November 2012

~ F I E L D F O R C E E XC E L L E N C E ~

TM

P H A R M A | M E D I C A L D E V I C E S | D I A G N O S T I C S | S U R G I C A L S

A BroadSpektrum Healthcare Business Media’s Corporate Social Responsibility Initiative

Vol. 2 Issue 11

MedicinMan

Editorial

www.medicinman.net

n recent times no other issue has ruffled Indian Pharma as

much as the generic vs. brand issue. At stake are millions of

jobs and revenues. But we forget that serving the needs of

patients through the physician community has created these

jobs and revenues. When commerce triumphs at the expense

and not at the benefit of consumers, then sooner or later the-

se storms are certain to strike like Hurricane Sandy. Remem-

ber, consumers are the ultimate drivers and shapers of mar-

kets whether through social activism or by influencing gov-

ernment policy. Industry leaders and associations should put

their heads together in enlightened self-interest and become

active players in reforming healthcare to benefit patients –

their ultimate payer.

We have an insightful article by Salil Kallianpur on the ge-

nerics vs brands issue on page 18; as well as links to articles

by Prof. Vivek Hattangadi and Gauri Kamath – both of them

are well known pharma industry commentators.

On the positive side, we have an excellent addition to the

learning and development of pharma professionals by way of

a new book by Prof. Vivek Hattangadi – ―Pharma First-line

Leader to CEO‖. This should serve as valuable guide to

those who aspire for career growth. Prof. Vivek Hattangadi

also assumes additional responsibility as Dean – Professional

Skills Development of MedicinMan Academy.

K. Hariram, our Chief Mentor continues his series on Coach-

ing for FLMs. We also have insightful articles by Dr. S.

Srinivasan, Dr. Amit Dang, V. Srinivasan adding to the skill

development of field force.

The article, ―KAM – Is it a New Sales Model?‖ by interna-

tional team of authors, Ralph Boyce, Ken Boyce and Tony

O‘Connor will add to our understanding of this new emerg-

ing area in Pharma Sales.

LinkedIn is emerging as an important learning platform for

pharma professionals and I invite all our readers to connect

with me on LinkedIn. Please send an invite to http://

in.linkedin.com/in/anupsoans. We have featured two ―Hot on

LinkedIn‖ discussions for the benefit of our readers.

HURRICANE GENERIC HITS INDIAN PHARMA

- Anup Soans, Editor

Digital Dose by Dinesh Chindarkar is especially useful for

those who want to use Social Media to further their profes-

sional interests.

We believe in lighting a lamp instead of cursing the darkness

– however clichéd that might sound given the decline in

skills of the Indian Pharma‘s field force (see page 8 for my

article). But unless we take remedial actions, how can we

expect a turnaround? A Medical Rep‘s skills can be only as

good or bad as his trainer‘s ability to equip and motivate

Medical Reps with knowledge, skills and attitude needed at

the workplace.

MedicinMan Academy will conduct a 3-day Pharma Sales

Trainer Certification Program in December 2012 (for details

see page 5) to bring about uniformity in the training of Medi-

cal Reps and FLMs. The program is ideally suited for those

who are working in training departments as well as senior

professionals in Sales, Marketing, HR, SFE and related areas

who wish to move into training.

The program will cover all essential areas of adult learning

and development relating effective development of Medical

Reps including psychometrics.

In the future MedicinMan Academy will also conduct vari-

ous other programs for the development of Front-line Man-

agers, SFE, SFA and related areas.

We invite senior managers in Pharma to connect and offer

your suggestions. – anupsoans@gmail.com

MedicinMan welcomes Prof. Vivek Hattangadi as Dean –

Professional Skills Development at MedicinMan Academy.

4. Customer Targeting for High Im-

pact Sales.

Regularly updated customer lists

are key to high ROI on sales efforts.

V. Srinivasan

6. Making “Calls” Effective

Making joint-work with Medical

Reps productive through coaching.

K. Hariram

8. “You” Matter Most in Getting

Repeat Rx

In the sea of generics, “you” are a

key differentiator for your brand.

Dr. S. Srinivasan

10. Field Force Excellence: Are we

kidding ourselves?

Is Field Force Excellence attainable

in this era of hyper-competition?

Anup Soans

14. Hot on Linkedin

1. How to make productive field

visits.

2. What are the key drivers of SFE?

Discussion seen on Indian Pharma

Connection and SFE respectively.

Contents

CLICK TO NAVIGATE.

18. India’s Health Policy - flip flops and

policy shifts.

What the recent DGCI order on generics

means for Indian pharma & healthcare

Salil Kallianpur

20. Digital Dose - Part 1

A regular column on social media for

pharma by leading experts.

Dinesh Chindarkar

21. Pharmacology Essentials - Pharmaco-

kinetics Parameters

Concepts of bioequivalence, steady-

state, leading dose, maintainence dose

and others explained.

Dr. Amit Dang

22. Key account Management - a new

sales model?

Key Account Management is a distilla-

tion of existing strategies & approaches

Ralph Boyce, Ken Boyce, Tony O’Connor

25. Book Preview: Front-line Leader to

CEO

What it takes to move up the ranks written

in a simple, conversationalist style.

Prof. Vivek Hattangadi

Editor and Publisher: Anup Soans CEO: Chayya S. Sankath COO: Arvind Nair Chief Mentor: K. Hariram

Advisory Board: Vivek Hattangadi; Jolly Mathews

Editorial Board: Salil Kallianpur; Dr. Shalini Ratan; Shashin Bodawala; Prabhakar Shetty; Varadarajan S; Dr. Mandar Kubal;

Dr. Surinder Kumar

MedicinMan Academy: Dr. S. Srinivasan, Dean, Medical Education Prof. Vivek Hattangaadi, Dean, Professional Skills Development

Now Available as an Ebook on

Calling → Connecting → Consulting → Collaborating

Repeat Rx

REPEAT Rx is the first-of-its-kind skill certification and competency

building program for creating trust and building relationships with Doctors

leading to lasting relationships and generating Repeat Rx.

REPEAT Rx is conceptualized and developed by Anup Soans who is the

Editor of MedicinMan and author of the widely read ―HardKnocks for the

GreenHorn‖ and ―SuperVision for the SuperWiser Front-line Manager.‖

Visit: http://amzn.com/B009G3SJ1Y

Repeat Rx can be read across devices such as iPad, Kindle, Android, MAC and PC.

Download the appropriate reading app for free HERE.

ustomer list is the foundation upon which the building

called Sales is built. If the foundation is strong, and main-

tained properly, then the building will also remain healthy

and strong. Let us see below how to keep the customer list

strong and active by periodical pruning, cleansing, and

updating so that it remains active and healthy at all times,

and yields the best possible results to the business.

First and foremost: the total number of customers, as well

as specialty-wise composition/ break-up of the same,

should be exactly as per Sales & Marketing strategy. The

selection of customers must be done only after thorough

RCPA to ensure right customers for right products are

chosen. The Line Managers and Product/Brand Managers

must ensure this, because there is a tendency at the lower

level to include customers who are easy to call on, irre-

spective of whether they are the right customers or not,

and whether they have potential to prescribe the products

being promoted or not. Having prepared the customer list

as per strategy, the next step is to give visits to each of the

listed customers strictly as per desired number and fre-

quency.

Having ensured both the above, the next, but important

step is to ensure that we get business support from each

customer on whom we are investing efforts and resources,

even though the quantum of support may vary from cus-

tomer to customer. This can be ensured by periodical au-

diting and cleansing of the customer list, as per following

procedure. Let the Medical Rep makes at least 6 calls, i.e.

if 2 calls are slated for a customer every month, after 3

months of visits and promoting the identified products to

the Doctor by the Medical Rep and at least two more visits

by any of his superiors like Area Manager, Regional Man-

ager, Zonal Manager, Sales Manager, Product Manager, if

no support has come from the customer, then such names

may be deleted from the coverage list. After a total of 8

visits (6 by Medical Rep & 2 more by any higher officials)

decide whether to retain or not. In that vacancy, another

potential customer from the same locality from the same

specialty who has the best potential to prescribe our prod-

ucts, based on RCPA already conducted, may be included.

MedicinMan November 2012 >>> Customer Targeting ← Home

Customer targeting

for high impact sales.

V. Srinivasan

While doing this exercise, side by side, we can also plan

for improving the business volume from customers from

whom we are getting very low volume of business sup-

port. If it is very clear that irrespective of any further

efforts, the business volume may not improve, then we

need to decide whether such customers can also be delet-

ed, and instead, new but potential customers from whom

we can get better business support can be included in the

coverage list.

A similar exercise with other customers like stockists and

retailers can also be conducted, and wherever necessary,

dead wood can be removed, and new but potential ones

included. Such an exercise will ensure that we remove

dead wood, and the customer list (i.e.foundation) is very

active, and we get support from all the customers in the

list. It also ensures that we focus all our efforts, activities,

and resources on the potential and right customers only,

thus avoiding wastages of promotional efforts and field

working. Many organizations do not do this activity sin-

cerely, and leave it at the discretion of the Medical Rep

and the Line Manager concerned.

Once we ensure active and updated customer list, besides

number and frequency of visits as per strategy, we should

also ensure proper detailing of the products being pro-

moted (i.e. communication) which can have the desired

impact for conversion of identified customers.

The whole exercise is aimed at keeping the business tree

free of dead wood, and dried leaves, and keep it hale and

healthy. If Organizations ensure the above in all sinceri-

ty, the results will be highly rewarding.▌

V. Srinivasan has headed Sales

Administration & HR functions in

reputed Pharma Companies, with

over 325 published articles in India

and abroad. He can be reached at

shridhar1956@rediffmail.com

Mob: 8056168585

Become A Certified Pharma Sales Trainer.

To register, email: anupsoans@gmail.com

17th, 18th & 19th December, 2012 at Mumbai

Fee: ` 22,500/- per participant.

Early bird fee: ` 19,500/- (for registrations before 10th November 2012)

uring joint working by the FLMs with their sales people,

post call analysis is a common practice. Mostly it ends up

as a post-mortem, or after-action call discussions. Gener-

ally you will look at what went well and what could have

gone better. But how many of the FLMs have considered

conducting 'advance-action sessions'?

Can the earlier experiences of the 'calls' be reflected? Can

the communication required to make the call be articulat-

ed and practiced? Look at this as 'pre-mortem' activity.

Prepare this by asking these 3 questions :

1. What worked well in previous calls that is worth

considering for this call?

2. What could have been done differently in previous

calls that should be kept in mind now?

3. What new things should be considered for trying on

the new calls ?

Lessons from the past is very helpful during ON THE

JOB coaching and helps find newer solutions. It also

breaks falling into the rut of the routine.

Creating a "high performance" climate. When you are dealing with 5 to 6 people in your team,

building the team's morale is your important responsibil-

ity. You can do this by ensuring that each of your team

member is engaged, enthusiastic and ready to make posi-

tive contributions.

MedicinMan November 2012 >>> Coaching | Page 6

Making “calls” effective. K. Hariram

Take these 4 steps :

1. Spend one-on-one time with each team member. Spend

time with each person and know how the individual is

doing on both personal and work level. Provide feedback

promptly.

2. Coach on the job. Show them how to do even better.

Help them in finding solutions to job-related problems.

Support them in finding alternate resources for solving

personal problems, without becoming too much involved

in the details of their personal lives.

3. Make their jobs more interesting. Build variety in their

assignments and challenge them positively. When they

demonstrate their competence, recognize and share it

with other team members.

4. Let them know you trust them. Clarify and explain

what you want them to do and allow them to suggest

ways. Set boundary lines and parameters and monitor the

same. Help them to learn from past mistakes. ▌

To create a “high-performance” climate

at work follow these 4 steps:

1. Spend one-on-one time with each

member of your team.

2. Coach them on-the-job.

3. Make their work interesting.

4. Let them know you trust them.”

K. Hariram is the former MD of Galderma

India. This article is fourth in a series on

“Coaching” authored by him.

“

← Home

MedicinMan PRESENTS

Where Pharma Business Leaders Brainstorm 3rd Edition

In Partnership with:

Kingpins

Management

Consultancy

BREAKFAST

FOR THE BRAIN

hen I moved from 1st MBBS to 2nd MBBS, the initial

excitement of bedside medicine was understandingly a bit

too overwhelming, given that I was all of eighteen going on

nineteen at that time. The burden of the white coat was

getting somewhat bearable but not the over-bearing pres-

ence of our medicine professor who prided himself on not

only superlative clinical knowledge but impeccable

Queen‘s English as well.

His favorite question was, what are the three most im-

portant things in clinical medicine? After we would hazard

one wild guess after another for ten minutes or so, he would

make his pronouncement in a triumphant voice from a

puffed up chest: ‗diagnosis, diagnosis, diagnosis‘. At that,

our awe for him would go up three notches: wow, how

clever! Never mind what today‘s professors and students

think about the disposable commodity called diagnosis!

3 ‘P’s A decade and a half later, my first ‗sales promotion man-

ager‘ (yes, marketing manager came later) with a similar

personality trait would ask a similar question: what are the

three most important things for a ‗medical rep‘ to succeed

in his career? Assorted sound bytes would come from dif-

ferent corners of the room, to which the manager would

only shake his head slowly and then pronounce in a serious

voice, ‗product knowledge, product knowledge, product

knowledge‘. And we would go, wow, how clever!

Mind you, it worked. And still does. Your display and dis-

semination of razor sharp product knowledge would surely

get you the doctor‘s ears as well as admiration, often culmi-

nating in that vital document called prescription. But when

the landscape of products underwent a sea change with

more and more branded generics flooding the market, there

came a time to re-think strategies.

Half - dollar A standard challenge in selling/marketing was, is and will

be, how to promote your half dollar over the other guy‘s?

The art and science of making a doctor prescribe your ge-

neric (forget the branding façade) version of say azithromy-

cin in preference to your competitor‘s generic version of

MedicinMan November 2012 >>> Personal Success | Page 12 ← Home

Dr. S. Srinivasan

“You” Matter Most in

Getting Repeat Rx.

azithromycin is still posing formidable challenges across

the board and up and down the hierarchy of most marketing

organizations.

And this started applying not only to small molecules but

also large ones like insulins, monoclonal antibodies and so

on. There was a phase when the ‗original‘ MNC marketer

of a molecule would attack the ‗copies‘ on quality issues to

justify his higher price. But this didn‘t last long as Indian

companies surged ahead with good quality products at low-

er prices, not only in India but even in ‗sophisticated‘ mar-

kets.

On expiry of the patent period for a block-buster, the origi-

nal discoverer would argue that his generic is superior to

the lesser mortal‘s generic but that argument too does not

wash any more as seen in recent examples of lipid lowering

and other types of drugs.

‘You’ matter

So, where do you stand in a crowded bazaar where you

have to out-shout the other guy selling the self-same medi-

cine at crazy prices with bizarre messages? Well, there is

no magic wand that would save you here save your own

self. By that I mean, when product knowledge alone won‘t

take you far, you wear one of de Bono‘s hats, or make your

own, and showcase yourself in clever ways.

There are doctors who would / should be asking for / think-

ing of YOU when it comes to writing a prescription. Your

command over the product, your communication skills,

your sense of anticipation of the doctor‘s thinking, your

unique value systems that make you what you are….these

are the things that somehow create a bond between you and

the prescriber and clinch the sale. In short, YOU should

start mattering more than the product. Sounds odd? Think

about it anyway. ▌

Dr. S. Srinivasan is former Sr. VP at

Aventis. He is currently a lifecoach

and Dean, Medical Education at

MedicinMan Academy.

Vacancies brought to you by Kingpins Management Consultancy

Position / designation

Area Business Manager (Rachi & Aurangabad). (MNC, Diagnos-

tics)

Essential qualifications:

B. Pharm/B.Sc in Bio Science/Chemistry

Critical attributes / qualities:

Good communication and Negotiation skill, good team player,

Fast learner, Good relationship with Diabetologists/Physicians

and Cardiologists of the area

Brief Job Description:

1. Promote the products to Diabetologists /Physicians/

GPs / Laboratories

2. Procure institutional business

3. Visit retailers to make the product available and collect

the information on competition. Arrange for product

displays at retail chemists.

4. Conduct diabetes awareness programmes

5. Attend to the product complaints.

6. Train and guide salesmen of the distributors who supple-

ment the sales efforts of the company sales staff.

7. Appoint distributors as per the business need

8. Organize CMEs for doctors

9. Organize training for the Nursing staff on the handling of

our products in institutions who use our products

Preferred age group: 24-28 years.

Compensation package: Rs 1.5 lacs- 2.25 lacs.

Job Description

Retail Business Manager (Mumbai & Chennai) (MNC)

Qualification: B.Sc. (minimum)

Experience: 1.5 – 4 years

CTC Offered: Rs. 1.65 Lacs – Rs. 3 Lacs

Reporting: Zonal Manager

Team: Marketing Associates (3 – 6 people as per the location /

market requirement)

Responsibilities:

1. New business development & maintenance of existing

accounts.

2. Meeting up with chemists, retailers (medical shops) for

Glucometer.

3. Managing the marketing associates & motivating them

for higher turnover, better productivity.

4. Organizing promotional events in banks, corporate offic-

es as well as relevant exhibits.

Job Description

District Manager (2 Positions—Nasik & Mumbai (Thane down

& Central Mumbai)

Job Title: District Manager

Span of Control: 5 Medical Representatives (outsourced – 3rd

party payroll)

Business Potential: 30 lacs / month

Salary offered: up to 5 lacs

Key Skills:

1. Candidate must be working on field as a First Line Manag-

er, in a Pharmaceutical company featuring in TOP 50

Companies rated by ORG.

2. Candidate must have a good command over English

language – Conversational & Written.

3. Candidate must have a good clarity of the role of a First

Line manager. Must have good management skills.

4. Candidate must be achievement oriented. Please provide

data of previous 2-3 years target achievement.

5. Candidate must have a passion to excel in Pharma Sales.

6. Candidate must have basic knowledge of MS Office.

Job Description

Medical Business Manager (Jaipur, Bangalore & Mumbai)

Experience: Fresher / 1.5 – 4 years

Qualification: B.Sc (minimum)

CTC Offered: Rs. 1.50 Lacs – Rs. 3 Lacs

Reporting: Zonal Manager

Responsibilities:

1. Generating new business leads &taking care of the

existing clients.

2. Meeting up with doctors, nursing homes & various

hospitals for Glucometer sales & getting prescriptions.

3. Actively participating in the special activities conducted

by the doctors.

Contact: Balraj Chandra Mob: 91.9769058671, +91.9833580904

Email: balraj@kingpinsindia.com Website: www.kingpinsindia.com

Attention HR and Placement Agencies!

MedicinMan reaches over 40,000 pharma professionals.

50% Discount of advertisement rates for Sales and Marketing

and related vacancies i.e. Rs. 15,000/- for full page color ad-

vertisement instead of Rs. 30,000/- for all other advertisers.

anupsoans@gmail.com

ield Force Excellence (FFE) can be defined as field

force – doctor engagement wherein:

1. The doctor experiences tangible value in their in-

teraction with pharma field force leading to better

patient outcomes.

2. The field force experiences satisfaction with their

career and meaning in their daily work.

3. The field force – doctor engagement results in in-

creased productivity for pharma companies.

―Field Force Excellence - are we kidding ourselves?‖

This remark by a senior SFE professional from a

reputed MNC summed up the thoughts of some of

the delegates at the first ever Pharma CEO

Roundtable on Field Force Excellence on June 16,

2012 at the JW Marriott, Mumbai.

In response, veteran CEO, Narayan B Gad of Pana-

cea Biotec took the question head-on by saying –

―Excellence might seem like a utopian idea, but we

can certainly move forward from efficiency to effec-

tiveness, which together will take us closer to excel-

lence as envisaged by MedicinMan, the organizers of

FFE 2012.‖

FFE 2012 was conducted in the backdrop of deterio-

rating quality of pharma field force in India. On

stage and in the audience were senior Indian pharma

industry professionals including CEOs, who had

risen from the ranks of field force in the preceding

25 years. Where had the Indian pharma field force

gone wrong so dramatically that it was now strug-

gling to find quality people to shore up the ever-

expanding front-lines and sales leadership positions?

Field Force

Excellence:

Are we kidding

ourselves ??

The rise of Indian pharma both in India and globally is

matched only by the Indian IT and BPO sector, which gave

the Indian professionals a great opportunity to build careers

at a hitherto unknown pace. Twenty somethings were be-

coming General Managers and VPs and acquiring houses

and cars within 5 years of working. The rise of IT and BPO

had a cascading effect on the increase in job opportunities in

Retail, Insurance, Finance and Banking and a host of other

Greenfield sectors. Pharma became a laggard in attracting

talent at the entry level and this has had a negative effect in

building a sales leadership pipeline in an industry that was

growing at thrice the speed of Indian economy.

Feet-on-street was the logic of many Indian pharma compa-

nies that were growing at a break-neck speed from the 80s

and forwards. MNCs and many Indian companies tried

Anup Soans

MedicinMan November 2012 >>> Field Force Excellence | Page 8

FFE 2012 hosted by MedicinMan, saw intense discussion on the fea-

sibility of field force excellence in the current business environment.

“

This article was first published in Pharmaphorum.

The Indian IT and BPO sector gave Indian

professionals an opportunity to build ca-

reers at a hitherto unknown pace and

had a cascading effect on Retail, Insur-

ance, Finance and Banking and a host

of other Greenfield sectors. Pharma be-

came a laggard in attracting talent at

the entry level and this has had a nega-

tive effect in building a sales leadership

pipeline in an industry that was growing

at thrice the speed of Indian economy.”

← Home

swimming against the prevailing trends by recruiting

and training people to perform at earlier levels of com-

petence. But it was a losing battle – the fast-growing

Indian pharma companies were liberally poaching from

the MNCs and other well-managed Indian companies

instead of nurturing their own field force. Medical Reps

in MNCs who had to wait for 10 years and more for

promotions now found themselves moving up the steep

ladder at the rapid pace of IT companies.

Just as prosperity comes with a price of obesity and a

host of related lifestyle disorders, the price of rapid

growth in the Indian Pharma has been the decline of

quality of field force people. Indian Pharma companies

not only reverse engineered and copied IP products of

MNCs, they added their own ‗jugaad‘ in creating ra-

tional and irrational combinations that had the doctors

reeling from an overdose of too many branded generics

(60,000) and their combinations.

Along with jugaad drug combinations, came the jugaad

promotions that did not need much talent. Carrying

expensive gifts and booking exotic tour locations re-

quired as much talent of a street-smart pizza delivery

boy. Irrational drug combinations, irrational copycat

promotions – nobody questions the sanity of methods

when the growth is assured. Ethics went for a toss as

MBAs competed with veteran field sales leaders to

prove their worth through get-rich-quick MLM like

strategies, which unfortunately led to decline of field

force – poor quality recruits, little training, promotions

without development and high pressure management.

Talent fled the pharma industry in large numbers and

mediocrity ruled the day. No wonder veterans look at

the present scenario and remark: ―Field Force Excel-

lence - are we kidding ourselves?‖

But the darkest night is also just before the dawn. The

declining productivity of field force, increasing social

activism against pharma-doctor nexus, governmental

regulations and an uncertain global economy are forcing

Indian Pharma to rethink their way of doing business.

The transactional relationship with doctors has run its

full course and the returns are diminishing steadily. To

reverse these negative trends and bring about a transfor-

mation in the relationship with doctors, Indian Pharma

will have to reinvent its field force again. The new gen-

erations of students coming out of campuses are coming

equipped with some unique skill sets – they are

the digital natives. The rise of technology enabled doc-

tor and social media will provide Indian Pharma with

unique ways of engaging the doctors – from fatigue to

fun. Both doctors and field force have been experienc-

ing a high level of dissatisfaction in their interactions.

While field force will remain the lynchpin of doctor-

pharma equation, it will be the technology enabled

Medical Rep and Front-line Managers who will re-

create trust and build relationship by understanding the

doctor‘s business and adding real value.

The repositioning of Field Force has to be well thought

out and must address the needs of patients and doctors

and not just the promotional interests of Pharma compa-

nies. There is a lot that pharma field force can do in this

MedicinMan November 2012 | Page 9 Field force excellence - are we kidding ourselves?

“ Along with jugaad drug com-

binations, came the jugaad

promotions that did not need

much talent. Carrying expen-

sive gifts and booking exotic

tour locations required as

much talent of a street-smart

pizza delivery boy.”

“Jugaad” - the Indian approach to

skirting obstacles.

regard as they are on the field where the action is.

Social media has the potential to engage, build trust

and communicate effectively in a media format that

already has the patients and doctors tuned in. Gadgets

like iPads have the potential to take CRM and other

customer engagement models to effectiveness levels

not possible earlier. These gadgets also have the po-

tential to make learning an ongoing practice instead

of periodic events.

iPads have the potential to transform the Medical

Reps learning process and make them more knowl-

edgeable about the therapy areas in which their cus-

tomers operate. A seamless loop that connects Medi-

cal Reps, Front-line Managers, Training Managers,

doctors, chemists and other stakeholders has the po-

tential to go beyond the present silo approach and

bring HR, Sales, Medical Affairs, Administration and

other function including finance on the same page. It

can bring about beneficial changes in neglected areas

like ADR by systematic reporting and response in

real time, adding much value to medical practice.

In short, the scope for field force excellence is enor-

mous if Indian Pharma takes the leap and re-

configures its field force strategy from recruitment to

management.

The results of a MedicinMan Poll with more than 400

respondents on LinkedIn are instructive of the aspira-

tions of employees. Learning and Development was

the No.1 job satisfier for employees in the 18–29 age

group (for details and comments of the poll: http://

linkd.in/MDfstI). This is very heartening indeed.

Entry-level employees are aware that Learning and

Development is the key to success in their career.

Presently most Indian Pharma companies pay scant attention

to learning and development needs of Medical Reps and

Front-line Managers. The high attrition rate serves as a

dampener on investing in people. This has led to the entire

ecosystem of field people being ill equipped to handle the

new challenges of healthcare marketing.

With the advent of Cloud Computing and the high involve-

ment of Gen Y in social media and the emergence of cell-

phone as an ubiquitous device, it is possible for pharma to

engage its field force on a regular basis and bring about field

force excellence in the near future.▌

MedicinMan November 2012 | Page 10

The scope for field force

excellence is enormous if

Indian Pharma takes the

leap and re-configures its

field force strategy from

recruitment to manage-

ment.”

“

MedicinMan poll on factors

influencing job-satisfaction.

Bringing about employee

engagement by taking these

factors into account is a key

part of Field Force Excellence.

Field force excellence - are we kidding ourselves?

Anup Soans is an author, facilitator

and the Editor of MedicinMan. Connect

with him on Linkedin (linkedin.com/in/

anupsoans) or write to him at

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MedicinMan November 2012 >>> Hot on Linkedin

“ ”

| Page 14

Field Managers are going blindly for their co-visit in the market with their field staff.

FLMs are going for fieldwork with medical reps blindly just to show to the top management that they

have done their job. They visit the areas and doctors from whom medical rep is already getting prescrip-

tions. They visit the stockist to get the order to achieve the budget through their visit influence. FLM‘s

visit cannot be called productive till the time they follow these guidelines:

1. Do a survey with chemists regarding Doctors that can prescribe products of the company. Who are

prescribing the competitor‘s brand?

2. Manager‘s visit can be called productive if he has been able to convert the doctors with his visit. He should ask the

medical rep to follow up with doctor for Rx in the subsequent call by medical rep.

3. Manager should check with chemist and stockist regarding any distribution problem.

4. He should solve problems being faced by the medical rep.

5. During the next visit FLM should find out the from medical rep regarding the outcome of his last co-visited areas and

he should give some time to the last visited area.

6. Manager should cover the complete territory of medical rep in a year.

7. Manager should give preference to territories from where sales are low to check what the reasons for low sales are and

give guidelines to medical reps on how to increase sales.

8. Manager should use his strengths to strengthen the medical rep.

Ajay Kumar

The entire industry is afflicted with the ―free radical syndrome‖ (high attrition), largely due to poorly em-

powered, uninformed and ill equipped FLMs, who come on board with limited knowledge of managerial

competencies - namely decision making, delegating, problem solving, team work, etc.

In the earlier days, the selection process used to be elaborate, comprehensive and tested a potential candi-

date from multiple perspectives, through group discussions, case study presentations, inter-

views. Candidates who came out successful from such intense screening were found to match the rigors &

demands of the managerial job.

The immediate need today therefore is to identify the potential in the system, not just in terms of sales

performance, but in terms of overall potential to succeed at the next level. This obviously requires mapping FLMs against

well defined job related competencies, investing time and effort to nurture & develop them on these competencies. Then

put them through a robust assessment process and put them on the job. The process is certainly time consuming, will not

show immediate visible results. However it is bound to pay rich dividends in the long run. For people don't leave organiza-

tions, they leave their bosses.

Sankaran SS

← Home

MedicinMan November 2012 >>> Hot on Linkedin MedicinMan November 2012 >>> Hot on Linkedin | Page 15 ← Home

During the 1st week & last week of the month, the Area Manager is found running from pillar to post to

close sales in order to fulfill sales commitments given in the monthly meeting. Once sales are closed, he

has to do preparation for presentation, compilation of secondary sales and deficits. For this he requires

time and nearly 1/3 of the month is lost in this process. What is the need for these monthly meetings?

This is a disincentive for carrying out productive joint in-clinic work. I have also observed higher man-

agement of some companies speaking late at nigh - at 10 PM or later - or in early morning, without any

concern about what time the AM / RM was back from tour or what time he has started his work.

These are the reasons for high attrition rates and the need to fill vacancies by compromising in the selection of MRs / AMs.

I can only say there should be come code of conduct, work norms, discipline in talk & clear communication especially dur-

ing month-ends, when the standard of talk goes down drastically. (paraphrased)

Manoj Singh

As long as 'come what may, get numbers by month end' approach continues, merely criticizing FLMs or

for that matter, even SLMs will only add to the problems. Sales force cycle meetings should be for renew-

ing, refreshing & rejuvenating the sales team and not merely to take out their frustrations and demoralize

the team. Create an environment where people have inner motivation. Do not simply throw motivating

words which are manipulative. Let the sales team get involved in their budgeting process. Yesterday's

work force swallowed the Top Down approach; certainly the current generation may not...unless con-

vinced. Focus on FLMs‘ development; the multiplying effect will be beneficial. At each level avoid

BLAME game; build a TAKE CHARGE attitude. Do not compromise on basics and fundamentals. Treat

the FLMs with respect and anything critical, discuss separately - in short, protect his self respect in front of his team. Right

from top to bottom, let every person ' walk the talk'. (paraphrased)

K. Hariram

FLM should spend good and quality time in field with MR. He should go in the field after doing proper

home work. Now, just imagine the situation we offer to FLM in most of the companies: with fixed days for

meeting and travelling, how much time do we give to him for his analyses / homework? Beside time, what

are the tools which we give to him to do analysis? Even in today's hi tech world, many of the companies are

working on ghostly looking excel sheets / pivot table, having lot of data but nothing obvious ACTIONA-

BLE shown. (paraphrased)

In order to bring about the role transformation from M.R to A.S.M. specific programs are needed to con-

sciously build the confidence of the A.S.M. as an observer and then a solution provider to the problems faced

by a M.R. An A.S.M. has to differentiate between product training (hard skills) ROLE training (soft skills) to

add value to joint work. This can be achieved by periodic induction. (paraphrased)

Jyoti Jain

Deb B.

It has been my personal experience that it is the FLM / SLM ( 80—20%) responsible for a company's fate.

In every cycle meet, I personally allot a day for product knowledge developmental activity. Accordingly,

each FLM/SLM has to come fully prepared with presentation on assigned ONE product each, and take

class in detail. It works wonderfully. All FLM, SLM, ZSMs are made to mandatorily visit and work along

with subordinates on permissible regular intervals. The visit plan must include Dr's (at least 2 of

each specialization, so as to ensure promotion of maximum available/ stocked products), C&F, Stockists

and Retail visits. Besides, even senior managers should follow the laid guidelines during their visits, so

as to set examples and help take appropriate decisions if problems exist. (paraphrased)

Pramod Sharma

MedicinMan November 2012 >>> Hot on Linkedin ← Home | Page 16

A Field Manager, before going to field work with medical rep, should visit the stockist/super stockist and find

out the product movement. Examining the medical rep's tour program he must find out which areas have poor

performance. Then the Manager should visit the poor performing areas with the medical rep and analyse the

reason for poor sales. After that he should find a solution for the problem and hand over the area to MR. In

his next visit again he should visit that area and see the results. With this exercise the sales will increase and

MR will be happy because AM has solved his problem. Also AM will build a personal bond with MR. R. Shetty

The basic objective of the FLM is to develop his MR, be it by demonstration, direction (training if required),

observation and delegation once ready. I would be a little concerned if the FLM is sorting out problems of the

MRs regularly, he should not be a solution provider but a solution facilitator.

Kultaran SS

Its true that the field managers go to field without any preparation and just become passengers on the bikes of

medical representatives. They go to doctors along with the medical representative and hijack the call, become

a ―super representative‖, try to boss over the poor Medical Representative and go home with false satisfac-

tion. This is true, not only for the line managers, but also most of the bosses of the medical representatives.

They feel delighted in doing super-MR's job. As a result, a good MR, who may need coaching or support or

delegation, feels depressed and remains disengaged. He simply waits for his so-called bosses to return to do

his job after 15 days or a month and does all the manipulations to achieve numbers. Finally, getting disappointed, he leaves

the organization with a hope that, someone, somewhere will take care of him. But it remains same across the companies

and across the management community. It can only be changed if, the bosses change their mindset from doing to observing,

giving proper feedback and caring for their subordinates.

Manas Dash

“ ” What are the priority areas? What do you think an SFE Manager/Analyst should focus on first? Is it segmentation

and targeting? Or maybe call frequency optimization? Or maybe the sales incentives program?

- Krzysztof Lasocki

The starting point always is the company's objective. Then you analyze and look into the sales process: from target-

ing to segmentation to segment strategies to execution. Once these details are all coherently driving and pointing

towards the company objective, you look into the call process. (Re to "objective" please look here.)

The effect of incentives (in mature markets) in any case is disputable. In general anything you measure must match

and drive objectives. SFE in this context should be defined as getting more for the same or the same for less. Hanno Wolfram

In my experience the Key Driver of any SFE initiative is communication and buy in. If the field sales force does not

understand the objective of the initiative then the data captured (if using a CRM system) can be manufactured to "Hit

the Number". As stated in Hanno's post the Objective must align with the process but the understanding of the Value

must be communicated and all stakeholders in agreement. James Buck

MedicinMan November 2012 >>> Hot on Linkedin MedicinMan November 2012 >>> Hot on Linkedin | Page 17 ← Home

Assuming that we are leading a start up organization and the primary objective is to generate productivity from the budgeted re-

sources from day one, then applying the 4S principle will help.

1. Structure - Deployment of field force on the basis of customer, coverage and competition . Also consider their alignment

basis channel of distribution.

2. Systems - set clear KRA, KPIs, sales targets, daily/weekly reporting formats/CRM.

3. Skills - KAM, multi stake holder selling.

4. Spirit - Reward/incentive and recognition.

Finally lot of discussion is happening on CLM and if implemented correctly the yield could be above average.

- Arupendra Das

Prescriptions are not only the reflections of one's sales behaviour but the reflections of one's beliefs. One of the

main drivers of SFE sould be to address this belief. High technical skills and conceptual skills are always impart-

ed. But what is neglected is the human part. In a highly competitive environment it is important that people

should be made to believe what an organization considers as "Effectiveness". If the indicators are "profitability &

target achievement‖ then we are missing the core of SFE. Many universities teach subjects ranging from history

to economics to Marketing but only few are really coaching people for "Sales‖. The curriculum should be fo-

cused on "Communication & Sales Behavior‖. Govindrajan D.

I like that Govindaraj has mentioned "profitability and target achievement are not the key indicators of effectiveness". This would

bring us to the question of what is meant by "Effectiveness". Would you consider a field force person who has very good

knowledge of the product and can communicate with the doctor very well, but cannot get the extra prescription that his manager

demands as ―effective‖ or would you consider a street smart rep who can discuss everything under the sun with the customer and

get the extra prescription?

I think before we even discuss the drivers of effectiveness we should understand what effectiveness means for various levels of

hierarchy in Pharma. For the frontline manager who has to keep his team‘s commitments it is totally sales and target driven, for

the brand manager it is totally strategy and campaign management driven and for product manager it is by the feedback on the

key messages that he creates every cycle. And the one person who has to keep everyone plus his doctors satisfied is the poor

rep.

- Venkatesh Annadevara

Following Venkatesh's request let me quote Peter Drucker, THE Management Teacher of the last century:

―Effectiveness = doing the right thing. Efficiency = doing things right‖

The problem in pharma is to know what is "right"!

1. I fully believe that "right" varies by company, by product portfolio and even by market place, There is noth-

ing like an interchangeable "best practice" (another one of those buzzwords) like a "one size fits all".

2. If "right" at all is defined in and for a company it is defined "inside-out": right for our revenue, right for our bottom line or

our fame etc.

3. The client perspective, be it prescribers, be it nurses or even patients is widely neglected.

In our daily life we are offered perceptions, solutions, concepts, feelings, ideas and not (no longer) products! (e.g. iPad, Coke,

BMW or Viagra). We are asked and offered to make our individual choice and no one "sells" something to us. All products we

ever buy or purchase meet our expectations and we have a preference, which was triggered by the marketing efforts of the re-

spective company.

SFE in pharma at the end of day could mean: Change perspective and look at your company (brand?) or product outside-in,

acknowledge what you see, hear and feel and then decide what is the right thing to do. Once this is done, identify the right way

doing it.

Hanno Wolfram

he directive from the Drug Controller General of

India‘s (DCGI) office to all State Drug Controllers to

issue trademarks for generic names instead of brands

– even if it was just to resolve trademark issues - is

yet another display of confounding decision making

by the Union Government that has been plaguing the

country in general and the health care sector in par-

ticular.

Over the years despite knowing of its multiplier ef-

fect on GDP, India never attached great importance

to the improved health of its population. Policy laps-

es witnessed the private sector stepping in to address

a fast rising demand for health care, creating one of

the most privatized medical systems in the world. As

a consequence, India is confronted with the problem

of meeting growing expenditure on health care which

is heavily skewed towards out-of-pocket expenses

for its citizens, driving large sections into poverty.

India‘s future lies in its demographic dividend – the

advantage of having a young, healthy and productive

work force. And to reap the benefits of this work

force we have to achieve decent health and education

outcomes for the majority. India averaged 8% p.a.

GDP growth rates over the 11th Plan period. And

yet, its public spending on health has hovered around

an abysmal 1-1.2% of GDP, one of the lowest in the

world. The Approach Paper to the 12th Plan declared

an increase to only 1.58% by 2017. And how is this

possible, given the government‘s recently vocalized

desire to move towards universal health care (UHC)

for not just its citizens but its residents that include

millions of illegal immigrants as well?

India chose to begin its journey towards UHC with

one step - to provide free medicines through its pub-

lic health system. The Centre released approximately

Rs. 30,000 crores to the States to fund the procure-

ment of medicines over the next 5 years (2012-17)

under the ongoing NRHM. After the Supreme

Court‘s intervention and with the five public-sector

pharmaceutical companies lying in shambles, the

government quickly approved the new drug pricing

policy that led to the inclusion of 348 medicines

(approximately 30% of medicines and 60% of the

market) into the National List of Essential Medicines

(NLEM) and effectively under a price controlled not

by the market, customers and competition but by the

government.

Over the years despite knowing of

its multiplier effect on GDP, India

never attached great importance

to the improved health of its pop-

ulation. Policy lapses witnessed

the private sector stepping in to

address a fast rising demand for

health care creating one of the

most privatized medical systems in

the world.

MedicinMan November 2012 >>> Industry Insight | Page 18 ← Home

Salil Kallianpur

India’s Health

Policy:

and opaque policy shifts.

Flip-flops

“

Indian

Health

Care

Simultaneously, in an ostensible effort to make medi-

cines affordable to its residents (not citizens), the gov-

ernment did two other things: 1) allow foreign direct

investment into brown field projects in the sector with

caveats such that foreign companies who invest in India

will produce stipulated quantities of essential medicines

and invest in local manufacturing and R&D 2) demon-

strate that it will use compulsory licensing more as a

weapon of choice than as one of need.

Both these steps make sense in the short term thus

providing political capital to the government for the

upcoming general elections in 2014, but harm the fu-

ture of India as a preferred destination in the long term,

thus depriving the opportunity to create economic capi-

tal. What vindicates this point is that to this date, there

has been no effort from the government to invest in

creating the infrastructure required to deliver superior

health outcomes to the population despite it being the

root cause for the inflow into the private sector despite

all its societal evils.

However, all this pales in comparison to the DCGI di-

rective to state drug controllers to not issue marketing

licenses for trademarks or branded drugs but in their

generic names alone. While the technicality of this de-

cision alone warrants a separate column, it suffices to

say that this makes no sense whatsoever. Authorities

are expected to regulate or legislate to help either the

industry, traders or end consumers. This decision helps

none of these groups or anyone else. All it does is com-

moditize the industry thus threatening to wipe out small

and medium players who lack the financial strength to

compete with MNCs who despite severe pressure on

profit margins will survive. The consumer has little or

no knowledge of the brands of medicines and therefore

is unlikely to benefit from the decision. The only group

that will benefit are the middlemen – the traders – who

will control the supply of medicines and make unholy

profits in the bargain. Under harsh criticism, the DCGI

recently clarified informally that this directive was

more to resolve trademark issues. Apparently, too

many similar sounding trademarks confuse doctors and

retailers. If it really is the reason, the decision is laugh-

able. Isn‘t it easier for similar sounding trademarks to

be denied by the regulators, thus pushing the onus back

on the industry to decide on clearly differentiated trade-

marks?

On one hand, India signals that it will welcome much

needed FDI into the sector. But on the other it threat-

ens to disregard product patents, invoke compulsory

licensing, discontinue issuance of marketing licenses

to trademarks while controlling prices on essential

drugs and also considers controlling prices for patent-

protected innovative drugs as well. Such indecisive-

ness about policy bodes ill for a country that faces the

daunting challenge of enrolling, financing and provid-

ing acceptable health outcomes for 1.2 billion citizens

and millions of other residents, illegal or otherwise.

For such largesse, it could actually do well with help it

can garner from all quarters.

Why then is the government alienating itself both from

the domestic industry as well the international society?

These policy flip-flops are confounding! Why would

the Indian government risk global criticism by openly

demonstrating clear indecisiveness? Is this driven by

an argument about poor public sector performance in

delivering health care? Undeniably, it has been lack-

ing, which reflects in the dismal health outcomes in the

country. Or as noted academic scholar, Kaveri Gill

wonders in a blog post, is this seemingly open decision

-making process merely a dangerous opaque shift in

policy, which has very little to do with evidence and

even less to do with broad-based consensus? ▌

The only group that will benefit

(from the DGCI’s recent directive)

are the middlemen – the traders –

who will control the supply of medi-

cines and make unholy profits in

the bargain.

MedicinMan November 2012 | Page 19

“

Salil Kallianpur is a health care market-

ing professional based in Mumbai, India.

He is an avid reader and follows the

health care industry, its politics, strategy

and current affairs and writes on the

intersection of health care and life in

general at his blog “My Pharma Reviews”. The views in this

article are his own. His twitter handle is @salilkallianpur.

India’s Health Care - flip-flops and opaque policy shifts.

MedicinMan November 2012 >>> Pharmacology for the Rep

Digital Dose

| Page 12 MedicinMan November 2012 >>> Social Media | Page 20 ← Home

For Natives and Immigrants

Dinesh Chindarkar

We are living in the Tech Age. The world is changing every

second. The quest for faster, better, more and beyond is rever-

berating throughout the globe. We are breaking barriers, reach-

ing across borders and exploring new dimensions in every

field, be it medicine, space travel, communications or enter-

tainment. Going Digital is the new mantra.

In this rapidly changing world, the concept of marketing is

rapidly undergoing a paradigm shift. The emerging digital me-

dia has not only attracted many marketers but growing number

of consumers are also getting hooked onto it. In developed

markets, even Pharma marketing is following the techno path.

This pattern is also being replicated in India as increasingly

aware patients are seeking more information. Indian medical

community is fast climbing on to the digital & social media

bandwagon apart from just browsing through studies on the

net. Hence, Digital marketing opens up a Pandora's box and

also throws up newer opportunities to marketing & sales to

connect with the customer & the consumer.

Hence we are initiating this series of articles – ‗Digital Dose

for Indian Pharma‘.

‗Digital Dose for Indian Pharma‘ – is a series that will take

you step by step through the varied properties of Digital and

Social Media world. We understand that social media is not

just about Facebook or posting Videos…its much more than

that.

IS IT THE END OF THE ROAD FOR THE INDIAN PHARMACEUTICAL INDUSTRY?

By Vivek Hattangadi

Is it the end of the road for the maturing pharmaceutical industry in India?

The signs are ominous. If the DCI goes ahead with its plan, (as reported in

Times of India of 16th October) to have only generic drugs in India, it will

sound the death knell of the industry. The market than will be dominated by

the militant middle men who already enjoy very high profit margins – over

35% - much higher than any other industry. The middle men are already

sucking blood from those who need blood transfusions – the critically ill!

Read the complete article HERE.

INDIA‘S MOVE TO VANILLA GENERICS: DON‘T HOLD

YOUR BREATH

By Gauri Kamath (apothecurry.wordpress.com)

By now, the news that India wants to move away

from branded generics and encourage vanilla gener-

ics to bring down drug prices has gone around the

world. But all those who think a structural reform of

the Indian drug industry is around the corner : stop.

And breathe.

Read the complete article HERE.

This series will help you gain an insight into social media

and will help you get comfortable with new media trends,

identify various opportunities in this segment and inform

you about some successful digital media strategies in the

Pharma space. In this part we are going to understand the

term Social Media.

What is social media?

To put it in simple words Social media is an interactive

means of social communication with the world. Newspa-

pers or TV are also informative medias but are not inter-

active channels – it is a one-way communication. So these

traditional media are like a one way lane, an article can be

read but your views on it cannot be expressed simultane-

ously or a television programme can be viewed but not

influenced in any way. On the other hand, social media is

like a two way lane in which information is given and

feedback is taken simultaneously. It is both informative as

well as interactive. At the core of Social Media lies

‗instant gratification‘.

The next part in this series will cover Facebook.▌

Dinesh Chindarkar is Co-Founder

& Vice President - Operations at

MediaMedic Communications and

is Country Head for Global

HealthPR.

ontinuing with the topic of Pharmacokinetics, this section

covers some of the remaining important definitions.

As mentioned in the earlier sections, liver is the major site

of drug metabolism, and the initial metabolism of drugs

in the liver is referred as Hepatic First Pass Metabolism.

When a drug is absorbed across the gastro-intestinal sys-

tem, it enters the liver before entering the circulation. If

the drug is rapidly metabolized by the liver, the amount of

unchanged drug that gains access to the systemic circula-

tion is decreased. Many drugs like propranolol undergo

significant biotransformation during a single passage

through the liver. The drugs given by the oral route un-

dergo significant hepatic first pass metabolism whereas

drugs given by parenteral route (e.g. intravenous or intra-

muscular route) do not undergo hepatic first pass metabo-

lism, thus achieve a higher a bioavailability. So, certain

drugs which are efficiently inactivated in the liver like

lidocaine cannot be given by oral route and have to be

given parenterally.

Another concept about the metabolism and excretion ki-

netics is the order of elimination i.e. first order or zero

order kinetics. Most of the drugs demonstrate first order

kinetics in standard therapeutic doses, i.e. the amount of

drug that is metabolized or excreted in a given unit of

time is directly proportional to the concentration of drug

in the systemic circulation at that time. On the other hand,

a small number of drugs e.g. phenytoin and aspirin

demonstrate zero order kinetics or saturation kinetics in

which the clearance rate remains constant despite increas-

ing plasma drug levels. This can result in dangerously

elevated plasma concentrations of the drug with a small

increase in the dose of the drug.

Some other clinically important definitions include bioe-

quivalence, steady state, loading dose and maintenance

dose.

Bioequivalence: Two related drugs are said to be bioe-

quivalent if they show comparable bioavailability and

similar times to achieve peak blood concentrations. Two

related drugs with a significant difference in bioavailabil-

ity are said to be bioinequivalent.

Steady state: Immediately following the initiation of drug

therapy, the rate of drug entry into the body is much great-

er than the elimination rate, therefore the drug concentra-

tion in the blood increases. As the plasma concentration

increases, the rate of elimination also increases, because

this rate is proportional to the plasma drug concentration.

Steady state is reached when the two rates are equal.

Loading dose: After administration of the drug, plasma

concentration increases, but distribution of the drug leads

to a decrease in the concentration. This decrease can be

significant for the drugs with high volume of distribution.

So, it takes four-five half-lives to achieve the therapeutic

concentration. Sometimes, a ‗loading dose‘ or a higher

dose is administered (or injected) as a single dose to

achieve the desired plasma levels rapidly.

Maintenance dose: The loading dose is followed by an

infusion to maintain the steady state and this is referred as

the maintenance dose.

All these parameters are important while deciding the dos-

ing schedule of drugs.▌

Pharmacology essentials: pharmacokinetic parameters

Dr. Amit Dang

MedicinMan November 2012 >>> Pharmacology for the Rep | Page 21 ← Home

Dr. Amit Dang is Director at Geronimo

Healthcare Solutions Pvt. Ltd.

This article is 3rd in a series of pharmacology

for the Medical Rep.

Figure 1: First order kinetics and zero order kinetics

any people think of key account management (KAM)

as a new sales model, developed as a strategic solu-

tion to the changing business needs of the healthcare

market. Do we restructure our whole organisation

around some new grouping of customers and move

completely away from the favoured coverage and

frequency model, which increasingly is being shown

to no longer work?

KAM is more of an evolution towards a more appro-

priate sales approach and does not require radical

change to be effective. Perhaps, more accurately,

KAM can be viewed as a distillation of the various

aspects of the promotional mix. While the pure aca-

demic theory of KAM promises one account plan per

key account regardless of therapy area, brand or ser-

vice, is this feasible (or even sensible) within the

pharma industry structure?

The KAM process

According to Dr Brian Smith, Open University Busi-

ness School, ―KAM is a contingency model, which

means that there is no single best way of doing it, but

rather a number of ways which work best in different

circumstances‖.

Whatever your approach, it is important to accept that

KAM is a process and not a simple one-off exercise.

In order to implement a KAM strategy, the process

must be clearly identified and metrics put in place to

monitor progress, success and what remains to be

done to achieve defined objectives.

In simple terms, KAM can be considered in three

basic steps, each of which requires further subdivi-

sion to suit specific circumstances.

Key Account

Management

Is it a new sales

model?

Account identification

The first stage of the KAM process is account identification,

profiling and segmentation. Who or what is our customer

and what is a key account? This is a familiar question be-

cause, as an industry, pharma has been profiling, segmenting

and targeting its customers in various ways. All that the

KAM approach seems to add is the need to break these cus-

tomers down into account groupings and then designate

some of them ‗key‘ to the business.

For some industries, identifying the customer is a straightfor-

ward task. However, in pharma, the question of who is the

customer always meets with the answer ―it depends‖. For

pharma, the first step in the KAM process is to agree to the

mission and purpose of the required KAM implementation

and accept that different therapy areas will probably require

Ralph Boyce, Ken Boyce, Tony O’Connor

MedicinMan November 2012 >>> Key Account Management | Page 22 ← Home

“ KAM is more of an evolution

towards a more appropriate

sales approach and does not

require radical change to be

effective. Perhaps, more ac-

curately, KAM can be viewed

as a distillation of the various

aspects of the promotional

mix.”

different but philosophically aligned KAM processes.

Once what needs to be achieved has been established,

we can move on to defining what constitutes an account

or ‗core unit‘. This can be almost anything depending

on the objective, ranging from a Cancer Network and

linked primary and secondary care bodies for an oncol-

ogy sales team, to a purchasing group of pharmacies for

a commercial sales team.

A pharma company that correctly identifies the account

or ‗core unit‘ it needs to influence and then segments

the most important ones as key accounts will greatly

increase its chances of success. The familiar

‗Pareto/80:20 rule‘ is once again an important factor in

determining the actual number of accounts that should

be considered as key.

Strategic and tactical planning

The next step in the process is to identify the individu-

als in the various parts of the key account and assess

how they interrelate. Often these individuals will work

in different locations within the key account and have

specific but related roles, such as financial, advisory

and clinical. There is then a need to repeat the profiling

and segmentation process at an individual level within

the key account, and construct the required processes

and plans. There are many experts who can help with

producing meaningful, relevant and actionable key ac-

count plans.

An individual customer contact plan will also need to be

designed to achieve objectives within the existing finan-

cial, legal and operational constraints. Once this is done,

the structure to deliver on the plans will be ready for

implementation.

Implementation

The ability to successfully implement a KAM approach

depends upon the company fully understanding its situa-

tion, developing a relevant proposition and process for

achieving its objectives and supporting the implementa-

tion with the appropriate business tools.

Analysis of different therapy areas will produce com-

pletely different key accounts. Correctly identifying the

account/core unit and applying realistic metrics to deter-

mine its importance are critical first steps. There is no

‗one size fits all‘ solution in the implementation of

KAM. Another major driver for a successful KAM im-

plementation in the pharma industry is the seniority/

maturity of the key account managers responsible for

the implementation.

MedicinMan November 2012 | Page 23 Key Account Management - a new sales model?

Key Account Management Implementation Process in

Pharmaceuticals

Profiling & Segmentation

Organisation Structure

Recruitment, Allocation & Training of KAM’s

Key account Selection

Key Account Plan

Process Implementation Process Implementation Tool

Performance Monitoring Process

Relationship Development Process

Resources Management Information & Intelligence

Purpose & Mission

© Pharma MI 2008

Key

Acc

ou

nt

Pla

nn

ing

Key

Acc

ou

nt

Exe

cuti

on

The old sales model of simply selling products to custom-

ers no longer applies. In a successful KAM approach de-

veloping a ‗win-win‘ proposition for the key account,

where the key accounts see the value of working with

pharma, will be a critical success factor. However, KAMs

are commercially astute people who have the company‘s

objectives at the forefront of their minds and who can

interact persuasively and credibly with the customers

identified as key accounts.

It must also be accepted that the KAM approach is a sales

process that has logical, time dependent, sequential steps

which, if followed correctly, will lead to success. Follow-

ing and tracking progress through the process with appro-

priate KAM business tools is another critical success fac-

tor. However, it is evident from practical experience that

many of the CRM tools pharma companies are familiar

with are no longer appropriate as they cannot adequately

support the implementation of KAM.

Measuring KAM effectiveness

Implementation of any KAM process requires the capture

and review of a number of performance indicators. These

fall into two categories: operational performance indica-

tors (OPIs) and key performance indicators (KPIs). It is

important that they are ―indicators‖ of the direction the

business is moving in and not ―measures‖ of what the

business has done. This becomes crucial at the KPI level.

From a performance management perspective, in order to

measure effectiveness it is essential that OPIs and KPIs

are derived together. KPIs must represent a summary

view of OPIs in order to maintain continuity of measure-

ment. KAMs mainly use OPIs to support their actions

when seeking to achieve high performance. They allow

the individuals concerned to record the achievement of the

various stages in the implementation plan and flag areas

that still need to be improved. KPIs pull these OPIs to-

gether and are used by the KAM management team to

monitor the performance of the business unit as a whole.

Conclusion

KAM is not as revolutionary as some suggest. Yes, it is a

departure from the traditional sales model, but it is only

evolving away from an approach that is failing. The phar-

ma industry‘s traditional relationships with its customers

are changing and, in response to this, progressive compa-

nies have adopted and successfully implemented KAM .

If the healthcare market continues to change as predicted,

the companies that are waiting and watching may find that

not only are their multiple sales forces no longer required,

but that they are unable to put a meaningful proposition to

their customers.▌

Operational Performance Indicators: The following are important indicators of performance,

i.e. they show the direction of the business as opposed to

what the business has done, such as other systems like

corporate dashboards and the balanced scorecards do.

Activities report - shows the current status of a key ac-

count plan or opportunity as compared to plan

Late task report - shows the current status of all tasks as

compared to planned completion

Key account relationship index report - tracks the sta-

tus of the supplier / client relationship over time

Key contact relationship index report - tracks the status

of the KAM / client contact relationship over time

Decision making unit (DMU) report - tracks the status

of the DMU status and relationship over time

Key account sales tracker - tracks sales by key account.

Key Performance Indicators

Time allocation analysis - tracks time allocation by cate-

gory over time

Key account relationship tracker - summary of equiva-

lent OPI

Key contact relationship tracker - summary of equiva-

lent OPI

Decision making unit - summary of equivalent OPI

Key account sales tracker - summary of equivalent OPI.

“ The KAM approach is a

sales process that has

logical, time dependent

sequential steps.”

Ralph Boyce, Ken Boyce, Tony O’Connor are

Directors at Pharma MI

This article was previously published in Pharma-

ceutical Marketing May 2008.

Published in MedicinMan with the permission of

authors.

MedicinMan November 2012 | Page 24 Key Account Management - a new sales model? MedicinMan November 2012 >>> Book Preview

MedicinMan November 2012 >>> Book Preview | Page 25 ← Home

Book Preview: Pharma Front-line Leader to CEO

by Vivek Hattangadi

The ost exciting characteristic of the pharmaceutical

industry in India is that many CEOs have started their

careers as humble medical representatives. By the time

they became first-line leaders, the ambitious amongst

them dreamt of reaching the top. This book is a guide for

such forward looking people!

The book has been written in a unique style – the entire

book is in the form of a conversation between a budding

First-line Leader Vinod Kamat and his Mentor. The les-

sons which the Mentor gives are the take-home messages

for the reader.

Prologue to the book. We all know that in 1999 India won the Kargil war

against Pakistan. The sacrifices of the jawans and officers

set many a young heart on fire. One of them was Vinod

Kamat, the only son of his parents. Vinod, who was then

barely 13 years old, declared his intention to join the

armed forces via the National Defence Academy route

and serve the country. His mother was in a state of shock

when she heard this. She spared no efforts to dissuade

him from taking up this risky career. However Vinod

was firm; nothing could shake his determination. He stud-

ied hard for the entrance examinations and passed with

flying colors. No sooner had he received a call for an in-

terview than his mother went on a hunger strike to dis-

suade him from attending it. After she went for three days

without food or water, Vinod‘s stand softened and he

bowed down to the wishes of his mother.

He joined Bhavan‘s College, Andheri, Mumbai to pursue

B.Sc., but his heart was not in studies. He scraped

through B.Sc. examinations with just 37% marks. And

who would give him a decent job with this ‗brilliant‘ aca-

demic record?

His first job was as a shop-to-shop salesman selling medi-

cated cough drops introduced by a well-known FMCG.

His customer audience included retail chemists, general

stores, grocery shops and even ‗pan-bidi-wallahs‗. Selling

the stuff packed in polythene bags, he was accompanied

by a cycle-rickshaw puller carrying the wares. A chance

encounter with the regional manager of Capella Pharma-

ceuticals changed his destiny. While in the field and

working at retail chemists, this gentleman spotted his

talent and invited him to join Capella Pharmaceuticals as a

medical representative; he was offered Ahmedabad as his

headquarters. Vinod was delighted and accepted the offer.

Capella Pharmaceuticals was a very fast growing organi-

zation which had acquired licenses to market some of the

top brands of various MNCs. Vinod decided to excel in

this company with an ambition to reach the top and be-

come a CEO one day.

Unfortunately for Vinod, his district manager at Ahmeda-

bad was a new incumbent. His behavior was more like

that of a super-medical representative. Vinod could neither

get any guidance from him nor learn anything from him.

Day in and day out he bragged about his success stories as

a medical representative. Vinod and his colleagues often

heard him saying, ―If I were you, I would have done this,

and I would have converted this doctor to our brands. I

converted a key opinion leader, Dr. Sharma, to our brand

within three visits.‖ Instead of leading the team forward,

he was boasting about his successes all the time!

Vinod realized the limitations of his immediate superior. He

was career conscious: – ―I couldn‘t join the armed forces; I

will make a career in selling, which is also tough and chal-

lenging,‖ he said to himself. Capella Pharmaceuticals was

growing rapidly and his growth prospects here appeared

very bright. Instead of leaving Capella Pharmaceuticals, he

began searching for someone who could guide him as a

mentor and found one in his father‘s friend, who was the

National Sales Manager of a large Indian multi-national

pharma company based at Ahmedabad. We shall refer to

him as Mentor (with a capital M) here. Mentor became his

constant guide. Vinod sought Mentor‘s help and advice

frequently to help him excel in his chosen profession.

Mentor taught him many things – and the most important

one was on his accountability as a medical representative.

Said Mentor to Vinod, ―As a medical representative you

have many roles and responsibilities; but you are accounta-

ble for results: to achieve value-wise, brand-wise targets

every month, month after month.‖

―Accountability,‖ explained Mentor, ―means being liable

for rewards or punishments for the tasks assigned to you.

Some of the responsibilities can be shared even with your

district manager, but accountability can never be shared.‖

Time and again Vinod continued to get guidance from

Mentor. Despite having a weak superior, he worked on

sharpening his skills. He worked very hard and displayed

his leadership qualities during cycle meetings, new product

launches and other developmental programs. He came into

the limelight and within four years was called for an inter-

view for the position of district manager, as the first-line

leaders in Capella Pharma were designated. After a grueling

four hour interview he was selected and posted at Pune.

Vinod went to share his success story with Mentor. It was

then that Mentor said, ―The job of the First-line leader

(FLL) is the most important position in the hierarchy of any

pharmaceutical company, whether in India, Bangladesh,

Pakistan, Nepal or the USA. A company is as strong or as

weak as its First-line Leaders (FLLs). Over 95% of the time

of a First-line Leader (FLL) in the pharmaceutical industry

is spent in working along with medical representatives. This

also means that a pharmaceutical company should invest

substantially to make joint field work effective and thus

develop his team of medical representatives. Pareto‘s Prin-

ciple is highly visible here,‖ went on Mentor. ―If 95% of

the time of an FLL is spent in joint field work, then 95% of

the investment on an FLL should be for making joint field

work effective. As a corollary, 95% of the training efforts

by an organization on an FLL should be to develop him to

make effective joint calls. If this is not happening, it needs

immediate attention.‖ Mentor continued to coach Vinod.

The lessons Mentor gave Vinod are narrated in this book.

After reading this, today‘s FLL should be able to spend his

time very constructively during joint field work which

eventually will be the roadmap to success. ▌

MedicinMan November 2012 >>> Book Preview | Page 26 ← Home

“ “Over 95% of the time of a First-

line Leader (FLL) in the pharma-

ceutical industry is spent in

working along with medical

representatives… If 95% of the

time of an FLL is spent in joint

field work, then 95% of the in-

vestment on an FLL should be

for making joint field work effec-

tive. If this is not happening, it

needs immediate attention.”

Mentor continued to coach

Vinod.

The lessons Mentor gave Vinod

are narrated in this book.

Prof. Vivek Hattangadi is a

Consultant in Pharma Brand

Management and Sales Training

at The Enablers. He is also visit-

ing faculty at CIPM Calcutta

(Vidyasagar University) for their

MBA course in Pharmaceutical

Management.

To find out more about the book write to Prof. Hattangadi:

vivekhattangadi@theenablers.org

The Half-Time Coach

A Psychometric Assessment-based Feedback and

Feed-forward Program for FLMs and SLMs

What do you expect

your FLMs and SLMs

to be good at?

1. Management Games

Relearning by Reflection,

Feedback by Observation

2. Case Studies

3. Movie Clippings

What are you doing to ensure that

they gain proficiency in the desired

skills?

Contact: anupsoans@medicinman.net

Ph. +91 93422 32949

The Half-Time Coach is delivered by Anup Soans, Editor MedicinMan &

Author of SuperVision for the SuperWiser Front-line Manager, HardKnocks for the

GreenHorn and RepeatRx