When asked about the process of change last century, the writer William Ward stated: “The pessimist complains about the wind, the optimist expects it to change and the realist adjusts the sails.”
Following the recent upheaval in the NHS, there has been a major “adjustment of sails” needed by pharma sales organisations. In short, it’s complex these days – you have to know and understand your local health economies (LHEs) in great detail.
The key reason is that the NHS, as a customer, has fundamentally changed. The arrival of the Health and Social Care Act in 2012 and the newly introduced CCG structure have had a huge impact on the way they manage patients and do business. Indeed, we are now operating within a four nation NHS, which has made things even more complex.
The general loss of physician level decision making and massively squeezed healthcare budgets has meant prescribing freedom is far more restricted. The NHS is struggling to achieve its £20 billion productivity improvements, and pharmaceutical companies are seen as a soft target for achieving savings.
There was a period where NICE and SMC approval meant sales would follow. Now, at best, it’s considered a starting point. No NICE/SMC approval often means no consideration for a local formulary inclusion. Of course, just to add a bit of spice, approval processes vary significantly around the country.
All that considered, the four biggest challenges pharmaceutical sales organisations face right now are …
Number 1: Right Channel
NHS customers are short of time and budget, and access is a real issue. You won’t be seen twice if you waste people’s time. Customers like getting information from a variety of channels. Some like online, some will read email, some prefer the face to face route – and most use all.
In 2016, you must have a multi-channel approach to get your message across.
Number 2: Right Resource
The sales model has changed. For example, if you’re launching a product in the primary care arena, you need a phased approach.
Pre-launch phase: KOL/Medicines Management/Payor development leading to early product positioning on formularies, patient pathways and guidelines is key. That requires highly skilled, commercially sound, well networked KAMs. Nothing happens without positive market access these days, and it can take well over 12 months to get it.
Post-launch phase: Rarely do you need to start with a full primary care sales team. Without the right permissioning for your product in the LHE, having a representative calling on GPs is equivalent to driving down the high street throwing five pound notes out of the window.
Territories need flexible resourcing. Bring in the resource needed at the right time. KAMs, MSLs, Health Economists and Medical at the start, Primary and Secondary care representatives thereafter. Add them and remove them when their job is completed.
Again, it comes down to mapping your LHE and knowing in exquisite detail which customer needs what information at what time via which route.
Number 3: Right Transition
Here’s the problem for many organisations: most already have established sales teams of some description. How do you move from the old structure to a new structure fit for purpose in today’s environment?
Firstly, communication is critical if you want to take a motivated – not “worried” – sales team along with you on the journey. Be honest. Present the new environment, discuss the need for change and share the vision. It’s also OK to say you don’t know everything. Generally, people find honesty refreshing.
Secondly, when you have your LHEs mapped and know the resource that you need, be quick to implement your changes. Don’t drag it out. Protracted change programmes are death by a thousand cuts to sales force morale.
Thirdly, build in flexibility. It’s difficult to know what level of resourcing is ideal. Sometimes it’s good to have a short term boost e.g. when a new positive formulary/pathway or guideline arrives. Sometimes you’re not sure about the viability of an area in the longer term. These days, there are lots of highly skilled individuals available on contract.
Number 4: Right Skill Set
In all this environmental turmoil, the information our customers need and how we share it has changed. There is a clear need for efficient, impactful, customer centric selling. Helping staff develop the right skill set is bread and butter for most sales organisations.
The process is simple – identify the new set of skills and knowledge required. Benchmark all staff and implement development programmes to close gaps. In truth, not all existing staff will be right for these new roles, which is a difficult part of the change management process.
Looking forward, we believe the old sales representative model will be replaced with flexible, multi-disciplinary teams having a thorough understanding of their LHE, a clear grasp of where their product fits in, and the ability to communicate effectively to our new NHS customers using a variety of channels.
Time to adjust those sails!
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