The Doctor Is in

An Executive Interview with IMS Health

NGP asked Stephen Fox of IMS Health to outline successful strategies for gaining access to physicians.

NGP. What is the most successful strategy today in gaining access to physicians? We all know it’s a major issue, so what do companies do to gain access?
Stephen Fox. Gaining access to physicians is a key challenge for many pharmaceutical companies. To stand out from competitors they need to provide a valuable service. This could either be in the form of the relationship the physician has with the representative and the information they provide, or it may be other things that the company provides such as access to clinical trials. Building a relationship is key so that it is not simply salesmanship.

NGP. Is e-detailing the best approach and how does it differ from other detailing methods? What are its benefits?
SF. E-detailing is one approach that many marketing teams are taking due to the convenience factor associated. Information can be presented in the evening or the weekends, improving convenience, rather than during office hours. It is also of great benefit for those physicians where geographic location makes it problematic to make actual face-to-face visits all the time.”

NGP.What is large pharma doing to change its compensation models and how are they ensuring their reps are effectively compensated?
SF. Large pharmaceutical companies have been quite slow in coming up with innovative ideas to change its compensation models to ensure their reps are effectively compensated. However, companies have recently started thinking about innovative measures. One of the ideas is to link incentive compensation to brand strategies. Nobody has done it yet – I think people are starting to think about it now.

I’ll give you an example. Consider a product where the strategy was to initiation treatment on a specific drug strength and then, if that dosage was insufficient to manage the disease, the recommendation was to titrate up to double the dosage. However, the representatives are incentivised purely on sales volume. So we look at that and say how can we align the incentive plan with marketing strategy? This can be done using anonymized patient level data by measuring what percentage of new patient starts are at the initial dosage level and then what percentage are switched to the higher dosage level compared to being switched to a competitor.

With the improved quality of data, such as anonymized patient level data and weekly sales data, some companies are talking about how they can use these improved data assets as a way of setting more appropriate compensation plans and then rapidly measuring performance.

It’s very important to understand the physician’s perspective regarding what value they perceive from the pharmaceutical company, their representatives and their products compared to the competition. The CVM score provides insights into customer satisfaction and can also be correlated to prescribing behavior. This then enables companies to truly focus on the relationship and those issues that the physicians consider important. CVM can be measured on a regular basis and we have found that with the appropriate support and resources, the sales increase in line with CVM scores. So I think this is one of the innovative things that’s being done.

NGP.What are the newest compensation models?
SF. I think Custom Value Metrics is probably one of the most interesting and innovative approaches. Surprisingly, something that I’ve seen very few companies take into consideration is pre-existing sales trends. For example, consider if you had a territory that was growing, one that was flat and one that was declining, but all three had the same sales last year; companies that take a ‘sales base plus’ approach to target setting would give the same quota to all three territories. Yet, the territory that is growing would easily exceed target, the territory with flat sales would struggle to reach its quota while the declining territory has no chance of achieving quota. So I think that companies should consider the underlying sales trends when they set quotas so as to create fairness and minimize bias. The overall concept should be to consider local situations when setting quotas.

Stephen Fox has a strong background in pharmaceutical commercials operations. He has worked for three of the largest global pharmaceutical companies, two of the largest service providers to the industry and three of the world's largest consulting firms. He has a unique mix of a medical background plus broad business experience and technical knowledge.