The past two decades have seen some radical changes to the structure of the NHS with the creation of Strategic Health Authorities and Primary Care Organisations (PCOs) and now, the introduction of Practice Level Commissioning. Anticipated by the end of 2006, Practice Level Commissioning presents possibly one of the biggest challenges yet to the pharmaceutical sales representative. As a market leader in specialist contract sales, In2Focus brings a dynamic, pioneering approach to the science of selling. As well as providing sales and nurse teams, In2Focus has developed unique technologies and an innovative range of services to support the pharmaceutical representative in this changing NHS environment of the 21st century.
The sales representative’s traditional target audience – the doctor – has relinquished much of their decision making power over the purchase of prescription treatments to a broader group which now encompasses the PCO pharmacist, members of the PCO prescribing committee, the health authority on big issues and the supplementary prescribers, mainly nurses. As elected representatives of this group, the individuals who are responsible for prescribing formulary are well known and therefore heavily targeted, squeezing their already precious time and ultimately their receptivity to sales approaches. The prospect of fewer blockbusting products and an increase in parallel imports means that the sales representative faces an increasingly complex environment in which to work and, to be successful, one in which they need to fully understand how these changes are affecting their customers.
With NHS doctors increasingly difficult to reach, sales activities should be targeting the new gatekeepers, that’s to say the 300 PCOs across the country. The Practice Level Commissioning initiative (outlined in the DoH document on Commissioning a Patient Led NHS) heralds a reconfiguration of primary health care trusts in England, transferring more prescribing influence to PCOs which are now setting their own formularies and guidelines, placing restrictions on the prescribing of all members in order to keep within the allocated budget. Technically GPs will still have the individual choice on what they want to prescribe; however peer pressure within the PCOs and the collective decision making process makes it difficult for individuals not to conform. Consequently, specialist sales organisations that have well developed contacts within the PCO environment and are able to influence the PCO agenda to implement therapeutic switch programmes are critical.
The changes in the NHS prescribing channels have already had an impact on the traditional syndicated sales model which is starting to look dated. PCO formularies and guidelines mean that, for companies which do not have their products on the list, there will be little or no value in sales representative calls to doctors, because the doctors will have their hands tied. Companies therefore need to work harder to ensure their products are endorsed by a PCO and only then deploy representatives to go in at ground level to encourage doctors to prescribe. Innovative approaches are evolving from specialised sales organisations such as In2Focus which now requires account managers to call upon keydecision makers in PCOs and Health Authorities. These specialists call on chief executives, clinical governance leads, lead prescribing GPs and pharmaceutical advisors amongst others, to influence strategy at PCO board level, to facilitate therapy review and, where appropriate, prescription switches. In2Focus is working closely with PCOs and key players in the pharmaceutical industry, on a therapy review service which provides PCOs with detailed audit programmes aimed at maximising the potential of costeffective drugs.
This certainly does not signal the end of the traditional sales representative. The foundations laid by the account managers are just one step, albeit a crucial one, to opening the door to the decision makers but the sales representative still plays a crucial role in closing the deal. At In2Focus, the sales representative is supported by industry leading technologies to help them operate more effectively in this changing environment. For example, the award winning Actis technology provides rapid access to customer data, as well as allowing immediate and fast-call reporting to help sales managers instantly assess the impact of strategies and modify where necessary.
With fewer individuals making more of the prescribing decisions, sales representatives get to see fewer customers less often, and neither the sales representative nor the pharmaceutical company can afford a wasted call. The assessment of representatives utilising healthcare professionals is now well proven, however, assessment of first-line managers can further enhance the overall impact of the representative and produce a more effective sales call.
As a thought leader in its field, In2Focus has developed Coaching Masterclass, a unique offering to help ensure representatives and their managers combine talents and experience in order to help create and develop maximum impact in the sales call. The Masterclasses review and evaluate the performance of the sales representative and provide the opportunity for managers to receive coaching evaluation and developmental feedback, in order to improve success in the future. Heads of sales force effectiveness, training managers and sales managers can act as assessors and observers of the event and In2Focus can provide independent training consultants to observe, assess and coach the managers. In short, the purpose of the Masterclass is to make sure that through effective coaching every sales call is a great call, delivering maximum ROI. Outputs from the Masterclass ensure that all managers and trainers personal development plans are highly targeted to maximise the potential of each team member. This approach also offers managers a unique opportunity to see each other’s coaching techniques in action and to share their skills and experience with the representatives whom they, in turn, will coach. As market leader in sales force effectiveness, In2Focus account managers are able to maximise marketing effectiveness by carefully targeting sales activities.