1 SALES FORCE EFFECTIVENESS SUPPLEMENT Call Planning that Delivers on Brand Strategy New Information Sources Determine Prescriber Value BY MATTHEW LINKEWICH AND JAY MARGOLIS, IMS HEALTH The challenge of optimally reaching physicians with resonating messages is an involved process. Each stage along the way is dependent on the precision of the one before. Creating a call plan may be a rather mechanical last step, but its impact hinges upon the thinking that has gone into the overall strategy most particularly in the segmentation and brand strategy phases much further back in the overall process. THE CASE FOR CHANGE About 75 percent of pharmaceutical companies are still determining which physicians they ll call on and how often just as they did ten years ago when the name of the game was reach and frequency. Even in a time of increasing financial pressures, thinner profit margins, a migration to specialty products and physician backlash against a waiting room full of pharmaceutical reps, companies still continue to allocate their sales resources on the basis of physicians prescribing volume and market share alone.with leadership focusing on improving field force productivity, it only makes sense to rethink the way sales efforts are directed. For a product to have the best opportunity to win in the marketplace, there must be a seamless progression from market intelligence and analytics to brand strategy and finally to sales execution. When a call plan is developed narrowly on the basis of physicians prescription volume and brand market share exclusively, the resultant plan is not
2 only a divergence from the brand strategy, but also can be widely inefficient given unseen or unaccounted market pressures such as managed care. As such, representatives will find themselves executing an errant plan that does not maximize their full potential. When properly conceived and configured, the call plan directs reps to those physicians whose practice characteristics, constellation of prescribing behaviors and attitudes are conducive to supporting the brand goals. Even without involving primary research to uncover physician attitudes, segmentations based on secondary data sources can identify and subsequently the call plan can direct reps to physicians who: Support the brand, and in the case of a new brand are early adopters of new treatment alternatives Respond positively to promotion Generate true new business (as opposed to repeat prescriptions) Frequently switch patients to/from the brand Treat patients fitting the product s profile Have a greater patient compliance and persistency than the market average Are in a position to prescribe the product from a managed care perspective Follow the product s dosing guidelines Stand to become more valuable to the brand over time Support the right mix of products for the company s portfolio goals Fortunately, there are solutions available to help companies capitalize on these additional insights in their call plans. In many cases, use of these additional insights has aided representative inputs to the overall process, in many cases raising their satisfaction with the insights delivered by the home office. WHEN TO REFRESH CALL PLANS In general, pharmaceutical companies should be refreshing their call plans about twice a year. One sure sign that it s time to overhaul the call plan, not simply update it, is if sales efforts are not gaining any traction in the marketplace. Other triggers include a major market event (loss of exclusivity), change in the company s product portfolio and a change in a competitor s product mix.the bottom line is that as products advance through their lifecycle and market dynamics shift, brand strategy should be continually reevaluated and therefore the call plan should be revised to reflect the new marketing approach. Call planning, being downstream from segmenting and identification of prospects, is totally dependent on the thoroughness and accuracy of these earlier steps. It only stands to reason that reps success in the field hinges on how well companies identify the physicians that hold the most potential for a brand however that potential is defined. Companies that are in the habit of viewing physician potential through the rather restrictive lens of prescription volume and share can also benefit from developing new call plans derived from more sophisticated market segmentations. For that reason, let s review the information components currently available from secondary data sources for segmenting and selecting physicians before we cover the call planning process itself. IDENTIFYING THE RIGHT PHYSICIANS The secret to a good call plan is a highly refined prospect list. And the secret to a good prospect list is choosing the right variables upon which to segment the physician universe in the first place. Reps success in the field hinges on how well companies identify the physicians that hold the most potential for a brand however that potential is defined.
3 Deciling prescribers only on prescriptions that are in play can lead to different physician selection decisions when compared to deciling prescribers on market TRx volume New to Brand (NBRx) Decile TRX Decile ,649,445 3,785, ,852 55,56 3,73 6,027 2,874, ,382 7,924 7,249 5,39 3,746 2,97, ,25,692 2,927 3,566 3,75 2,462, , ,683 2,62 2,23, , ,49,683, , , , , , , , ,928 36,093 2,09 4,770 0,937 8,5 5,64 3,382 2,022,26 37,096 More than half of all TRx deciled prescribers did NOT initiate or switch therapy;,30 were TRx decile 5 or higher NBRx results in more focused physician selections with 3,93 docs in top 3 deciles, compared to 6,530 based on TRx deciles While the industry is not yet broadly using many of the behavioral information components on the following list, all are readily available and provide insight into the brand potential that resides within each physician s office: STANDARD PRESCRIBING VOLUME AND MARKET SHARE METRICS Measures of what physicians currently prescribe are decidedly important in determining a physician s value to a brand. But they should not be the only metric used to evaluate physicians (as they are for the vast majority of companies).this will become clear as we move through the other information components. PROMOTIONAL RESPONSIVENESS Similar to consumer buying behaviors, physicians do not respond uniformly to marketing promotion. Therefore, it is important to delineate those physicians that value representative detailing activities by longitudinally tracking call activity and physician prescribing behavior.while this analysis is frequently conducted by many larger brands, it is rarely infused into the resource allocation and call planning process. PHYSICIAN PRACTICE AND PATIENT CHARACTERISTICS FROM APLD To date, only a few progressive companies have ventured to use anonymized patient-level data (APLD) in segmenting physicians.this rich information source can be leveraged to hone in on physicians whose prescribing behaviors and practice profile are compatible with brand strategy. New to Brand Prescriptions Longitudinal analyses of physician prescribing can filter out new prescriptions that continue or restart therapy, leaving only the volume of prescriptions generated for patients who have been prescribed a brand for the first time.the resulting measure of New to Brand prescriptions (NBRx s) serves as an important indication of which physicians are generating the most true new business for a brand an especially
4 Bringing further segmentation variables to bear produces six segments and identifies 32,086 high potential prescribers Prescribing Universe: 37,096 Physicians Segmentation Variables Market Volume & Product Share Portfolio Value High Potential Segments S S2 Included 70,862 Physicians in NTB Decile 2-0 Managed Care Favorability Responsiveness % New to Brand S3 S5 S4 S6 Adoption Behaviors Excluded 246,234 Physicians in NTB Decile 0- Dosing, Compliance and Persistency Physician Lifetime Value 32,086 Physicians in 6 Segments important piece of information for products treating a chronic condition in a market where brand loyalty is high. When deciles are created based on the number of prescriptions truly in play compared to using total prescribing volume, the call plan can look dramatically different. Product Switching It may be valuable for companies to look beneath new prescription volumes to understand what percentage of a physician s prescriptions that initiate therapy actually represent switches to or from a given product.this is particularly beneficial if brand strategy is built on the premise of competitive detailing. Patient Compliance and Persistence Patient compliance and persistence varies dramatically from one physician to another. Companies with a product for a chronic condition in a market in which persistence is generally low would want to identify those physicians whose patient base is above average in this area. Additionally, brand managers can actively target those areas with higher persistency rates to understand prescribing dynamics which ultimately can be used for the development of promotional messaging in other areas of the country. Patient Age and Gender Depending on the therapeutic area and the product s attributes, such characteristics of a physician s patient base may be important in determining the best physicians to reach. For instance, a company marketing a therapy delivered via a transdermal patch may want to concentrate its sales efforts on physicians treating patients who are predominantly over age 65. Dosing Particularly for products with dose-dependent pricing, it could be valuable to identify those physicians who are dosing appropriately. In certain drug classes, atypical anti-psychotics for example; the price difference associated with various doses can be hundreds of dollars per patient per month/prescription.
5 MANAGED CARE AFFILIATIONS Few would dispute the importance of understanding the role that managed care policies and affiliations play on a physician s prescribing. When a physician is not in a position to prescribe a company s product because of formulary restrictions, calls made to that physician will not be effective from an ROI perspective. Although many companies have the ability to push managed care information out to sales reps, doing so is impractical. Reps can become overwhelmed trying to access, retain and make use of information about formulary status in relation to individual physician practices. However, when managed care level of control is factored into the physician segmentation, it is taken into consideration automatically in creating call lists, without reps having to worry about it. LIFETIME VALUE OF PHYSICIANS It may be worthwhile to calculate and consider the anticipated lifetime value that a physician represents to a brand. Some physicians who have a low portfolio value today may be on a trajectory to become a valuable portfolio prescriber in a matter of a few years. Depending upon where a product is in its lifecycle and the company s pipeline, it may make sense to identify these physicians and cultivate relationships with them today. Another option would be to consider the profitability characteristics of physicians in the marketplace. Depending on brand strategy, physician profitability based on their method of payment dynamic (cash, Medicaid, commercial insurance, Medicare Part D), could be considered so sales representatives spend time in physician segments where the pharmaceutical company s bottom line is maximized. PORTFOLIO VALUE A physician can easily be a valued prescriber for one brand in a company s portfolio and not for another. Knowing this is important when trade-offs have to be made between finite resources. AFFILIATIONS AND INFLUENCE A physician s membership in a group practice or degree of influence over other practitioners may When a call plan is developed narrowly on the basis of physicians new prescription volume and brand market share exclusively, the sales force cannot hope to support the brand strategy with any degree of precision. also be valid criteria for segmentation.while a physician may not generate many prescriptions directly, he or she may indirectly influence many high prescribers. CALL PLANNING MADE EASY Following the segmentation exercise (which ideally was conducted on an array of variables), all physicians in the universe are assigned a score based on their estimated value to the brand.they are then segmented based upon their overall portfolio valuation. Now, it s a matter of determining which segments to include, which to exclude, how many calls should be directed at each individual and in what order products should be discussed. The first step is to plot the physical location of all prospects to see how they are distributed among existing territories.the next is to perform a work load build-up to determine the capacity needed to reach the most valuable physicians and understand how that compares to the current sales force constraints in place. A computer program then tests various scenarios, territory by territory, to determine the optimum number of calls for each physician and the best order of the product details. It is important at this stage to look across the portfolio and to make trade-offs according to what will be most beneficial
6 to the company overall.to find the best approach for the company, the analysis must take a holistic approach to evaluating the portfolio mix and promotional allocation. For each scenario, the computer model will estimate the expected impact on sales associated with each level of effort, product by product. A BLUEPRINT FOR FIELD SUCCESS The resulting call plan provides each rep with a road map that specifies which physicians to call on, how often and in what order to detail products. Depending upon how much information the company wants to share with reps and on the capabilities of its sales force automation system, individual call plans can also indicate the reasons behind the instructions for each physician. For instance, the plan might indicate that a physician is particularly responsive to promotion and that is why he or she is to receive a higher volume of calls. Or, it might explain that one physician who is a high volume prescriber is nevertheless to receive few calls because of his or her managed care status. Or, it could specify that a given physician frequently switches patients from the company s brand. While not all companies want to share this level of detail with reps, it is potentially important because the reasons for channeling effort to two physicians in the same decile might be completely different. It can also help reps adjust to the changes sometimes dramatic that they see in their call plans when factors other than prescribing volume and share are taken into consideration.the new plan may ask them to forego calling on physicians they ve always regarded as their top priority and suddenly begin calling on relatively unknown physicians. The more reps understand about why decisions were made, the more confidence they will have in their new direction. Ultimately, this will lead to a greater ability to effectively implement brand strategy and drive portfolio performance. A PRIME EXAMPLE One company operating in a chronic therapy market with a relatively small sales force needed STEPS TO CREATING AN EFFECTIVE CALL PLAN Start by segmenting physicians along variables that relate to your brand strategy Create a workable prospect list from the segmentation Generate a call plan from the prospect list that makes the best trade-offs from a resource and portfolio standpoint Determine how much information you want to share with reps about the reasons each physician is on the call list Educate reps on the strategy behind your new call plan Give reps an opportunity to make adjustments based on their field experience (for instance, physician access) Refresh the data every six months and make ongoing refinements to the plan as market dynamics change help in creating a call plan that would allow it to compete effectively against much larger companies. Sales for the company s product were relatively flat; only percent of its market growth was coming from new patients and persistence was low across the class. Given its market situation, the company realized that its success depended upon capturing market share within physician s offices that may not be on the radar screen of its larger competitors. The company s initial volumetric deciling exercise reduced the number of prospective physicians for their product from more than 300,000 in the universe to approximately 7,000 still too many for the company to reach given the size of its sales force. However, once a new initial filtering process and segmentation parameters were applied to the universe of physicians the prospect list dropped to a much more manageable 32,000 physicians.
7 The reasons for channeling effort to two physicians in the same decile might be completely different. Matt Linkewich Engagement Manager, Sales & Account Management Consulting IMS Physicians were selected for in-person promotion based on their new to brand volume, product share, promotional response level and managed care influence. MONEY ON THE TABLE Traditional volume-based call planning has been utilized for years due to its simplicity and ease of implementation. However, this has come at the expense of brands ability to capitalize on their strategy and positioning. Companies that fail to take advantage of the new information resources available are ultimately sacrificing brand success by not properly equipping their largest promotional investment, the sales force. The real issue is the money on the table.whether it is sourced via potential expense reductions, better overall use of promotional resources or through sales increases, the use of these new information resources can provide a more precise, informed and focused call plan. Jay Margolis Engagement Manager, Sales & Account Management Consulting IMS Matt Linkewich and Jay Margolis are Engagement Managers in the Sales & Account Management Consulting practice at IMS, helping pharmaceutical and biotech clients of all sizes develop and execute sales strategies designed to maximize brand and market performance. Matt and Jay have developed and delivered mission-critical solutions to clients in the areas of customer segmentation, resource optimization, incentive compensation and call planning. Their collective background includes nearly 25 years of pharmaceutical industry and consulting experience. They can be reached at and respectively.
8 IS IT TIME TO RETHINK THE SIZE AND STRUCTURE OF YOUR SALES FORCE? THE BEST WAY TO KNOW. ASK IMS. We have a point of view. And the assets and expertise to optimize your sales resources with precision. Our detailed prescribing information, powerful allocation models and deep knowledge of local markets will identify the best allocation for you. So you can make changes with minimal risk. And make the most of every sales call. Only IMS has the information, analytics, and consulting expertise to master the market. Our global information sources capture the facts. Our analytical tools extract their meaning. And our,000 business consultants deliver solutions that are based on evidence and forged by experience. FOR MORE INFORMATION, or visit IMS Health Incorporated or its affiliates. All Rights Reserved.
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