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All things Pharma

A problem shared

 Key Account Managers need to know more than just facts and figures to influence the new breed of NHS stakeholders. They need to understand their customers’ environment and be able to capture, interpret and share valuable information about it, as Richard Gray, Commercial Director, Cegedim Dendrite UK, explains.

According to a recent survey conducted by Cegedim Dendrite across Europe, 87% of pharmaceutical organisations are capturing information about key market access stakeholders such as position/specialism and role, with 81% collecting the level of importance or influence.

But just what value are companies deriving from this information? Whilst every organisation recognises that a fundamental component of a successful shift to the Key Account Management model is up-to-date accurate stakeholder information, only 35% of pharmaceutical companies are collecting information about stakeholder drivers.

Whilst organisations can leverage the depth of information available to successfully identify and segment decision-makers, to effectively exert influence requires excellent local intelligence. This intelligence needs to extend far beyond the traditional contact and specialism information to incorporate a deep understanding of the underlying drivers that will inform decision-making. For example, a public health director may be concerned with health inequalities; whilst a director of finance will be primarily concerned with cost containment and value for money.

These key NHS stakeholders now expect pharmaceutical company representatives to understand local drivers; to have insight into strategies for disease management and to understand the challenges associated with the local health economy.

New obstacles ahead

But the challenge for pharmaceutical KAMs in the UK is now increased by the coalition Government’s proposed acceleration of NHS change, from greater patient choice to local health provider empowerment. The NHS is facing massive structural change, from PCT mergers and the creation of GP Commissioning groups to the abolition of SHAs and the growing emphasis on the joining up of local NHS services, social care and health improvement. As a result, the stakeholders will change; as will their underlying drivers and objectives.

There is little time for anyone within the NHS to assess the impact of these changes: in this quality-focused, financially-tied and fast changing NHS, stakeholders at every level now require a pharmaceutical company KAM to arrive with local insight, understanding and a tailored offering that reflects that individual’s specific operational challenges and personal drivers.

This requires extraordinary insight into the minutiae of local NHS stakeholder strategy. It demands detailed analysis of published strategy backed up with continuous assessment of monthly board papers to determine which areas are being prioritised. For example, having identified that prostate cancer is being picked up later in one area than the national average, the PCT is likely to be focusing on improving its screening programme. If this is the case, approaching this PCT with a therapy dedicated to later stage care is unlikely to gain a hearing.

In contrast, a pharmaceutical company with a product that can reduce the need for community patient care, and is able to time its communication with the PCT just at the point the community nurse programme/strategy is being overhauled, will have a far better chance of receiving a positive hearing.

Sharing NHS information

It is this combination of in-depth background research and regular updates that enables pharmaceutical KAMs to leverage both expertise and timing to maximise influence. But, if the NHS stakeholders increasingly expect pharmaceutical companies to approach with a clear-cut solution to a specific healthcare delivery problem, it is essential that the NHS shares key information which can then be analysed by experts to support the pharmaceutical company’s strategy, from plans to rationalise SHAs to boosting co-operation between local service providers.

The onus will be on pharmaceutical companies to understand the new structure, to determine the new market access stakeholders and to ascertain quickly a potential opportunity within this fast changing structure.

This is a hugely challenging marketplace; and whilst pharmaceutical companies have a raft of highly talented personnel, it has become rapidly apparent that an individual cannot possibly be a rep on a Friday morning and a KAM on a Monday morning simply with a new job title and remit. Key Account Management demands a very different skill set; it requires in-depth understanding of the drivers of key decision makers and stakeholders, of the local health economy and, critically, the ability to respond dynamically to any issues these individuals may raise.

Benefits of effective KAM

Furthermore, in this complex, multi-tiered, multi-driver environment, getting a drug on formulary is just the beginning; the pharmaceutical company must then continue to work with patient care bodies to assess how the drug is going to be used and in what context to maximise its market potential.

This pace of change, combined with the complexity and diversity of stakeholder drivers underlines the huge challenge facing today’s pharmaceutical KAMs. How does an individual address the problem of selling a drug to a budget holding hospital pharmacist when the actual financial/productivity benefits will in fact be felt at PCT level, rather than the pharmacist’s?

The new coalition Government’s plans include a pledge to pay drug companies according to the value of new medicines, to promote innovation, ensure better access for patients to effective drugs and improve value for money.

But the messaging is not that straightforward: a drug that can meet targets for Quality, Innovation, Productivity and Prevention (QIPP) through, for example, reduced demand for community services, is likely to be, on the face of it, more expensive for the pharmacist – reinforcing the need for effective Key Account Management that works across the whole health economy and patient journey.

This raises a fundamental issue: while 83% of pharmaceutical companies believe that Key Account Management is the way forward in dealing effectively with stakeholders and influencers; the way in which this approach is implemented will have a huge impact on pharma success.

With the need for dynamic interaction at multiple levels, a KAM needs to be have rapid access to in-depth information about drivers and, increasingly, relationships to provide multiple routes to a key stakeholder. If these KAMs are to be effective therefore, the requirement is not simply to capture reams of stakeholder information but to capture relevant information – such as key drivers – and provide the tools that enable KAMs to track and manage those complex relationships and support relevant cross-boundary communication.


Richard Gray is the Commercial Director of Cegedim Dendrite UK. Founded in 1969, Cegedim is a global technology and services company specialising in the healthcare field. Further details are found online at www.cegedimdendrite.com.

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