Pharmaceutical Sales Reps & MCM: The Way Forward

What are the implications of the changing role of the sales representative on the pharma organization?

“For us, in our market, the traditional ‘showing a visual aid and some messages’ with the HCP is dead… But the face to face meeting is certainly not. Its role, however, will be more about adding value, about finding the right patients for the right drug.”

The words of this sales director at Roche UK show clearly the challenge that stands before the pharmaceutical industry’s sales organizations; a world where access to physicians is diminishing, trust in the information the industry provides is dwindling, and having a costly sales force is increasingly hard to defend.

In the Nordic countries, decreasing access to the physician has been a reality for years, but even within the sacred haven for pharmaceutical marketing, the US, diminishing access is starting to become a concern. According to data from ZS Associates, the physicians that were deemed easy to access has dropped from almost 80% in 2008, to below 50% today.

The reasons for this negative trend are many: regulation, reduction in physician’s clinical freedom, physicians' lack of time, and perhaps most importantly the deep distrust of information provided by the pharmaceutical industry and the feeling that many physicians share, that interacting with sales representatives offers little value. 

Multichannel marketing has been seen as an answer: give the physician the information he/she  wants in the channel he/she prefers. When the concept made its way into the industry in the late 1990s, companies were enthusiastic about its potential impact on sales and marketing practices. But that enthusiasm has since subsided somewhat. 

In eyeforpharma’s new report, The Role of the Sales Representative in a Multichannel World: Advancing Multichannel Customer Engagement in Pharma, we look at this issue in depth and point to where the industry may go from here.

The report was written using the input of senior pharma executives in 30 in-depth interviews, countless confidential conversations and talks with sales representatives from AbbVie, Astellas, GSK, LEO Pharma and MSD, as well as a quantitative survey with industry representatives. Our hypothesis was that the role of the sales representative was changing rapidly in the industry. However, what we found was not clear-cut.

The sales representative in the world

On a global level, some companies are moving beyond what we call ‘business as usual’ and are taking the first steps to integrate the field force in MCM strategies. Meanwhile, others are in the process of creating their strategy and getting it endorsed and spread across the organization – but still more companies are only at the stage of thinking about what they need to do. 

Our survey, undertaken as part of the research, illustrates this mixed picture: a third of respondents felt they had a clear strategic roadmap that was endorsed by senior leadership and available across the organization. Another third lacked endorsement for, or communication of, their blueprint – and the rest were still trying to define their intent or create a tangible strategy.

When we scratched below the surface of these responses, we found there is often confusion, contradictory opinions and lack of awareness about the journey forward. One industry executive, for example, captured this complexity when he described that, although they have a clear plan in the head office, individual markets will have to embark on this journey in different ways, which means many might still be unclear about the pace of change and the actual steps to take.

Also, silos are still common across the industry: individuals from different parts of the same company may have highly contrasting views about the clarity of the strategic vision. Those in departments driving MCM felt the vision and roadmap was clear and concise – but others from marketing or sales areas were less sure that a definite strategy existed.

All this means that, even where moves to integrate the activities of pharma’s field forces with the world of MCM are relatively advanced, the prospects of these activities having a profound impact on the business are slim. It has simply not yet been clearly articulated why this is being done and where the industry wants it to go.

The sales representative in Scandinavia

The Nordic markets are prime examples of both the rapid decrease in access to physicians and in the physicians' decision-making power over high cost treatment options. This means that companies in the Nordic countries have had to adapt to rapidly changing market conditions and this has driven a cross-channel approach within this market.

There has, therefore, been a qualitative change in the representative’s role: “Over a ten-year period, the sales representative has become better educated, with a deeper understanding of both the disease area and healthcare in general. The representative also has much more elaborate business acumen now.” However, there is still a lot of work left integrate the sales representative as part of a multichannel approach. 

The future

"'Would you please tell me, please, which way I ought to go from here,’ said Alice.

‘That depends a good deal on where you want to get to,’ said the Cat.

‘I don’t much care where,’ said Alice.

‘Then it doesn’t matter which way you go,’ said the Cat".

 Lewis Carrol, Alice’s Adventures in Wonderland - 

The industry is thus changing the role of the sales representative, albeit slowly and irregularly across companies, markets and brands.

The industry is not alien to pilots and tests, and it is often difficult to see whether small steps are actually part of a greater journey or if they will end up evaporating without any great impact on the business.

In this report, we identify three possible scenarios linked to the envisioned final destination of change, each of which poses different degrees of challenge, as well as potential gains:

1. Moving beyond business as usual

Continue using multiple channels to engage customers but with very little synchronization and integration between them. The representative may or may not be aware of marketing use of other channels with their customers or they have limited exposure to these tactics. Some representatives may leverage some MCM tools but it is far from complete and probably varies by brand, certainly by country.

2. Incremental improvement

Alternative channels are getting increasingly integrated with the field force, and the sales representative is able to see, and act upon, the company's activities  in the digital channels.

3. Incremental transformation

Complete integration of sales and MCM, where a customer can work through a range of channels and receive a consistent and coherent message across all channels including the representative. Here, customers have a very different experience than with the other two options because there is someone responsible for the experience they receive. The unanswered question is whether it is the representative themselves or someone else within the company that controls those levers.

Which path is the industry choosing?

So how is pharma getting on with all this? Our research confirms that the industry is firmly in stage 1. There is some piloting and testing into phase 2, with numerous country-level, small experiments being carried out. One European executive at a Top 10 pharma company describes what has become a common situation as the role of the sales force is reimagined. 

This company has the strategic plan for the next two years in place: “We have a roadmap for the coming years, where every step has been trialled and tested,” the executive explains. “We are running pilots in Denmark and Portugal with a limited number of sales representatives and complementary digital channels and content. These pilots have shown proof-of-concept and we are now solidifying the business case to scale up these initiatives in the big seven European markets, including Turkey.”

This situation is indicative of the third of the survey respondents who have a strategic roadmap in place, endorsed and communicated across the organization. However, it is also clear that is just the first step of a two- to three-year journey.

But the journey itself is not completely alien to pharma: many representatives are actually already working across different channels. “We have found that our top 10% performing representatives are actually already working in multiple channels and know exactly what their customers want,” reveals one executive. “They are already emailing with them, for example.” Another senior executive in Asia was surprised when he found out that the majority of his sales force was in contact with their physicians via email, WhatsApp, and even Facebook. While there are obvious compliance issues here, several contributors identified this as evidence of what can be done.

There is some attraction to working more fully in phase 2 as it offers the opportunity to better position the representative with their customers and provides them some additional, value-added tools and offers. But there remains a high level of scepticism that this approach will deliver significant business benefit.

Looked at in this context, stage 3 just seems to be a bridge too far at this time. While delivering a consistent and valuable customer experience is seen as a useful benefit to customers, the industry is not convinced this translates into more sales or lower costs. Many also think that the organizational transformation and accompanying disruption to get to this stage is too much of a distraction for now. We saw a small number of companies that want to change to something approaching stage 3, but they are only at the beginning of a long and arduous journey.

In the end, this is a strategic choice and without clarity, the organization is likely to wallow somewhere between stages 1 and 2 and never realize the benefits, which only seem to accrue once complete integration has been reached.