
- handling
- services
- etc
Margin
Creation of Customer Value (W Reijnders 2005)
Price
Eg
Information search
Travel expenses
Wait time
Consult or guidance
Annoyances of
Building
Personnel
Others
et cetera
Eg
- accessibility
- consult service
- attitude
problem solving
client directed
friendly
et cetera
Brand characteristics
Confidence
Function
Emotion
Et cetera
Customer desired
product range
breadth length depth
of assortment
Complementarities
Cohesion
Services
Guarantee
Et cetera
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value
Revenue before cost Drive profitability with higher volume and price not lower cost
There are no other rules Do whatever you have to in order to remain aligned with the first two rules
Invigorating biopharma How the three rules can drive superior performance DUPresscom
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL
Invigorating biopharma How the three rules can drive superior performance DUPresscom
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
THE EVOLVING STAKEHOLDER LANDSCAPE
Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES
Transforming commercial models to address new health care realities
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
NEW COMMERCIAL MODEL PILOTS
Multifaceted patient-support
programs
New partnerships and collaborations
Disease education and patient screening
Online communities to support peer-
to-peer education and information
exchange
Programs to diversify the sales
toolkit
Transforming commercial models to address new health care realities
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
PART OF A DOSSIER FOR AN AREA MANAGER
Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters
Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT
2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET
The EphMRA Learning amp Development Committee
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
ARE SALES REPS NECESSARY
Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10
Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)
Only 43 of pharma reps ever get past the receptionist
Only 7 of pharma rep visits last more than 2 minutes
Only 6 of physicians think representatives are very fair balanced
Only 8 of calls are remembered by the physician
56 of physicians think representatives are more aggressive today than in the past
Less experienced younger sales forces (average age of a US rep is 26)
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR
Increase Scripts Written
Deliver Samples
Source of Practical Information for Docs
Cater Lunches for Docs
Compensate for Lack of Trained HospitalOffice Staff
Manage Patient Assistance Programs
All of the Above
None of the Above
19
13
24
9
7
6
8
14
copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
Top Performers
Sales Rep A
Sales Development Plan Sales Rep A
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED
Customized to their practice
Responsive to the conversation
Delivered how and when itrsquos convenient
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
WHY COACH SALES REPS
Sales people who receive fewer
than two hours of coaching
per month achieve 90 of quota
Sales people who receive at least
three hours of coaching per
month achieve 107 of quota
Sales people who receive 2-3
hours of coaching per
month achieve 92 of quota
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
A NEW PARADIGM THE REP RELIANT BLOCKBUSTER
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
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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
IT WAS SUPPOSED TO IMPROVE EVERY CALL
more personal
more flexible
more effective
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized
categoriesmdashwill 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
top related