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MedicinMan
        ~         FIELD                   FORCE                             E XCE L LE N CE                                          ~
                                                                                                                                           TM




 PHARMA               |   MEDICAL               DE VICES                |      DIAGNOSTICS                         |      SURGICALS
Vol. 2 Issue 11                                                 www.medicinman.net                                                   November 2012




Editorial


HURRICANE GENERIC HITS INDIAN PHARMA
n recent times no other issue has ruffled Indian Pharma as                    Digital Dose by Dinesh Chindarkar is especially useful for
much as the generic vs. brand issue. At stake are millions of                 those who want to use Social Media to further their profes-
jobs and revenues. But we forget that serving the needs of                    sional interests.
patients through the physician community has created these                    We believe in lighting a lamp instead of cursing the darkness
jobs and revenues. When commerce triumphs at the expense                      – however clichéd that might sound given the decline in
and not at the benefit of consumers, then sooner or later the-                skills of the Indian Pharma‘s field force (see page 8 for my
se storms are certain to strike like Hurricane Sandy. Remem-                  article). But unless we take remedial actions, how can we
ber, consumers are the ultimate drivers and shapers of mar-                   expect a turnaround? A Medical Rep‘s skills can be only as
kets whether through social activism or by influencing gov-                   good or bad as his trainer‘s ability to equip and motivate
ernment policy. Industry leaders and associations should put                  Medical Reps with knowledge, skills and attitude needed at
their heads together in enlightened self-interest and become                  the workplace.
active players in reforming healthcare to benefit patients –
                                                                              MedicinMan Academy will conduct a 3-day Pharma Sales
their ultimate payer.
                                                                              Trainer Certification Program in December 2012 (for details
We have an insightful article by Salil Kallianpur on the ge-                  see page 5) to bring about uniformity in the training of Medi-
nerics vs brands issue on page 18; as well as links to articles               cal Reps and FLMs. The program is ideally suited for those
by Prof. Vivek Hattangadi and Gauri Kamath – both of them                     who are working in training departments as well as senior
are well known pharma industry commentators.                                  professionals in Sales, Marketing, HR, SFE and related areas
On the positive side, we have an excellent addition to the                    who wish to move into training.
learning and development of pharma professionals by way of                    The program will cover all essential areas of adult learning
a new book by Prof. Vivek Hattangadi – ―Pharma First-line                     and development relating effective development of Medical
Leader to CEO‖. This should serve as valuable guide to                        Reps including psychometrics.
those who aspire for career growth. Prof. Vivek Hattangadi
                                                                              In the future MedicinMan Academy will also conduct vari-
also assumes additional responsibility as Dean – Professional
                                                                              ous other programs for the development of Front-line Man-
Skills Development of MedicinMan Academy.
                                                                              agers, SFE, SFA and related areas.
K. Hariram, our Chief Mentor continues his series on Coach-
                                                                              We invite senior managers in Pharma to connect and offer
ing for FLMs. We also have insightful articles by Dr. S.
                                                                              your suggestions. – anupsoans@gmail.com
Srinivasan, Dr. Amit Dang, V. Srinivasan adding to the skill
development of field force.                                                                                               - Anup Soans, Editor
The article, ―KAM – Is it a New Sales Model?‖ by interna-
tional team of authors, Ralph Boyce, Ken Boyce and Tony
O‘Connor will add to our understanding of this new emerg-
ing area in Pharma Sales.
LinkedIn is emerging as an important learning platform for                           MedicinMan welcomes Prof. Vivek Hattangadi as Dean –
pharma professionals and I invite all our readers to connect                         Professional Skills Development at MedicinMan Academy.
with me on LinkedIn. Please send an invite to http://
in.linkedin.com/in/anupsoans. We have featured two ―Hot on
LinkedIn‖ discussions for the benefit of our readers.
Contents

                                             CLICK         TO     NAVIGATE.

4. Customer Targeting for High Im-                                   18. India’s Health Policy - flip flops and
   pact Sales.                                                          policy shifts.
   Regularly updated customer lists                                        What the recent DGCI order on generics
   are key to high ROI on sales efforts.                                   means for Indian pharma & healthcare
   V. Srinivasan                                                           Salil Kallianpur

6. Making “Calls” Effective                                           20. Digital Dose - Part 1
   Making joint-work with Medical                                          A regular column on social media for
   Reps productive through coaching.                                       pharma by leading experts.
   K. Hariram                                                              Dinesh Chindarkar

8. “You” Matter Most in Getting                                      21. Pharmacology Essentials - Pharmaco-
   Repeat Rx                                                            kinetics Parameters
   In the sea of generics, “you” are a                                     Concepts of bioequivalence, steady-
   key differentiator for your brand.                                      state, leading dose, maintainence dose
   Dr. S. Srinivasan                                                       and others explained.
                                                                           Dr. Amit Dang
10. Field Force Excellence: Are we
    kidding ourselves?                                               22. Key account Management - a new
                                                                        sales model?
   Is Field Force Excellence attainable
   in this era of hyper-competition?                                       Key Account Management is a distilla-
   Anup Soans                                                              tion of existing strategies & approaches
                                                                           Ralph Boyce, Ken Boyce, Tony O’Connor
14. Hot on Linkedin
   1. How to make productive field                                   25. Book Preview: Front-line Leader to
      visits.                                                            CEO

   2. What are the key drivers of SFE?                                     What it takes to move up the ranks written
                                                                           in a simple, conversationalist style.
   Discussion seen on Indian Pharma
                                                                           Prof. Vivek Hattangadi
   Connection and SFE respectively.




               Editor and Publisher: Anup Soans CEO: Chayya S. Sankath COO: Arvind Nair Chief Mentor: K. Hariram

                                          Advisory Board: Vivek Hattangadi; Jolly Mathews

      Editorial Board: Salil Kallianpur; Dr. Shalini Ratan; Shashin Bodawala; Prabhakar Shetty; Varadarajan S; Dr. Mandar Kubal;
                                                              Dr. Surinder Kumar

  MedicinMan Academy: Dr. S. Srinivasan, Dean, Medical Education Prof. Vivek Hattangaadi, Dean, Professional Skills Development
Now Available as an Ebook on




Repeat Rx
Calling → Connecting → Consulting → Collaborating
REPEAT Rx is the first-of-its-kind skill certification and competency
building program for creating trust and building relationships with Doctors
leading to lasting relationships and generating Repeat Rx.
REPEAT Rx is conceptualized and developed by Anup Soans who is the
Editor of MedicinMan and author of the widely read ―HardKnocks for the
GreenHorn‖ and ―SuperVision for the SuperWiser Front-line Manager.‖


                Visit: http://amzn.com/B009G3SJ1Y

Repeat Rx can be read across devices such as iPad, Kindle, Android, MAC and PC.
             Download the appropriate reading app for free HERE.
← Home                       MedicinMan November 2012 >>> Customer Targeting



Customer targeting
for high impact sales.
                     V. Srinivasan

   ustomer list is the foundation upon which the building            While doing this exercise, side by side, we can also plan
   called Sales is built. If the foundation is strong, and main-     for improving the business volume from customers from
   tained properly, then the building will also remain healthy       whom we are getting very low volume of business sup-
   and strong. Let us see below how to keep the customer list        port. If it is very clear that irrespective of any further
   strong and active by periodical pruning, cleansing, and           efforts, the business volume may not improve, then we
   updating so that it remains active and healthy at all times,      need to decide whether such customers can also be delet-
   and yields the best possible results to the business.             ed, and instead, new but potential customers from whom
   First and foremost: the total number of customers, as well        we can get better business support can be included in the
   as specialty-wise composition/ break-up of the same,              coverage list.
   should be exactly as per Sales & Marketing strategy. The          A similar exercise with other customers like stockists and
   selection of customers must be done only after thorough           retailers can also be conducted, and wherever necessary,
   RCPA to ensure right customers for right products are             dead wood can be removed, and new but potential ones
   chosen. The Line Managers and Product/Brand Managers              included. Such an exercise will ensure that we remove
   must ensure this, because there is a tendency at the lower        dead wood, and the customer list (i.e.foundation) is very
   level to include customers who are easy to call on, irre-         active, and we get support from all the customers in the
   spective of whether they are the right customers or not,          list. It also ensures that we focus all our efforts, activities,
   and whether they have potential to prescribe the products         and resources on the potential and right customers only,
   being promoted or not. Having prepared the customer list          thus avoiding wastages of promotional efforts and field
   as per strategy, the next step is to give visits to each of the   working. Many organizations do not do this activity sin-
   listed customers strictly as per desired number and fre-          cerely, and leave it at the discretion of the Medical Rep
   quency.                                                           and the Line Manager concerned.
   Having ensured both the above, the next, but important            Once we ensure active and updated customer list, besides
   step is to ensure that we get business support from each          number and frequency of visits as per strategy, we should
   customer on whom we are investing efforts and resources,          also ensure proper detailing of the products being pro-
   even though the quantum of support may vary from cus-             moted (i.e. communication) which can have the desired
   tomer to customer. This can be ensured by periodical au-          impact for conversion of identified customers.
   diting and cleansing of the customer list, as per following       The whole exercise is aimed at keeping the business tree
   procedure. Let the Medical Rep makes at least 6 calls, i.e.       free of dead wood, and dried leaves, and keep it hale and
   if 2 calls are slated for a customer every month, after 3         healthy. If Organizations ensure the above in all sinceri-
   months of visits and promoting the identified products to
                                                                     ty, the results will be highly rewarding.▌
   the Doctor by the Medical Rep and at least two more visits
   by any of his superiors like Area Manager, Regional Man-
   ager, Zonal Manager, Sales Manager, Product Manager, if
   no support has come from the customer, then such names                                 V. Srinivasan has headed Sales
   may be deleted from the coverage list. After a total of 8                              Administration & HR functions in
   visits (6 by Medical Rep & 2 more by any higher officials)                             reputed Pharma Companies, with
                                                                                          over 325 published articles in India
   decide whether to retain or not. In that vacancy, another
                                                                                          and abroad. He can be reached at
   potential customer from the same locality from the same                                shridhar1956@rediffmail.com
   specialty who has the best potential to prescribe our prod-                            Mob: 8056168585
   ucts, based on RCPA already conducted, may be included.
Become A Certified Pharma Sales Trainer.




                17th, 18th & 19th December, 2012 at Mumbai
                      Fee: ` 22,500/- per participant.
Early bird fee: ` 19,500/- (for registrations before 10th November 2012)
                 To register, email: anupsoans@gmail.com
← Home                             MedicinMan November 2012 >>> Coaching                                                 | Page 6




 Making “calls” effective.
                         K. Hariram



                                                                  “
   uring joint working by the FLMs with their sales people,           To create a “high-performance” climate
   post call analysis is a common practice. Mostly it ends up
   as a post-mortem, or after-action call discussions. Gener-
                                                                      at work follow these 4 steps:
   ally you will look at what went well and what could have           1. Spend one-on-one time with each
   gone better. But how many of the FLMs have considered
   conducting 'advance-action sessions'?
                                                                         member of your team.
   Can the earlier experiences of the 'calls' be reflected? Can       2. Coach them on-the-job.
   the communication required to make the call be articulat-
   ed and practiced? Look at this as 'pre-mortem' activity.           3. Make their work interesting.
   Prepare this by asking these 3 questions :
                                                                      4. Let them know you trust them.”
   1.   What worked well in previous calls that is worth
        considering for this call?
   2.   What could have been done differently in previous
        calls that should be kept in mind now?
                                                                      Take these 4 steps :
   3.   What new things should be considered for trying on
                                                                      1. Spend one-on-one time with each team member. Spend
        the new calls ?
                                                                      time with each person and know how the individual is
   Lessons from the past is very helpful during ON THE                doing on both personal and work level. Provide feedback
   JOB coaching and helps find newer solutions. It also               promptly.
   breaks falling into the rut of the routine.
                                                                      2. Coach on the job. Show them how to do even better.

   Creating a "high                                                   Help them in finding solutions to job-related problems.
                                                                      Support them in finding alternate resources for solving
   performance" climate.                                              personal problems, without becoming too much involved
                                                                      in the details of their personal lives.
   When you are dealing with 5 to 6 people in your team,
   building the team's morale is your important responsibil-          3. Make their jobs more interesting. Build variety in their
   ity. You can do this by ensuring that each of your team            assignments and challenge them positively. When they
   member is engaged, enthusiastic and ready to make posi-            demonstrate their competence, recognize and share it
   tive contributions.                                                with other team members.
                                                                      4. Let them know you trust them. Clarify and explain
                                                                      what you want them to do and allow them to suggest
                                                                      ways. Set boundary lines and parameters and monitor the
                                                                      same. Help them to learn from past mistakes. ▌




                                                                                    K. Hariram is the former MD of Galderma
                                                                                    India. This article is fourth in a series on
                                                                                    “Coaching” authored by him.
MedicinMan              PRESENTS




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← Home                        MedicinMan November 2012 >>> Personal Success                                        | Page 12




 “You” Matter Most in
 Getting Repeat Rx.
              Dr. S. Srinivasan
  hen I moved from 1st MBBS to 2nd MBBS, the initial              azithromycin is still posing formidable challenges across
  excitement of bedside medicine was understandingly a bit        the board and up and down the hierarchy of most marketing
  too overwhelming, given that I was all of eighteen going on     organizations.
  nineteen at that time. The burden of the white coat was         And this started applying not only to small molecules but
  getting somewhat bearable but not the over-bearing pres-        also large ones like insulins, monoclonal antibodies and so
  ence of our medicine professor who prided himself on not        on. There was a phase when the ‗original‘ MNC marketer
  only superlative clinical knowledge but impeccable              of a molecule would attack the ‗copies‘ on quality issues to
  Queen‘s English as well.                                        justify his higher price. But this didn‘t last long as Indian
  His favorite question was, what are the three most im-          companies surged ahead with good quality products at low-
  portant things in clinical medicine? After we would hazard      er prices, not only in India but even in ‗sophisticated‘ mar-
  one wild guess after another for ten minutes or so, he would    kets.
  make his pronouncement in a triumphant voice from a             On expiry of the patent period for a block-buster, the origi-
  puffed up chest: ‗diagnosis, diagnosis, diagnosis‘. At that,    nal discoverer would argue that his generic is superior to
  our awe for him would go up three notches: wow, how             the lesser mortal‘s generic but that argument too does not
  clever! Never mind what today‘s professors and students         wash any more as seen in recent examples of lipid lowering
  think about the disposable commodity called diagnosis!          and other types of drugs.
  3 ‘P’s                                                          ‘You’ matter
  A decade and a half later, my first ‗sales promotion man-       So, where do you stand in a crowded bazaar where you
  ager‘ (yes, marketing manager came later) with a similar        have to out-shout the other guy selling the self-same medi-
  personality trait would ask a similar question: what are the    cine at crazy prices with bizarre messages? Well, there is
  three most important things for a ‗medical rep‘ to succeed      no magic wand that would save you here save your own
  in his career? Assorted sound bytes would come from dif-        self. By that I mean, when product knowledge alone won‘t
  ferent corners of the room, to which the manager would          take you far, you wear one of de Bono‘s hats, or make your
  only shake his head slowly and then pronounce in a serious      own, and showcase yourself in clever ways.
  voice, ‗product knowledge, product knowledge, product
                                                                  There are doctors who would / should be asking for / think-
  knowledge‘. And we would go, wow, how clever!
                                                                  ing of YOU when it comes to writing a prescription. Your
  Mind you, it worked. And still does. Your display and dis-      command over the product, your communication skills,
  semination of razor sharp product knowledge would surely        your sense of anticipation of the doctor‘s thinking, your
  get you the doctor‘s ears as well as admiration, often culmi-   unique value systems that make you what you are….these
  nating in that vital document called prescription. But when     are the things that somehow create a bond between you and
  the landscape of products underwent a sea change with           the prescriber and clinch the sale. In short, YOU should
  more and more branded generics flooding the market, there       start mattering more than the product. Sounds odd? Think
  came a time to re-think strategies.                             about it anyway. ▌
  Half - dollar
  A standard challenge in selling/marketing was, is and will                        Dr. S. Srinivasan is former Sr. VP at
  be, how to promote your half dollar over the other guy‘s?                         Aventis. He is currently a lifecoach
  The art and science of making a doctor prescribe your ge-                         and Dean, Medical Education at
  neric (forget the branding façade) version of say azithromy-                      MedicinMan Academy.
  cin in preference to your competitor‘s generic version of
Vacancies
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Position / designation                                             Job Description
Area Business Manager (Rachi & Aurangabad). (MNC, Diagnos-         District Manager (2 Positions—Nasik & Mumbai (Thane down
tics)                                                              & Central Mumbai)
Essential qualifications:                                          Job Title: District Manager
B. Pharm/B.Sc in Bio Science/Chemistry                             Span of Control: 5 Medical Representatives (outsourced – 3rd
Critical attributes / qualities:                                   party payroll)
Good communication and Negotiation skill, good team player,        Business Potential: 30 lacs / month
Fast learner, Good relationship with Diabetologists/Physicians     Salary offered: up to 5 lacs
and Cardiologists of the area                                      Key Skills:
Brief Job Description:                                             1.    Candidate must be working on field as a First Line Manag-
1.    Promote the products to Diabetologists /Physicians/                er, in a Pharmaceutical company featuring in TOP 50
      GPs / Laboratories                                                 Companies rated by ORG.
2.    Procure institutional business                               2.    Candidate must have a good command over English
3.    Visit retailers to make the product available and collect          language – Conversational & Written.
      the information on competition. Arrange for product          3.    Candidate must have a good clarity of the role of a First
      displays at retail chemists.                                       Line manager. Must have good management skills.
4.    Conduct diabetes awareness programmes                        4.    Candidate must be achievement oriented. Please provide
5.    Attend to the product complaints.                                  data of previous 2-3 years target achievement.
6.    Train and guide salesmen of the distributors who supple-     5.    Candidate must have a passion to excel in Pharma Sales.
      ment the sales efforts of the company sales staff.           6.    Candidate must have basic knowledge of MS Office.
7.    Appoint distributors as per the business need
8.    Organize CMEs for doctors
9.    Organize training for the Nursing staff on the handling of   Job Description
      our products in institutions who use our products            Medical Business Manager (Jaipur, Bangalore & Mumbai)
Preferred age group: 24-28 years.                                  Experience: Fresher / 1.5 – 4 years
Compensation package: Rs 1.5 lacs- 2.25 lacs.
                                                                   Qualification: B.Sc (minimum)
                                                                   CTC Offered: Rs. 1.50 Lacs – Rs. 3 Lacs
                                                                   Reporting: Zonal Manager
                                                                   Responsibilities:
Job Description
                                                                   1.    Generating new business leads &taking care of the
Retail Business Manager (Mumbai & Chennai) (MNC)
                                                                         existing clients.
Qualification: B.Sc. (minimum)
                                                                   2.    Meeting up with doctors, nursing homes & various
Experience: 1.5 – 4 years                                                hospitals for Glucometer sales & getting prescriptions.
CTC Offered: Rs. 1.65 Lacs – Rs. 3 Lacs                            3.    Actively participating in the special activities conducted
Reporting: Zonal Manager                                                 by the doctors.
Team: Marketing Associates (3 – 6 people as per the location /
market requirement)
Responsibilities:                                                  Contact: Balraj Chandra Mob: 91.9769058671, +91.9833580904
1.    New business development & maintenance of existing           Email: balraj@kingpinsindia.com Website: www.kingpinsindia.com
      accounts.
2.    Meeting up with chemists, retailers (medical shops) for
      Glucometer.
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← Home                    MedicinMan November 2012 >>> Field Force Excellence                                         | Page 8



 Field Force
 Excellence:
 Are we kidding
 ourselves ??                                                FFE 2012 hosted by MedicinMan, saw intense discussion on the fea-
 This article was first published in Pharmaphorum.           sibility of field force excellence in the current business environment.


              Anup Soans



                                                             “
    ield Force Excellence (FFE) can be defined as field          The Indian IT and BPO sector gave Indian
    force – doctor engagement wherein:
                                                                 professionals an opportunity to build ca-
    1. The doctor experiences tangible value in their in-
    teraction with pharma field force leading to better
                                                                 reers at a hitherto unknown pace and
    patient outcomes.                                            had a cascading effect on Retail, Insur-
    2. The field force experiences satisfaction with their       ance, Finance and Banking and a host
    career and meaning in their daily work.                      of other Greenfield sectors. Pharma be-
    3. The field force – doctor engagement results in in-        came a laggard in attracting talent at
    creased productivity for pharma companies.
                                                                 the entry level and this has had a nega-
    ―Field Force Excellence - are we kidding ourselves?‖
                                                                 tive effect in building a sales leadership
    This remark by a senior SFE professional from a
    reputed MNC summed up the thoughts of some of                pipeline in an industry that was growing
    the delegates at the first ever Pharma CEO                   at thrice the speed of Indian economy.”
    Roundtable on Field Force Excellence on June 16,
    2012 at the JW Marriott, Mumbai.
    In response, veteran CEO, Narayan B Gad of Pana-
    cea Biotec took the question head-on by saying –             The rise of Indian pharma both in India and globally is
    ―Excellence might seem like a utopian idea, but we           matched only by the Indian IT and BPO sector, which gave
    can certainly move forward from efficiency to effec-         the Indian professionals a great opportunity to build careers
    tiveness, which together will take us closer to excel-       at a hitherto unknown pace. Twenty somethings were be-
    lence as envisaged by MedicinMan, the organizers of          coming General Managers and VPs and acquiring houses
    FFE 2012.‖                                                   and cars within 5 years of working. The rise of IT and BPO
    FFE 2012 was conducted in the backdrop of deterio-           had a cascading effect on the increase in job opportunities in
    rating quality of pharma field force in India. On            Retail, Insurance, Finance and Banking and a host of other
    stage and in the audience were senior Indian pharma          Greenfield sectors. Pharma became a laggard in attracting
    industry professionals including CEOs, who had               talent at the entry level and this has had a negative effect in
    risen from the ranks of field force in the preceding         building a sales leadership pipeline in an industry that was
    25 years. Where had the Indian pharma field force            growing at thrice the speed of Indian economy.
    gone wrong so dramatically that it was now strug-            Feet-on-street was the logic of many Indian pharma compa-
    gling to find quality people to shore up the ever-           nies that were growing at a break-neck speed from the 80s
    expanding front-lines and sales leadership positions?        and forwards. MNCs and many Indian companies tried
MedicinMan November 2012              Field force excellence - are we kidding ourselves?                                 | Page 9




                                                                “
   swimming against the prevailing trends by recruiting
   and training people to perform at earlier levels of com-         Along with jugaad drug com-
   petence. But it was a losing battle – the fast-growing           binations, came the jugaad
   Indian pharma companies were liberally poaching from
   the MNCs and other well-managed Indian companies                 promotions that did not need
   instead of nurturing their own field force. Medical Reps
                                                                    much talent. Carrying expen-
   in MNCs who had to wait for 10 years and more for
   promotions now found themselves moving up the steep              sive gifts and booking exotic
   ladder at the rapid pace of IT companies.
                                                                    tour locations required as
   Just as prosperity comes with a price of obesity and a
   host of related lifestyle disorders, the price of rapid          much talent of a street-smart
   growth in the Indian Pharma has been the decline of
                                                                    pizza delivery boy.”
   quality of field force people. Indian Pharma companies
   not only reverse engineered and copied IP products of
   MNCs, they added their own ‗jugaad‘ in creating ra-
   tional and irrational combinations that had the doctors
   reeling from an overdose of too many branded generics            Talent fled the pharma industry in large numbers and
   (60,000) and their combinations.                                 mediocrity ruled the day. No wonder veterans look at
   Along with jugaad drug combinations, came the jugaad             the present scenario and remark: ―Field Force Excel-
   promotions that did not need much talent. Carrying               lence - are we kidding ourselves?‖
   expensive gifts and booking exotic tour locations re-            But the darkest night is also just before the dawn. The
   quired as much talent of a street-smart pizza delivery           declining productivity of field force, increasing social
   boy. Irrational drug combinations, irrational copycat            activism against pharma-doctor nexus, governmental
   promotions – nobody questions the sanity of methods              regulations and an uncertain global economy are forcing
   when the growth is assured. Ethics went for a toss as            Indian Pharma to rethink their way of doing business.
   MBAs competed with veteran field sales leaders to
                                                                    The transactional relationship with doctors has run its
   prove their worth through get-rich-quick MLM like
                                                                    full course and the returns are diminishing steadily. To
   strategies, which unfortunately led to decline of field
                                                                    reverse these negative trends and bring about a transfor-
   force – poor quality recruits, little training, promotions
                                                                    mation in the relationship with doctors, Indian Pharma
   without development and high pressure management.
                                                                    will have to reinvent its field force again. The new gen-
                                                                    erations of students coming out of campuses are coming
                                                                    equipped with some unique skill sets – they are
                                                                    the digital natives. The rise of technology enabled doc-
                                                                    tor and social media will provide Indian Pharma with
                                                                    unique ways of engaging the doctors – from fatigue to
                                                                    fun. Both doctors and field force have been experienc-
                                                                    ing a high level of dissatisfaction in their interactions.
                                                                    While field force will remain the lynchpin of doctor-
                                                                    pharma equation, it will be the technology enabled
                                                                    Medical Rep and Front-line Managers who will re-
                                                                    create trust and build relationship by understanding the
                                                                    doctor‘s business and adding real value.
                                                                    The repositioning of Field Force has to be well thought
                                                                    out and must address the needs of patients and doctors
                                                                    and not just the promotional interests of Pharma compa-
            “Jugaad” - the Indian approach to                       nies. There is a lot that pharma field force can do in this
                   skirting obstacles.
MedicinMan November 2012              Field force excellence - are we kidding ourselves?                               | Page 10




                                                              “
    regard as they are on the field where the action is.
    Social media has the potential to engage, build trust          The scope for field force
    and communicate effectively in a media format that
    already has the patients and doctors tuned in. Gadgets         excellence is enormous if
    like iPads have the potential to take CRM and other
    customer engagement models to effectiveness levels             Indian Pharma takes the
    not possible earlier. These gadgets also have the po-
    tential to make learning an ongoing practice instead           leap and re-configures its
                                                                   field force strategy from
    of periodic events.
    iPads have the potential to transform the Medical
    Reps learning process and make them more knowl-                recruitment to manage-
    edgeable about the therapy areas in which their cus-
    tomers operate. A seamless loop that connects Medi-            ment.”
    cal Reps, Front-line Managers, Training Managers,
    doctors, chemists and other stakeholders has the po-
    tential to go beyond the present silo approach and
    bring HR, Sales, Medical Affairs, Administration and          Presently most Indian Pharma companies pay scant attention
    other function including finance on the same page. It         to learning and development needs of Medical Reps and
    can bring about beneficial changes in neglected areas         Front-line Managers. The high attrition rate serves as a
    like ADR by systematic reporting and response in              dampener on investing in people. This has led to the entire
    real time, adding much value to medical practice.             ecosystem of field people being ill equipped to handle the
                                                                  new challenges of healthcare marketing.
    In short, the scope for field force excellence is enor-
    mous if Indian Pharma takes the leap and re-                  With the advent of Cloud Computing and the high involve-
    configures its field force strategy from recruitment to       ment of Gen Y in social media and the emergence of cell-
    management.                                                   phone as an ubiquitous device, it is possible for pharma to
                                                                  engage its field force on a regular basis and bring about field
    The results of a MedicinMan Poll with more than 400
                                                                  force excellence in the near future.▌
    respondents on LinkedIn are instructive of the aspira-
    tions of employees. Learning and Development was
                                                                                       Anup Soans is an author, facilitator
    the No.1 job satisfier for employees in the 18–29 age
                                                                                       and the Editor of MedicinMan. Connect
    group (for details and comments of the poll: http://
                                                                                       with him on Linkedin (linkedin.com/in/
    linkd.in/MDfstI). This is very heartening indeed.
                                                                                       anupsoans) or write to him at
    Entry-level employees are aware that Learning and                                  anupsoans@gmail.com
    Development is the key to success in their career.




                                                                                                     MedicinMan poll on factors
                                                                                                     influencing job-satisfaction.
                                                                                                     Bringing about employee
                                                                                                     engagement by taking these
                                                                                                     factors into account is a key
                                                                                                     part of Field Force Excellence.
Does your work often feel like this?
Boss is again at his action-oriented program to motivate
underperforming PSRs




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← Home                       MedicinMan November 2012 >>> Hot on Linkedin                                            | Page 14




  “                                                                                                                                   ”
                      Field Managers are going blindly for their co-visit in the market with their field staff.
                      FLMs are going for fieldwork with medical reps blindly just to show to the top management that they
                      have done their job. They visit the areas and doctors from whom medical rep is already getting prescrip-
                      tions. They visit the stockist to get the order to achieve the budget through their visit influence. FLM‘s
                      visit cannot be called productive till the time they follow these guidelines:
     Ajay Kumar       1. Do a survey with chemists regarding Doctors that can prescribe products of the company. Who are
                      prescribing the competitor‘s brand?
     2.   Manager‘s visit can be called productive if he has been able to convert the doctors with his visit. He should ask the
          medical rep to follow up with doctor for Rx in the subsequent call by medical rep.
     3.   Manager should check with chemist and stockist regarding any distribution problem.
     4.   He should solve problems being faced by the medical rep.
     5.   During the next visit FLM should find out the from medical rep regarding the outcome of his last co-visited areas and
          he should give some time to the last visited area.
     6.   Manager should cover the complete territory of medical rep in a year.
     7.   Manager should give preference to territories from where sales are low to check what the reasons for low sales are and
          give guidelines to medical reps on how to increase sales.
     8.   Manager should use his strengths to strengthen the medical rep.




                      The entire industry is afflicted with the ―free radical syndrome‖ (high attrition), largely due to poorly em-
                      powered, uninformed and ill equipped FLMs, who come on board with limited knowledge of managerial
                      competencies - namely decision making, delegating, problem solving, team work, etc.
                      In the earlier days, the selection process used to be elaborate, comprehensive and tested a potential candi-
                      date from multiple perspectives, through group discussions, case study presentations, inter-
                      views. Candidates who came out successful from such intense screening were found to match the rigors &
     Sankaran SS      demands of the managerial job.
                        The immediate need today therefore is to identify the potential in the system, not just in terms of sales
     performance, but in terms of overall potential to succeed at the next level. This obviously requires mapping FLMs against
     well defined job related competencies, investing time and effort to nurture & develop them on these competencies. Then
     put them through a robust assessment process and put them on the job. The process is certainly time consuming, will not
     show immediate visible results. However it is bound to pay rich dividends in the long run. For people don't leave organiza-
     tions, they leave their bosses.
← Home                         MedicinMan November 2012 >>> Hot on Linkedin                                                 | Page 15



                     During the 1st week & last week of the month, the Area Manager is found running from pillar to post to
                     close sales in order to fulfill sales commitments given in the monthly meeting. Once sales are closed, he
                     has to do preparation for presentation, compilation of secondary sales and deficits. For this he requires
                     time and nearly 1/3 of the month is lost in this process. What is the need for these monthly meetings?
                     This is a disincentive for carrying out productive joint in-clinic work. I have also observed higher man-
    Manoj Singh      agement of some companies speaking late at nigh - at 10 PM or later - or in early morning, without any
                     concern about what time the AM / RM was back from tour or what time he has started his work.
   These are the reasons for high attrition rates and the need to fill vacancies by compromising in the selection of MRs / AMs.
   I can only say there should be come code of conduct, work norms, discipline in talk & clear communication especially dur-
   ing month-ends, when the standard of talk goes down drastically. (paraphrased)




                     As long as 'come what may, get numbers by month end' approach continues, merely criticizing FLMs or
                     for that matter, even SLMs will only add to the problems. Sales force cycle meetings should be for renew-
                     ing, refreshing & rejuvenating the sales team and not merely to take out their frustrations and demoralize
                     the team. Create an environment where people have inner motivation. Do not simply throw motivating
                     words which are manipulative. Let the sales team get involved in their budgeting process. Yesterday's
                     work force swallowed the Top Down approach; certainly the current generation may not...unless con-
                     vinced. Focus on FLMs‘ development; the multiplying effect will be beneficial. At each level avoid
      K. Hariram
                     BLAME game; build a TAKE CHARGE attitude. Do not compromise on basics and fundamentals. Treat
    the FLMs with respect and anything critical, discuss separately - in short, protect his self respect in front of his team. Right
    from top to bottom, let every person ' walk the talk'. (paraphrased)




                     FLM should spend good and quality time in field with MR. He should go in the field after doing proper
                     home work. Now, just imagine the situation we offer to FLM in most of the companies: with fixed days for
                     meeting and travelling, how much time do we give to him for his analyses / homework? Beside time, what
                     are the tools which we give to him to do analysis? Even in today's hi tech world, many of the companies are
                     working on ghostly looking excel sheets / pivot table, having lot of data but nothing obvious ACTIONA-
      Jyoti Jain     BLE shown. (paraphrased)




                   In order to bring about the role transformation from M.R to A.S.M. specific programs are needed to con-
                   sciously build the confidence of the A.S.M. as an observer and then a solution provider to the problems faced
                   by a M.R. An A.S.M. has to differentiate between product training (hard skills) ROLE training (soft skills) to
                   add value to joint work. This can be achieved by periodic induction. (paraphrased)

      Deb B.



                      It has been my personal experience that it is the FLM / SLM ( 80—20%) responsible for a company's fate.
                     In every cycle meet, I personally allot a day for product knowledge developmental activity. Accordingly,
                     each FLM/SLM has to come fully prepared with presentation on assigned ONE product each, and take
                     class in detail. It works wonderfully. All FLM, SLM, ZSMs are made to mandatorily visit and work along
                      with subordinates on permissible regular intervals. The visit plan must include Dr's (at least 2 of
     Pramod Sharma    each specialization, so as to ensure promotion of maximum available/ stocked products), C&F, Stockists
                      and Retail visits. Besides, even senior managers should follow the laid guidelines during their visits, so
    as to set examples and help take appropriate decisions if problems exist. (paraphrased)
← Home                           MedicinMan November 2012 >>> Hot on Linkedin                                             | Page 16



                    A Field Manager, before going to field work with medical rep, should visit the stockist/super stockist and find
                    out the product movement. Examining the medical rep's tour program he must find out which areas have poor
                    performance. Then the Manager should visit the poor performing areas with the medical rep and analyse the
                    reason for poor sales. After that he should find a solution for the problem and hand over the area to MR. In
                    his next visit again he should visit that area and see the results. With this exercise the sales will increase and
   R. Shetty
                    MR will be happy because AM has solved his problem. Also AM will build a personal bond with MR.




                    The basic objective of the FLM is to develop his MR, be it by demonstration, direction (training if required),
                    observation and delegation once ready. I would be a little concerned if the FLM is sorting out problems of the
                    MRs regularly, he should not be a solution provider but a solution facilitator.


   Kultaran SS




                  Its true that the field managers go to field without any preparation and just become passengers on the bikes of
                  medical representatives. They go to doctors along with the medical representative and hijack the call, become
                  a ―super representative‖, try to boss over the poor Medical Representative and go home with false satisfac-
                  tion. This is true, not only for the line managers, but also most of the bosses of the medical representatives.
                  They feel delighted in doing super-MR's job. As a result, a good MR, who may need coaching or support or
    Manas Dash
                  delegation, feels depressed and remains disengaged. He simply waits for his so-called bosses to return to do
   his job after 15 days or a month and does all the manipulations to achieve numbers. Finally, getting disappointed, he leaves
   the organization with a hope that, someone, somewhere will take care of him. But it remains same across the companies
   and across the management community. It can only be changed if, the bosses change their mindset from doing to observing,
   giving proper feedback and caring for their subordinates.




 “                                                                                                                            ”
                    What are the priority areas? What do you think an SFE Manager/Analyst should focus on first? Is it segmentation
                    and targeting? Or maybe call frequency optimization? Or maybe the sales incentives program?
                    - Krzysztof Lasocki




                   The starting point always is the company's objective. Then you analyze and look into the sales process: from target-
                   ing to segmentation to segment strategies to execution. Once these details are all coherently driving and pointing
                   towards the company objective, you look into the call process. (Re to "objective" please look here.)
                   The effect of incentives (in mature markets) in any case is disputable. In general anything you measure must match
   Hanno Wolfram   and drive objectives. SFE in this context should be defined as getting more for the same or the same for less.



                   In my experience the Key Driver of any SFE initiative is communication and buy in. If the field sales force does not
                   understand the objective of the initiative then the data captured (if using a CRM system) can be manufactured to "Hit
                   the Number". As stated in Hanno's post the Objective must align with the process but the understanding of the Value
   James Buck
                   must be communicated and all stakeholders in agreement.
← Home                           MedicinMan November 2012 >>> Hot on Linkedin                                                 | Page 17



  Assuming that we are leading a start up organization and the primary objective is to generate productivity from the budgeted re-
  sources from day one, then applying the 4S principle will help.
  1.   Structure - Deployment of field force on the basis of customer, coverage and competition . Also consider their alignment
       basis channel of distribution.
  2.   Systems - set clear KRA, KPIs, sales targets, daily/weekly reporting formats/CRM.
  3.   Skills - KAM, multi stake holder selling.
  4.   Spirit - Reward/incentive and recognition.
  Finally lot of discussion is happening on CLM and if implemented correctly the yield could be above average.
   - Arupendra Das



                     Prescriptions are not only the reflections of one's sales behaviour but the reflections of one's beliefs. One of the
                     main drivers of SFE sould be to address this belief. High technical skills and conceptual skills are always impart-
                     ed. But what is neglected is the human part. In a highly competitive environment it is important that people
                     should be made to believe what an organization considers as "Effectiveness". If the indicators are "profitability &
                     target achievement‖ then we are missing the core of SFE. Many universities teach subjects ranging from history
   Govindrajan D.    to economics to Marketing but only few are really coaching people for "Sales‖. The curriculum should be fo-
                     cused on "Communication & Sales Behavior‖.



  I like that Govindaraj has mentioned "profitability and target achievement are not the key indicators of effectiveness". This would
  bring us to the question of what is meant by "Effectiveness". Would you consider a field force person who has very good
  knowledge of the product and can communicate with the doctor very well, but cannot get the extra prescription that his manager
  demands as ―effective‖ or would you consider a street smart rep who can discuss everything under the sun with the customer and
  get the extra prescription?
  I think before we even discuss the drivers of effectiveness we should understand what effectiveness means for various levels of
  hierarchy in Pharma. For the frontline manager who has to keep his team‘s commitments it is totally sales and target driven, for
  the brand manager it is totally strategy and campaign management driven and for product manager it is by the feedback on the
  key messages that he creates every cycle. And the one person who has to keep everyone plus his doctors satisfied is the poor
  rep.
  - Venkatesh Annadevara




                    Following Venkatesh's request let me quote Peter Drucker, THE Management Teacher of the last century:
                    ―Effectiveness = doing the right thing. Efficiency = doing things right‖
                    The problem in pharma is to know what is "right"!
                    1. I fully believe that "right" varies by company, by product portfolio and even by market place, There is noth-
   Hanno Wolfram
                    ing like an interchangeable "best practice" (another one of those buzzwords) like a "one size fits all".
  2.   If "right" at all is defined in and for a company it is defined "inside-out": right for our revenue, right for our bottom line or
       our fame etc.
  3.   The client perspective, be it prescribers, be it nurses or even patients is widely neglected.
  In our daily life we are offered perceptions, solutions, concepts, feelings, ideas and not (no longer) products! (e.g. iPad, Coke,
  BMW or Viagra). We are asked and offered to make our individual choice and no one "sells" something to us. All products we
  ever buy or purchase meet our expectations and we have a preference, which was triggered by the marketing efforts of the re-
  spective company.
  SFE in pharma at the end of day could mean: Change perspective and look at your company (brand?) or product outside-in,
  acknowledge what you see, hear and feel and then decide what is the right thing to do. Once this is done, identify the right way
  doing it.
← Home                        MedicinMan November 2012 >>> Industry Insight                                 | Page 18




 India’s Health
 Policy: Flip-flops                                                                                               Indian
                                                                                                                  Health
                                                                                                                    Care
 and opaque policy shifts.

                Salil Kallianpur




                                                             “
  he directive from the Drug Controller General of
  India‘s (DCGI) office to all State Drug Controllers to
  issue trademarks for generic names instead of brands           Over the years despite knowing of
  – even if it was just to resolve trademark issues - is         its multiplier effect on GDP, India
  yet another display of confounding decision making             never attached great importance
  by the Union Government that has been plaguing the
  country in general and the health care sector in par-
                                                                 to the improved health of its pop-
  ticular.                                                       ulation. Policy lapses witnessed
  Over the years despite knowing of its multiplier ef-           the private sector stepping in to
  fect on GDP, India never attached great importance             address a fast rising demand for
  to the improved health of its population. Policy laps-
                                                                 health care creating one of the
  es witnessed the private sector stepping in to address
  a fast rising demand for health care, creating one of          most privatized medical systems in
  the most privatized medical systems in the world. As           the world.
  a consequence, India is confronted with the problem
  of meeting growing expenditure on health care which
  is heavily skewed towards out-of-pocket expenses
  for its citizens, driving large sections into poverty.         India chose to begin its journey towards UHC with
  India‘s future lies in its demographic dividend – the          one step - to provide free medicines through its pub-
  advantage of having a young, healthy and productive            lic health system. The Centre released approximately
  work force. And to reap the benefits of this work              Rs. 30,000 crores to the States to fund the procure-
  force we have to achieve decent health and education           ment of medicines over the next 5 years (2012-17)
  outcomes for the majority. India averaged 8% p.a.              under the ongoing NRHM. After the Supreme
  GDP growth rates over the 11th Plan period. And                Court‘s intervention and with the five public-sector
  yet, its public spending on health has hovered around          pharmaceutical companies lying in shambles, the
  an abysmal 1-1.2% of GDP, one of the lowest in the             government quickly approved the new drug pricing
  world. The Approach Paper to the 12th Plan declared            policy that led to the inclusion of 348 medicines
  an increase to only 1.58% by 2017. And how is this             (approximately 30% of medicines and 60% of the
  possible, given the government‘s recently vocalized            market) into the National List of Essential Medicines
  desire to move towards universal health care (UHC)             (NLEM) and effectively under a price controlled not
  for not just its citizens but its residents that include       by the market, customers and competition but by the
  millions of illegal immigrants as well?                        government.
MedicinMan November 2012           India’s Health Care - flip-flops and opaque policy shifts. | Page 19


  Simultaneously, in an ostensible effort to make medi-
  cines affordable to its residents (not citizens), the gov-
  ernment did two other things: 1) allow foreign direct
  investment into brown field projects in the sector with
  caveats such that foreign companies who invest in India
                                                                  “   The only group that will benefit
                                                                      (from the DGCI’s recent directive)
                                                                      are the middlemen – the traders –
                                                                      who will control the supply of medi-
  will produce stipulated quantities of essential medicines
  and invest in local manufacturing and R&D 2) demon-
                                                                      cines and make unholy profits in
  strate that it will use compulsory licensing more as a              the bargain.
  weapon of choice than as one of need.
  Both these steps make sense in the short term thus
  providing political capital to the government for the               On one hand, India signals that it will welcome much
  upcoming general elections in 2014, but harm the fu-                needed FDI into the sector. But on the other it threat-
  ture of India as a preferred destination in the long term,          ens to disregard product patents, invoke compulsory
  thus depriving the opportunity to create economic capi-             licensing, discontinue issuance of marketing licenses
  tal. What vindicates this point is that to this date, there         to trademarks while controlling prices on essential
  has been no effort from the government to invest in                 drugs and also considers controlling prices for patent-
  creating the infrastructure required to deliver superior            protected innovative drugs as well. Such indecisive-
  health outcomes to the population despite it being the              ness about policy bodes ill for a country that faces the
  root cause for the inflow into the private sector despite           daunting challenge of enrolling, financing and provid-
  all its societal evils.                                             ing acceptable health outcomes for 1.2 billion citizens
  However, all this pales in comparison to the DCGI di-               and millions of other residents, illegal or otherwise.
  rective to state drug controllers to not issue marketing            For such largesse, it could actually do well with help it
  licenses for trademarks or branded drugs but in their               can garner from all quarters.
  generic names alone. While the technicality of this de-             Why then is the government alienating itself both from
  cision alone warrants a separate column, it suffices to             the domestic industry as well the international society?
  say that this makes no sense whatsoever. Authorities                These policy flip-flops are confounding! Why would
  are expected to regulate or legislate to help either the            the Indian government risk global criticism by openly
  industry, traders or end consumers. This decision helps             demonstrating clear indecisiveness? Is this driven by
  none of these groups or anyone else. All it does is com-            an argument about poor public sector performance in
  moditize the industry thus threatening to wipe out small            delivering health care? Undeniably, it has been lack-
  and medium players who lack the financial strength to               ing, which reflects in the dismal health outcomes in the
  compete with MNCs who despite severe pressure on                    country. Or as noted academic scholar, Kaveri Gill
  profit margins will survive. The consumer has little or             wonders in a blog post, is this seemingly open decision
  no knowledge of the brands of medicines and therefore               -making process merely a dangerous opaque shift in
  is unlikely to benefit from the decision. The only group            policy, which has very little to do with evidence and
  that will benefit are the middlemen – the traders – who             even less to do with broad-based consensus? ▌
  will control the supply of medicines and make unholy
  profits in the bargain. Under harsh criticism, the DCGI
                                                                                       Salil Kallianpur is a health care market-
  recently clarified informally that this directive was
                                                                                       ing professional based in Mumbai, India.
  more to resolve trademark issues. Apparently, too                                    He is an avid reader and follows the
  many similar sounding trademarks confuse doctors and                                 health care industry, its politics, strategy
  retailers. If it really is the reason, the decision is laugh-                        and current affairs and writes on the
  able. Isn‘t it easier for similar sounding trademarks to                             intersection of health care and life in
  be denied by the regulators, thus pushing the onus back         general at his blog “My Pharma Reviews”. The views in this
  on the industry to decide on clearly differentiated trade-      article are his own. His twitter handle is @salilkallianpur.
  marks?
| Page 12
← Home                            MedicinMan November 2012 >>> Social Media                                                   | Page 20

 IS IT THE END OF THE ROAD FOR THE INDIAN PHARMACEUTICAL INDUSTRY?                  INDIA‘S MOVE TO VANILLA GENERICS: DON‘T HOLD
 By Vivek Hattangadi                                                                YOUR BREATH

 Is it the end of the road for the maturing pharmaceutical industry in India?       By Gauri Kamath (apothecurry.wordpress.com)
 The signs are ominous. If the DCI goes ahead with its plan, (as reported in        By now, the news that India wants to move away
 Times of India of 16th October) to have only generic drugs in India, it will       from branded generics and encourage vanilla gener-
 sound the death knell of the industry. The market than will be dominated by        ics to bring down drug prices has gone around the
 the militant middle men who already enjoy very high profit margins – over          world. But all those who think a structural reform of
 35% - much higher than any other industry. The middle men are already              the Indian drug industry is around the corner : stop.
 sucking blood from those who need blood transfusions – the critically ill!         And breathe.
 Read the complete article HERE.                                                    Read the complete article HERE.




                                                  Digital Dose
                                                   For Natives and Immigrants




                   Dinesh Chindarkar                                            This series will help you gain an insight into social media
                                                                                and will help you get comfortable with new media trends,
   We are living in the Tech Age. The world is changing every                   identify various opportunities in this segment and inform
   second. The quest for faster, better, more and beyond is rever-              you about some successful digital media strategies in the
   berating throughout the globe. We are breaking barriers, reach-              Pharma space. In this part we are going to understand the
   ing across borders and exploring new dimensions in every                     term Social Media.
   field, be it medicine, space travel, communications or enter-
   tainment. Going Digital is the new mantra.                                   What is social media?
   In this rapidly changing world, the concept of marketing is                  To put it in simple words Social media is an interactive
   rapidly undergoing a paradigm shift. The emerging digital me-                means of social communication with the world. Newspa-
   dia has not only attracted many marketers but growing number                 pers or TV are also informative medias but are not inter-
   of consumers are also getting hooked onto it. In developed                   active channels – it is a one-way communication. So these
   markets, even Pharma marketing is following the techno path.                 traditional media are like a one way lane, an article can be
   This pattern is also being replicated in India as increasingly               read but your views on it cannot be expressed simultane-
   aware patients are seeking more information. Indian medical                  ously or a television programme can be viewed but not
   community is fast climbing on to the digital & social media                  influenced in any way. On the other hand, social media is
   bandwagon apart from just browsing through studies on the                    like a two way lane in which information is given and
   net. Hence, Digital marketing opens up a Pandora's box and                   feedback is taken simultaneously. It is both informative as
   also throws up newer opportunities to marketing & sales to                   well as interactive. At the core of Social Media lies
   connect with the customer & the consumer.                                    ‗instant gratification‘.

   Hence we are initiating this series of articles – ‗Digital Dose              The next part in this series will cover Facebook.▌
   for Indian Pharma‘.
                                                                                                    Dinesh Chindarkar is Co-Founder
   ‗Digital Dose for Indian Pharma‘ – is a series that will take                                    & Vice President - Operations at
   you step by step through the varied properties of Digital and                                    MediaMedic Communications and
   Social Media world. We understand that social media is not                                       is Country Head for Global
   just about Facebook or posting Videos…its much more than                                         HealthPR.
   that.
← Home                  MedicinMan November 2012 >>> Pharmacology for the Rep                                         | Page 21

Pharmacology essentials: pharmacokinetic parameters


                  Dr. Amit Dang
 ontinuing with the topic of Pharmacokinetics, this section      Steady state: Immediately following the initiation of drug
 covers some of the remaining important definitions.             therapy, the rate of drug entry into the body is much great-
 As mentioned in the earlier sections, liver is the major site   er than the elimination rate, therefore the drug concentra-
 of drug metabolism, and the initial metabolism of drugs         tion in the blood increases. As the plasma concentration
 in the liver is referred as Hepatic First Pass Metabolism.      increases, the rate of elimination also increases, because
 When a drug is absorbed across the gastro-intestinal sys-       this rate is proportional to the plasma drug concentration.
 tem, it enters the liver before entering the circulation. If    Steady state is reached when the two rates are equal.
 the drug is rapidly metabolized by the liver, the amount of     Loading dose: After administration of the drug, plasma
 unchanged drug that gains access to the systemic circula-       concentration increases, but distribution of the drug leads
 tion is decreased. Many drugs like propranolol undergo          to a decrease in the concentration. This decrease can be
 significant biotransformation during a single passage           significant for the drugs with high volume of distribution.
 through the liver. The drugs given by the oral route un-        So, it takes four-five half-lives to achieve the therapeutic
 dergo significant hepatic first pass metabolism whereas         concentration. Sometimes, a ‗loading dose‘ or a higher
 drugs given by parenteral route (e.g. intravenous or intra-     dose is administered (or injected) as a single dose to
 muscular route) do not undergo hepatic first pass metabo-       achieve the desired plasma levels rapidly.
 lism, thus achieve a higher a bioavailability. So, certain      Maintenance dose: The loading dose is followed by an
 drugs which are efficiently inactivated in the liver like       infusion to maintain the steady state and this is referred as
 lidocaine cannot be given by oral route and have to be          the maintenance dose.
 given parenterally.
                                                                 All these parameters are important while deciding the dos-
 Another concept about the metabolism and excretion ki-          ing schedule of drugs.▌
 netics is the order of elimination i.e. first order or zero
 order kinetics. Most of the drugs demonstrate first order
 kinetics in standard therapeutic doses, i.e. the amount of
 drug that is metabolized or excreted in a given unit of
 time is directly proportional to the concentration of drug
 in the systemic circulation at that time. On the other hand,
 a small number of drugs e.g. phenytoin and aspirin
 demonstrate zero order kinetics or saturation kinetics in
 which the clearance rate remains constant despite increas-
 ing plasma drug levels. This can result in dangerously
 elevated plasma concentrations of the drug with a small
 increase in the dose of the drug.                                 Figure 1: First order kinetics and zero order kinetics

 Some other clinically important definitions include bioe-
 quivalence, steady state, loading dose and maintenance
 dose.                                                                              Dr. Amit Dang is Director at Geronimo
                                                                                    Healthcare Solutions Pvt. Ltd.
 Bioequivalence: Two related drugs are said to be bioe-
 quivalent if they show comparable bioavailability and                              This article is 3rd in a series of pharmacology
 similar times to achieve peak blood concentrations. Two                            for the Medical Rep.
 related drugs with a significant difference in bioavailabil-
 ity are said to be bioinequivalent.
← Home                MedicinMan November 2012 >>> Key Account Management                                            | Page 22



   Key Account
   Management
   Is it a new sales
   model?
   Ralph Boyce, Ken Boyce, Tony O’Connor




                                                             “    KAM is more of an evolution
   any people think of key account management (KAM)
   as a new sales model, developed as a strategic solu-
   tion to the changing business needs of the healthcare          towards a more appropriate
   market. Do we restructure our whole organisation
   around some new grouping of customers and move                 sales approach and does not
   completely away from the favoured coverage and
   frequency model, which increasingly is being shown
                                                                  require radical change to be
   to no longer work?                                             effective. Perhaps, more ac-
   KAM is more of an evolution towards a more appro-
   priate sales approach and does not require radical             curately, KAM can be viewed
   change to be effective. Perhaps, more accurately,
   KAM can be viewed as a distillation of the various
                                                                  as a distillation of the various
   aspects of the promotional mix. While the pure aca-            aspects of the promotional
   demic theory of KAM promises one account plan per
   key account regardless of therapy area, brand or ser-          mix.”
   vice, is this feasible (or even sensible) within the
   pharma industry structure?

   The KAM process                                               Account identification
   According to Dr Brian Smith, Open University Busi-            The first stage of the KAM process is account identification,
   ness School, ―KAM is a contingency model, which               profiling and segmentation. Who or what is our customer
   means that there is no single best way of doing it, but       and what is a key account? This is a familiar question be-
   rather a number of ways which work best in different          cause, as an industry, pharma has been profiling, segmenting
   circumstances‖.                                               and targeting its customers in various ways. All that the
   Whatever your approach, it is important to accept that        KAM approach seems to add is the need to break these cus-
   KAM is a process and not a simple one-off exercise.           tomers down into account groupings and then designate
   In order to implement a KAM strategy, the process             some of them ‗key‘ to the business.
   must be clearly identified and metrics put in place to        For some industries, identifying the customer is a straightfor-
   monitor progress, success and what remains to be              ward task. However, in pharma, the question of who is the
   done to achieve defined objectives.                           customer always meets with the answer ―it depends‖. For
   In simple terms, KAM can be considered in three               pharma, the first step in the KAM process is to agree to the
   basic steps, each of which requires further subdivi-          mission and purpose of the required KAM implementation
   sion to suit specific circumstances.                          and accept that different therapy areas will probably require
MedicinMan November 2012                          Key Account Management - a new sales model?                                                | Page 23



   different but philosophically aligned KAM processes.                                  and plans. There are many experts who can help with
   Once what needs to be achieved has been established,                                  producing meaningful, relevant and actionable key ac-
   we can move on to defining what constitutes an account                                count plans.
   or ‗core unit‘. This can be almost anything depending                                 An individual customer contact plan will also need to be
   on the objective, ranging from a Cancer Network and                                   designed to achieve objectives within the existing finan-
   linked primary and secondary care bodies for an oncol-                                cial, legal and operational constraints. Once this is done,
   ogy sales team, to a purchasing group of pharmacies for                               the structure to deliver on the plans will be ready for
   a commercial sales team.                                                              implementation.
   A pharma company that correctly identifies the account
   or ‗core unit‘ it needs to influence and then segments                                Implementation
   the most important ones as key accounts will greatly                                  The ability to successfully implement a KAM approach
   increase its chances of success. The familiar                                         depends upon the company fully understanding its situa-
   ‗Pareto/80:20 rule‘ is once again an important factor in                              tion, developing a relevant proposition and process for
   determining the actual number of accounts that should                                 achieving its objectives and supporting the implementa-
   be considered as key.                                                                 tion with the appropriate business tools.
   Strategic and tactical planning                                                       Analysis of different therapy areas will produce com-
   The next step in the process is to identify the individu-                             pletely different key accounts. Correctly identifying the
   als in the various parts of the key account and assess                                account/core unit and applying realistic metrics to deter-
   how they interrelate. Often these individuals will work                               mine its importance are critical first steps. There is no
   in different locations within the key account and have                                ‗one size fits all‘ solution in the implementation of
   specific but related roles, such as financial, advisory                               KAM. Another major driver for a successful KAM im-
   and clinical. There is then a need to repeat the profiling                            plementation in the pharma industry is the seniority/
   and segmentation process at an individual level within                                maturity of the key account managers responsible for
   the key account, and construct the required processes                                 the implementation.



                                       Key Account Management Implementation Process in
                                                        Pharmaceuticals

                                                                               Purpose & Mission
               Key Account Planning




                                                                            Profiling & Segmentation



                                                    Key account Selection                              Organisation Structure

                                                                                                       Recruitment, Allocation
                                                                                                         & Training of KAM’s


                                                                                Key Account Plan
               Key Account Execution




                                          Information & Intelligence                                         Resources Management



                                                                            Relationship Development
                                           Process Implementation                                          Process Implementation Tool
                                                                                     Process


                                                                            Performance Monitoring
                                                                                    Process                   © Pharma MI 2008
MedicinMan November 2012               Key Account Management - a new sales model?                                      | Page 24




                                                                 “
  The old sales model of simply selling products to custom-
  ers no longer applies. In a successful KAM approach de-            The KAM approach is a
  veloping a ‗win-win‘ proposition for the key account,
  where the key accounts see the value of working with
  pharma, will be a critical success factor. However, KAMs
                                                                     sales process that has
  are commercially astute people who have the company‘s
  objectives at the forefront of their minds and who can
                                                                     logical, time dependent
  interact persuasively and credibly with the customers
  identified as key accounts.                                        sequential steps.”
  It must also be accepted that the KAM approach is a sales
  process that has logical, time dependent, sequential steps
  which, if followed correctly, will lead to success. Follow-
  ing and tracking progress through the process with appro-
  priate KAM business tools is another critical success fac-
  tor. However, it is evident from practical experience that
  many of the CRM tools pharma companies are familiar                Operational Performance Indicators:
  with are no longer appropriate as they cannot adequately           The following are important indicators of performance,
  support the implementation of KAM.                                 i.e. they show the direction of the business as opposed to
                                                                     what the business has done, such as other systems like
  Measuring KAM effectiveness                                        corporate dashboards and the balanced scorecards do.

  Implementation of any KAM process requires the capture             Activities report - shows the current status of a key ac-
  and review of a number of performance indicators. These            count plan or opportunity as compared to plan
                                                                     Late task report - shows the current status of all tasks as
  fall into two categories: operational performance indica-
                                                                     compared to planned completion
  tors (OPIs) and key performance indicators (KPIs). It is           Key account relationship index report - tracks the sta-
  important that they are ―indicators‖ of the direction the          tus of the supplier / client relationship over time
  business is moving in and not ―measures‖ of what the               Key contact relationship index report - tracks the status
  business has done. This becomes crucial at the KPI level.          of the KAM / client contact relationship over time
                                                                     Decision making unit (DMU) report - tracks the status
  From a performance management perspective, in order to             of the DMU status and relationship over time
  measure effectiveness it is essential that OPIs and KPIs           Key account sales tracker - tracks sales by key account.
  are derived together. KPIs must represent a summary
  view of OPIs in order to maintain continuity of measure-           Key Performance Indicators
  ment. KAMs mainly use OPIs to support their actions                Time allocation analysis - tracks time allocation by cate-
  when seeking to achieve high performance. They allow               gory over time
  the individuals concerned to record the achievement of the         Key account relationship tracker - summary of equiva-
  various stages in the implementation plan and flag areas           lent OPI
                                                                     Key contact relationship tracker - summary of equiva-
  that still need to be improved. KPIs pull these OPIs to-
                                                                     lent OPI
  gether and are used by the KAM management team to                  Decision making unit - summary of equivalent OPI
  monitor the performance of the business unit as a whole.           Key account sales tracker - summary of equivalent OPI.

  Conclusion
  KAM is not as revolutionary as some suggest. Yes, it is a
  departure from the traditional sales model, but it is only
  evolving away from an approach that is failing. The phar-           Ralph Boyce, Ken Boyce, Tony O’Connor are
  ma industry‘s traditional relationships with its customers          Directors at Pharma MI
  are changing and, in response to this, progressive compa-
  nies have adopted and successfully implemented KAM .                This article was previously published in Pharma-
  If the healthcare market continues to change as predicted,          ceutical Marketing May 2008.
  the companies that are waiting and watching may find that
  not only are their multiple sales forces no longer required,        Published in MedicinMan with the permission of
  but that they are unable to put a meaningful proposition to         authors.
  their customers.▌
← Home                             MedicinMan November 2012 >>> Book Preview                                     | Page 25



Book Preview: Pharma Front-line Leader to CEO
                                                                                     by Vivek Hattangadi
The ost exciting characteristic of the pharmaceutical
industry in India is that many CEOs have started their
careers as humble medical representatives. By the time
they became first-line leaders, the ambitious amongst
them dreamt of reaching the top. This book is a guide for
such forward looking people!
The book has been written in a unique style – the entire
book is in the form of a conversation between a budding
First-line Leader Vinod Kamat and his Mentor. The les-
sons which the Mentor gives are the take-home messages
for the reader.

Prologue to the book.
We all know that in 1999 India won the Kargil war
against Pakistan. The sacrifices of the jawans and officers
set many a young heart on fire. One of them was Vinod
Kamat, the only son of his parents. Vinod, who was then
barely 13 years old, declared his intention to join the
armed forces via the National Defence Academy route
and serve the country. His mother was in a state of shock
when she heard this. She spared no efforts to dissuade
him from taking up this risky career. However Vinod
was firm; nothing could shake his determination. He stud-
ied hard for the entrance examinations and passed with
flying colors. No sooner had he received a call for an in-    talent and invited him to join Capella Pharmaceuticals as a
terview than his mother went on a hunger strike to dis-       medical representative; he was offered Ahmedabad as his
suade him from attending it. After she went for three days    headquarters. Vinod was delighted and accepted the offer.
without food or water, Vinod‘s stand softened and he          Capella Pharmaceuticals was a very fast growing organi-
bowed down to the wishes of his mother.                       zation which had acquired licenses to market some of the
He joined Bhavan‘s College, Andheri, Mumbai to pursue         top brands of various MNCs. Vinod decided to excel in
B.Sc., but his heart was not in studies. He scraped           this company with an ambition to reach the top and be-
through B.Sc. examinations with just 37% marks. And           come a CEO one day.
who would give him a decent job with this ‗brilliant‘ aca-
                                                              Unfortunately for Vinod, his district manager at Ahmeda-
demic record?
                                                              bad was a new incumbent. His behavior was more like
His first job was as a shop-to-shop salesman selling medi-    that of a super-medical representative. Vinod could neither
cated cough drops introduced by a well-known FMCG.            get any guidance from him nor learn anything from him.
His customer audience included retail chemists, general       Day in and day out he bragged about his success stories as
stores, grocery shops and even ‗pan-bidi-wallahs‗. Selling    a medical representative. Vinod and his colleagues often
the stuff packed in polythene bags, he was accompanied        heard him saying, ―If I were you, I would have done this,
by a cycle-rickshaw puller carrying the wares. A chance       and I would have converted this doctor to our brands. I
encounter with the regional manager of Capella Pharma-        converted a key opinion leader, Dr. Sharma, to our brand
ceuticals changed his destiny. While in the field and         within three visits.‖ Instead of leading the team forward,
working at retail chemists, this gentleman spotted his        he was boasting about his successes all the time!
A BroadSpektrum Healthcare's CSR Initiative Promotes Patient Care
A BroadSpektrum Healthcare's CSR Initiative Promotes Patient Care

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A BroadSpektrum Healthcare's CSR Initiative Promotes Patient Care

  • 1. A BroadSpektrum Healthcare Business Media’s Corporate Social Responsibility Initiative MedicinMan ~ FIELD FORCE E XCE L LE N CE ~ TM PHARMA | MEDICAL DE VICES | DIAGNOSTICS | SURGICALS Vol. 2 Issue 11 www.medicinman.net November 2012 Editorial HURRICANE GENERIC HITS INDIAN PHARMA n recent times no other issue has ruffled Indian Pharma as Digital Dose by Dinesh Chindarkar is especially useful for much as the generic vs. brand issue. At stake are millions of those who want to use Social Media to further their profes- jobs and revenues. But we forget that serving the needs of sional interests. patients through the physician community has created these We believe in lighting a lamp instead of cursing the darkness jobs and revenues. When commerce triumphs at the expense – however clichéd that might sound given the decline in and not at the benefit of consumers, then sooner or later the- skills of the Indian Pharma‘s field force (see page 8 for my se storms are certain to strike like Hurricane Sandy. Remem- article). But unless we take remedial actions, how can we ber, consumers are the ultimate drivers and shapers of mar- expect a turnaround? A Medical Rep‘s skills can be only as kets whether through social activism or by influencing gov- good or bad as his trainer‘s ability to equip and motivate ernment policy. Industry leaders and associations should put Medical Reps with knowledge, skills and attitude needed at their heads together in enlightened self-interest and become the workplace. active players in reforming healthcare to benefit patients – MedicinMan Academy will conduct a 3-day Pharma Sales their ultimate payer. Trainer Certification Program in December 2012 (for details We have an insightful article by Salil Kallianpur on the ge- see page 5) to bring about uniformity in the training of Medi- nerics vs brands issue on page 18; as well as links to articles cal Reps and FLMs. The program is ideally suited for those by Prof. Vivek Hattangadi and Gauri Kamath – both of them who are working in training departments as well as senior are well known pharma industry commentators. professionals in Sales, Marketing, HR, SFE and related areas On the positive side, we have an excellent addition to the who wish to move into training. learning and development of pharma professionals by way of The program will cover all essential areas of adult learning a new book by Prof. Vivek Hattangadi – ―Pharma First-line and development relating effective development of Medical Leader to CEO‖. This should serve as valuable guide to Reps including psychometrics. those who aspire for career growth. Prof. Vivek Hattangadi In the future MedicinMan Academy will also conduct vari- also assumes additional responsibility as Dean – Professional ous other programs for the development of Front-line Man- Skills Development of MedicinMan Academy. agers, SFE, SFA and related areas. K. Hariram, our Chief Mentor continues his series on Coach- We invite senior managers in Pharma to connect and offer ing for FLMs. We also have insightful articles by Dr. S. your suggestions. – anupsoans@gmail.com Srinivasan, Dr. Amit Dang, V. Srinivasan adding to the skill development of field force. - Anup Soans, Editor The article, ―KAM – Is it a New Sales Model?‖ by interna- tional team of authors, Ralph Boyce, Ken Boyce and Tony O‘Connor will add to our understanding of this new emerg- ing area in Pharma Sales. LinkedIn is emerging as an important learning platform for MedicinMan welcomes Prof. Vivek Hattangadi as Dean – pharma professionals and I invite all our readers to connect Professional Skills Development at MedicinMan Academy. with me on LinkedIn. Please send an invite to http:// in.linkedin.com/in/anupsoans. We have featured two ―Hot on LinkedIn‖ discussions for the benefit of our readers.
  • 2. Contents CLICK TO NAVIGATE. 4. Customer Targeting for High Im- 18. India’s Health Policy - flip flops and pact Sales. policy shifts. Regularly updated customer lists What the recent DGCI order on generics are key to high ROI on sales efforts. means for Indian pharma & healthcare V. Srinivasan Salil Kallianpur 6. Making “Calls” Effective 20. Digital Dose - Part 1 Making joint-work with Medical A regular column on social media for Reps productive through coaching. pharma by leading experts. K. Hariram Dinesh Chindarkar 8. “You” Matter Most in Getting 21. Pharmacology Essentials - Pharmaco- Repeat Rx kinetics Parameters In the sea of generics, “you” are a Concepts of bioequivalence, steady- key differentiator for your brand. state, leading dose, maintainence dose Dr. S. Srinivasan and others explained. Dr. Amit Dang 10. Field Force Excellence: Are we kidding ourselves? 22. Key account Management - a new sales model? Is Field Force Excellence attainable in this era of hyper-competition? Key Account Management is a distilla- Anup Soans tion of existing strategies & approaches Ralph Boyce, Ken Boyce, Tony O’Connor 14. Hot on Linkedin 1. How to make productive field 25. Book Preview: Front-line Leader to visits. CEO 2. What are the key drivers of SFE? What it takes to move up the ranks written in a simple, conversationalist style. Discussion seen on Indian Pharma Prof. Vivek Hattangadi Connection and SFE respectively. Editor and Publisher: Anup Soans CEO: Chayya S. Sankath COO: Arvind Nair Chief Mentor: K. Hariram Advisory Board: Vivek Hattangadi; Jolly Mathews Editorial Board: Salil Kallianpur; Dr. Shalini Ratan; Shashin Bodawala; Prabhakar Shetty; Varadarajan S; Dr. Mandar Kubal; Dr. Surinder Kumar MedicinMan Academy: Dr. S. Srinivasan, Dean, Medical Education Prof. Vivek Hattangaadi, Dean, Professional Skills Development
  • 3. Now Available as an Ebook on Repeat Rx Calling → Connecting → Consulting → Collaborating REPEAT Rx is the first-of-its-kind skill certification and competency building program for creating trust and building relationships with Doctors leading to lasting relationships and generating Repeat Rx. REPEAT Rx is conceptualized and developed by Anup Soans who is the Editor of MedicinMan and author of the widely read ―HardKnocks for the GreenHorn‖ and ―SuperVision for the SuperWiser Front-line Manager.‖ Visit: http://amzn.com/B009G3SJ1Y Repeat Rx can be read across devices such as iPad, Kindle, Android, MAC and PC. Download the appropriate reading app for free HERE.
  • 4. ← Home MedicinMan November 2012 >>> Customer Targeting Customer targeting for high impact sales. V. Srinivasan ustomer list is the foundation upon which the building While doing this exercise, side by side, we can also plan called Sales is built. If the foundation is strong, and main- for improving the business volume from customers from tained properly, then the building will also remain healthy whom we are getting very low volume of business sup- and strong. Let us see below how to keep the customer list port. If it is very clear that irrespective of any further strong and active by periodical pruning, cleansing, and efforts, the business volume may not improve, then we updating so that it remains active and healthy at all times, need to decide whether such customers can also be delet- and yields the best possible results to the business. ed, and instead, new but potential customers from whom First and foremost: the total number of customers, as well we can get better business support can be included in the as specialty-wise composition/ break-up of the same, coverage list. should be exactly as per Sales & Marketing strategy. The A similar exercise with other customers like stockists and selection of customers must be done only after thorough retailers can also be conducted, and wherever necessary, RCPA to ensure right customers for right products are dead wood can be removed, and new but potential ones chosen. The Line Managers and Product/Brand Managers included. Such an exercise will ensure that we remove must ensure this, because there is a tendency at the lower dead wood, and the customer list (i.e.foundation) is very level to include customers who are easy to call on, irre- active, and we get support from all the customers in the spective of whether they are the right customers or not, list. It also ensures that we focus all our efforts, activities, and whether they have potential to prescribe the products and resources on the potential and right customers only, being promoted or not. Having prepared the customer list thus avoiding wastages of promotional efforts and field as per strategy, the next step is to give visits to each of the working. Many organizations do not do this activity sin- listed customers strictly as per desired number and fre- cerely, and leave it at the discretion of the Medical Rep quency. and the Line Manager concerned. Having ensured both the above, the next, but important Once we ensure active and updated customer list, besides step is to ensure that we get business support from each number and frequency of visits as per strategy, we should customer on whom we are investing efforts and resources, also ensure proper detailing of the products being pro- even though the quantum of support may vary from cus- moted (i.e. communication) which can have the desired tomer to customer. This can be ensured by periodical au- impact for conversion of identified customers. diting and cleansing of the customer list, as per following The whole exercise is aimed at keeping the business tree procedure. Let the Medical Rep makes at least 6 calls, i.e. free of dead wood, and dried leaves, and keep it hale and if 2 calls are slated for a customer every month, after 3 healthy. If Organizations ensure the above in all sinceri- months of visits and promoting the identified products to ty, the results will be highly rewarding.▌ the Doctor by the Medical Rep and at least two more visits by any of his superiors like Area Manager, Regional Man- ager, Zonal Manager, Sales Manager, Product Manager, if no support has come from the customer, then such names V. Srinivasan has headed Sales may be deleted from the coverage list. After a total of 8 Administration & HR functions in visits (6 by Medical Rep & 2 more by any higher officials) reputed Pharma Companies, with over 325 published articles in India decide whether to retain or not. In that vacancy, another and abroad. He can be reached at potential customer from the same locality from the same shridhar1956@rediffmail.com specialty who has the best potential to prescribe our prod- Mob: 8056168585 ucts, based on RCPA already conducted, may be included.
  • 5. Become A Certified Pharma Sales Trainer. 17th, 18th & 19th December, 2012 at Mumbai Fee: ` 22,500/- per participant. Early bird fee: ` 19,500/- (for registrations before 10th November 2012) To register, email: anupsoans@gmail.com
  • 6. ← Home MedicinMan November 2012 >>> Coaching | Page 6 Making “calls” effective. K. Hariram “ uring joint working by the FLMs with their sales people, To create a “high-performance” climate post call analysis is a common practice. Mostly it ends up as a post-mortem, or after-action call discussions. Gener- at work follow these 4 steps: ally you will look at what went well and what could have 1. Spend one-on-one time with each gone better. But how many of the FLMs have considered conducting 'advance-action sessions'? member of your team. Can the earlier experiences of the 'calls' be reflected? Can 2. Coach them on-the-job. the communication required to make the call be articulat- ed and practiced? Look at this as 'pre-mortem' activity. 3. Make their work interesting. Prepare this by asking these 3 questions : 4. Let them know you trust them.” 1. What worked well in previous calls that is worth considering for this call? 2. What could have been done differently in previous calls that should be kept in mind now? Take these 4 steps : 3. What new things should be considered for trying on 1. Spend one-on-one time with each team member. Spend the new calls ? time with each person and know how the individual is Lessons from the past is very helpful during ON THE doing on both personal and work level. Provide feedback JOB coaching and helps find newer solutions. It also promptly. breaks falling into the rut of the routine. 2. Coach on the job. Show them how to do even better. Creating a "high Help them in finding solutions to job-related problems. Support them in finding alternate resources for solving performance" climate. personal problems, without becoming too much involved in the details of their personal lives. When you are dealing with 5 to 6 people in your team, building the team's morale is your important responsibil- 3. Make their jobs more interesting. Build variety in their ity. You can do this by ensuring that each of your team assignments and challenge them positively. When they member is engaged, enthusiastic and ready to make posi- demonstrate their competence, recognize and share it tive contributions. with other team members. 4. Let them know you trust them. Clarify and explain what you want them to do and allow them to suggest ways. Set boundary lines and parameters and monitor the same. Help them to learn from past mistakes. ▌ K. Hariram is the former MD of Galderma India. This article is fourth in a series on “Coaching” authored by him.
  • 7. MedicinMan PRESENTS BREAKFAST FOR THE BRAIN Where Pharma Business Leaders Brainstorm 3rd Edition In Partnership with: Kingpins Management Consultancy
  • 8. ← Home MedicinMan November 2012 >>> Personal Success | Page 12 “You” Matter Most in Getting Repeat Rx. Dr. S. Srinivasan hen I moved from 1st MBBS to 2nd MBBS, the initial azithromycin is still posing formidable challenges across excitement of bedside medicine was understandingly a bit the board and up and down the hierarchy of most marketing too overwhelming, given that I was all of eighteen going on organizations. nineteen at that time. The burden of the white coat was And this started applying not only to small molecules but getting somewhat bearable but not the over-bearing pres- also large ones like insulins, monoclonal antibodies and so ence of our medicine professor who prided himself on not on. There was a phase when the ‗original‘ MNC marketer only superlative clinical knowledge but impeccable of a molecule would attack the ‗copies‘ on quality issues to Queen‘s English as well. justify his higher price. But this didn‘t last long as Indian His favorite question was, what are the three most im- companies surged ahead with good quality products at low- portant things in clinical medicine? After we would hazard er prices, not only in India but even in ‗sophisticated‘ mar- one wild guess after another for ten minutes or so, he would kets. make his pronouncement in a triumphant voice from a On expiry of the patent period for a block-buster, the origi- puffed up chest: ‗diagnosis, diagnosis, diagnosis‘. At that, nal discoverer would argue that his generic is superior to our awe for him would go up three notches: wow, how the lesser mortal‘s generic but that argument too does not clever! Never mind what today‘s professors and students wash any more as seen in recent examples of lipid lowering think about the disposable commodity called diagnosis! and other types of drugs. 3 ‘P’s ‘You’ matter A decade and a half later, my first ‗sales promotion man- So, where do you stand in a crowded bazaar where you ager‘ (yes, marketing manager came later) with a similar have to out-shout the other guy selling the self-same medi- personality trait would ask a similar question: what are the cine at crazy prices with bizarre messages? Well, there is three most important things for a ‗medical rep‘ to succeed no magic wand that would save you here save your own in his career? Assorted sound bytes would come from dif- self. By that I mean, when product knowledge alone won‘t ferent corners of the room, to which the manager would take you far, you wear one of de Bono‘s hats, or make your only shake his head slowly and then pronounce in a serious own, and showcase yourself in clever ways. voice, ‗product knowledge, product knowledge, product There are doctors who would / should be asking for / think- knowledge‘. And we would go, wow, how clever! ing of YOU when it comes to writing a prescription. Your Mind you, it worked. And still does. Your display and dis- command over the product, your communication skills, semination of razor sharp product knowledge would surely your sense of anticipation of the doctor‘s thinking, your get you the doctor‘s ears as well as admiration, often culmi- unique value systems that make you what you are….these nating in that vital document called prescription. But when are the things that somehow create a bond between you and the landscape of products underwent a sea change with the prescriber and clinch the sale. In short, YOU should more and more branded generics flooding the market, there start mattering more than the product. Sounds odd? Think came a time to re-think strategies. about it anyway. ▌ Half - dollar A standard challenge in selling/marketing was, is and will Dr. S. Srinivasan is former Sr. VP at be, how to promote your half dollar over the other guy‘s? Aventis. He is currently a lifecoach The art and science of making a doctor prescribe your ge- and Dean, Medical Education at neric (forget the branding façade) version of say azithromy- MedicinMan Academy. cin in preference to your competitor‘s generic version of
  • 9. Vacancies brought to you by Kingpins Management Consultancy Position / designation Job Description Area Business Manager (Rachi & Aurangabad). (MNC, Diagnos- District Manager (2 Positions—Nasik & Mumbai (Thane down tics) & Central Mumbai) Essential qualifications: Job Title: District Manager B. Pharm/B.Sc in Bio Science/Chemistry Span of Control: 5 Medical Representatives (outsourced – 3rd Critical attributes / qualities: party payroll) Good communication and Negotiation skill, good team player, Business Potential: 30 lacs / month Fast learner, Good relationship with Diabetologists/Physicians Salary offered: up to 5 lacs and Cardiologists of the area Key Skills: Brief Job Description: 1. Candidate must be working on field as a First Line Manag- 1. Promote the products to Diabetologists /Physicians/ er, in a Pharmaceutical company featuring in TOP 50 GPs / Laboratories Companies rated by ORG. 2. Procure institutional business 2. Candidate must have a good command over English 3. Visit retailers to make the product available and collect language – Conversational & Written. the information on competition. Arrange for product 3. Candidate must have a good clarity of the role of a First displays at retail chemists. Line manager. Must have good management skills. 4. Conduct diabetes awareness programmes 4. Candidate must be achievement oriented. Please provide 5. Attend to the product complaints. data of previous 2-3 years target achievement. 6. Train and guide salesmen of the distributors who supple- 5. Candidate must have a passion to excel in Pharma Sales. ment the sales efforts of the company sales staff. 6. Candidate must have basic knowledge of MS Office. 7. Appoint distributors as per the business need 8. Organize CMEs for doctors 9. Organize training for the Nursing staff on the handling of Job Description our products in institutions who use our products Medical Business Manager (Jaipur, Bangalore & Mumbai) Preferred age group: 24-28 years. Experience: Fresher / 1.5 – 4 years Compensation package: Rs 1.5 lacs- 2.25 lacs. Qualification: B.Sc (minimum) CTC Offered: Rs. 1.50 Lacs – Rs. 3 Lacs Reporting: Zonal Manager Responsibilities: Job Description 1. Generating new business leads &taking care of the Retail Business Manager (Mumbai & Chennai) (MNC) existing clients. Qualification: B.Sc. (minimum) 2. Meeting up with doctors, nursing homes & various Experience: 1.5 – 4 years hospitals for Glucometer sales & getting prescriptions. CTC Offered: Rs. 1.65 Lacs – Rs. 3 Lacs 3. Actively participating in the special activities conducted Reporting: Zonal Manager by the doctors. Team: Marketing Associates (3 – 6 people as per the location / market requirement) Responsibilities: Contact: Balraj Chandra Mob: 91.9769058671, +91.9833580904 1. New business development & maintenance of existing Email: balraj@kingpinsindia.com Website: www.kingpinsindia.com accounts. 2. Meeting up with chemists, retailers (medical shops) for Glucometer. Attention HR and Placement Agencies! 3. Managing the marketing associates & motivating them for higher turnover, better productivity. MedicinMan reaches over 40,000 pharma professionals. 4. Organizing promotional events in banks, corporate offic- 50% Discount of advertisement rates for Sales and Marketing es as well as relevant exhibits. and related vacancies i.e. Rs. 15,000/- for full page color ad- vertisement instead of Rs. 30,000/- for all other advertisers. anupsoans@gmail.com
  • 10. ← Home MedicinMan November 2012 >>> Field Force Excellence | Page 8 Field Force Excellence: Are we kidding ourselves ?? FFE 2012 hosted by MedicinMan, saw intense discussion on the fea- This article was first published in Pharmaphorum. sibility of field force excellence in the current business environment. Anup Soans “ ield Force Excellence (FFE) can be defined as field The Indian IT and BPO sector gave Indian force – doctor engagement wherein: professionals an opportunity to build ca- 1. The doctor experiences tangible value in their in- teraction with pharma field force leading to better reers at a hitherto unknown pace and patient outcomes. had a cascading effect on Retail, Insur- 2. The field force experiences satisfaction with their ance, Finance and Banking and a host career and meaning in their daily work. of other Greenfield sectors. Pharma be- 3. The field force – doctor engagement results in in- came a laggard in attracting talent at creased productivity for pharma companies. the entry level and this has had a nega- ―Field Force Excellence - are we kidding ourselves?‖ tive effect in building a sales leadership This remark by a senior SFE professional from a reputed MNC summed up the thoughts of some of pipeline in an industry that was growing the delegates at the first ever Pharma CEO at thrice the speed of Indian economy.” Roundtable on Field Force Excellence on June 16, 2012 at the JW Marriott, Mumbai. In response, veteran CEO, Narayan B Gad of Pana- cea Biotec took the question head-on by saying – The rise of Indian pharma both in India and globally is ―Excellence might seem like a utopian idea, but we matched only by the Indian IT and BPO sector, which gave can certainly move forward from efficiency to effec- the Indian professionals a great opportunity to build careers tiveness, which together will take us closer to excel- at a hitherto unknown pace. Twenty somethings were be- lence as envisaged by MedicinMan, the organizers of coming General Managers and VPs and acquiring houses FFE 2012.‖ and cars within 5 years of working. The rise of IT and BPO FFE 2012 was conducted in the backdrop of deterio- had a cascading effect on the increase in job opportunities in rating quality of pharma field force in India. On Retail, Insurance, Finance and Banking and a host of other stage and in the audience were senior Indian pharma Greenfield sectors. Pharma became a laggard in attracting industry professionals including CEOs, who had talent at the entry level and this has had a negative effect in risen from the ranks of field force in the preceding building a sales leadership pipeline in an industry that was 25 years. Where had the Indian pharma field force growing at thrice the speed of Indian economy. gone wrong so dramatically that it was now strug- Feet-on-street was the logic of many Indian pharma compa- gling to find quality people to shore up the ever- nies that were growing at a break-neck speed from the 80s expanding front-lines and sales leadership positions? and forwards. MNCs and many Indian companies tried
  • 11. MedicinMan November 2012 Field force excellence - are we kidding ourselves? | Page 9 “ swimming against the prevailing trends by recruiting and training people to perform at earlier levels of com- Along with jugaad drug com- petence. But it was a losing battle – the fast-growing binations, came the jugaad Indian pharma companies were liberally poaching from the MNCs and other well-managed Indian companies promotions that did not need instead of nurturing their own field force. Medical Reps much talent. Carrying expen- in MNCs who had to wait for 10 years and more for promotions now found themselves moving up the steep sive gifts and booking exotic ladder at the rapid pace of IT companies. tour locations required as Just as prosperity comes with a price of obesity and a host of related lifestyle disorders, the price of rapid much talent of a street-smart growth in the Indian Pharma has been the decline of pizza delivery boy.” quality of field force people. Indian Pharma companies not only reverse engineered and copied IP products of MNCs, they added their own ‗jugaad‘ in creating ra- tional and irrational combinations that had the doctors reeling from an overdose of too many branded generics Talent fled the pharma industry in large numbers and (60,000) and their combinations. mediocrity ruled the day. No wonder veterans look at Along with jugaad drug combinations, came the jugaad the present scenario and remark: ―Field Force Excel- promotions that did not need much talent. Carrying lence - are we kidding ourselves?‖ expensive gifts and booking exotic tour locations re- But the darkest night is also just before the dawn. The quired as much talent of a street-smart pizza delivery declining productivity of field force, increasing social boy. Irrational drug combinations, irrational copycat activism against pharma-doctor nexus, governmental promotions – nobody questions the sanity of methods regulations and an uncertain global economy are forcing when the growth is assured. Ethics went for a toss as Indian Pharma to rethink their way of doing business. MBAs competed with veteran field sales leaders to The transactional relationship with doctors has run its prove their worth through get-rich-quick MLM like full course and the returns are diminishing steadily. To strategies, which unfortunately led to decline of field reverse these negative trends and bring about a transfor- force – poor quality recruits, little training, promotions mation in the relationship with doctors, Indian Pharma without development and high pressure management. will have to reinvent its field force again. The new gen- erations of students coming out of campuses are coming equipped with some unique skill sets – they are the digital natives. The rise of technology enabled doc- tor and social media will provide Indian Pharma with unique ways of engaging the doctors – from fatigue to fun. Both doctors and field force have been experienc- ing a high level of dissatisfaction in their interactions. While field force will remain the lynchpin of doctor- pharma equation, it will be the technology enabled Medical Rep and Front-line Managers who will re- create trust and build relationship by understanding the doctor‘s business and adding real value. The repositioning of Field Force has to be well thought out and must address the needs of patients and doctors and not just the promotional interests of Pharma compa- “Jugaad” - the Indian approach to nies. There is a lot that pharma field force can do in this skirting obstacles.
  • 12. MedicinMan November 2012 Field force excellence - are we kidding ourselves? | Page 10 “ regard as they are on the field where the action is. Social media has the potential to engage, build trust The scope for field force and communicate effectively in a media format that already has the patients and doctors tuned in. Gadgets excellence is enormous if like iPads have the potential to take CRM and other customer engagement models to effectiveness levels Indian Pharma takes the not possible earlier. These gadgets also have the po- tential to make learning an ongoing practice instead leap and re-configures its field force strategy from of periodic events. iPads have the potential to transform the Medical Reps learning process and make them more knowl- recruitment to manage- edgeable about the therapy areas in which their cus- tomers operate. A seamless loop that connects Medi- ment.” cal Reps, Front-line Managers, Training Managers, doctors, chemists and other stakeholders has the po- tential to go beyond the present silo approach and bring HR, Sales, Medical Affairs, Administration and Presently most Indian Pharma companies pay scant attention other function including finance on the same page. It to learning and development needs of Medical Reps and can bring about beneficial changes in neglected areas Front-line Managers. The high attrition rate serves as a like ADR by systematic reporting and response in dampener on investing in people. This has led to the entire real time, adding much value to medical practice. ecosystem of field people being ill equipped to handle the new challenges of healthcare marketing. In short, the scope for field force excellence is enor- mous if Indian Pharma takes the leap and re- With the advent of Cloud Computing and the high involve- configures its field force strategy from recruitment to ment of Gen Y in social media and the emergence of cell- management. phone as an ubiquitous device, it is possible for pharma to engage its field force on a regular basis and bring about field The results of a MedicinMan Poll with more than 400 force excellence in the near future.▌ respondents on LinkedIn are instructive of the aspira- tions of employees. Learning and Development was Anup Soans is an author, facilitator the No.1 job satisfier for employees in the 18–29 age and the Editor of MedicinMan. Connect group (for details and comments of the poll: http:// with him on Linkedin (linkedin.com/in/ linkd.in/MDfstI). This is very heartening indeed. anupsoans) or write to him at Entry-level employees are aware that Learning and anupsoans@gmail.com Development is the key to success in their career. MedicinMan poll on factors influencing job-satisfaction. Bringing about employee engagement by taking these factors into account is a key part of Field Force Excellence.
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  • 14. ← Home MedicinMan November 2012 >>> Hot on Linkedin | Page 14 “ ” Field Managers are going blindly for their co-visit in the market with their field staff. FLMs are going for fieldwork with medical reps blindly just to show to the top management that they have done their job. They visit the areas and doctors from whom medical rep is already getting prescrip- tions. They visit the stockist to get the order to achieve the budget through their visit influence. FLM‘s visit cannot be called productive till the time they follow these guidelines: Ajay Kumar 1. Do a survey with chemists regarding Doctors that can prescribe products of the company. Who are prescribing the competitor‘s brand? 2. Manager‘s visit can be called productive if he has been able to convert the doctors with his visit. He should ask the medical rep to follow up with doctor for Rx in the subsequent call by medical rep. 3. Manager should check with chemist and stockist regarding any distribution problem. 4. He should solve problems being faced by the medical rep. 5. During the next visit FLM should find out the from medical rep regarding the outcome of his last co-visited areas and he should give some time to the last visited area. 6. Manager should cover the complete territory of medical rep in a year. 7. Manager should give preference to territories from where sales are low to check what the reasons for low sales are and give guidelines to medical reps on how to increase sales. 8. Manager should use his strengths to strengthen the medical rep. The entire industry is afflicted with the ―free radical syndrome‖ (high attrition), largely due to poorly em- powered, uninformed and ill equipped FLMs, who come on board with limited knowledge of managerial competencies - namely decision making, delegating, problem solving, team work, etc. In the earlier days, the selection process used to be elaborate, comprehensive and tested a potential candi- date from multiple perspectives, through group discussions, case study presentations, inter- views. Candidates who came out successful from such intense screening were found to match the rigors & Sankaran SS demands of the managerial job. The immediate need today therefore is to identify the potential in the system, not just in terms of sales performance, but in terms of overall potential to succeed at the next level. This obviously requires mapping FLMs against well defined job related competencies, investing time and effort to nurture & develop them on these competencies. Then put them through a robust assessment process and put them on the job. The process is certainly time consuming, will not show immediate visible results. However it is bound to pay rich dividends in the long run. For people don't leave organiza- tions, they leave their bosses.
  • 15. ← Home MedicinMan November 2012 >>> Hot on Linkedin | Page 15 During the 1st week & last week of the month, the Area Manager is found running from pillar to post to close sales in order to fulfill sales commitments given in the monthly meeting. Once sales are closed, he has to do preparation for presentation, compilation of secondary sales and deficits. For this he requires time and nearly 1/3 of the month is lost in this process. What is the need for these monthly meetings? This is a disincentive for carrying out productive joint in-clinic work. I have also observed higher man- Manoj Singh agement of some companies speaking late at nigh - at 10 PM or later - or in early morning, without any concern about what time the AM / RM was back from tour or what time he has started his work. These are the reasons for high attrition rates and the need to fill vacancies by compromising in the selection of MRs / AMs. I can only say there should be come code of conduct, work norms, discipline in talk & clear communication especially dur- ing month-ends, when the standard of talk goes down drastically. (paraphrased) As long as 'come what may, get numbers by month end' approach continues, merely criticizing FLMs or for that matter, even SLMs will only add to the problems. Sales force cycle meetings should be for renew- ing, refreshing & rejuvenating the sales team and not merely to take out their frustrations and demoralize the team. Create an environment where people have inner motivation. Do not simply throw motivating words which are manipulative. Let the sales team get involved in their budgeting process. Yesterday's work force swallowed the Top Down approach; certainly the current generation may not...unless con- vinced. Focus on FLMs‘ development; the multiplying effect will be beneficial. At each level avoid K. Hariram BLAME game; build a TAKE CHARGE attitude. Do not compromise on basics and fundamentals. Treat the FLMs with respect and anything critical, discuss separately - in short, protect his self respect in front of his team. Right from top to bottom, let every person ' walk the talk'. (paraphrased) FLM should spend good and quality time in field with MR. He should go in the field after doing proper home work. Now, just imagine the situation we offer to FLM in most of the companies: with fixed days for meeting and travelling, how much time do we give to him for his analyses / homework? Beside time, what are the tools which we give to him to do analysis? Even in today's hi tech world, many of the companies are working on ghostly looking excel sheets / pivot table, having lot of data but nothing obvious ACTIONA- Jyoti Jain BLE shown. (paraphrased) In order to bring about the role transformation from M.R to A.S.M. specific programs are needed to con- sciously build the confidence of the A.S.M. as an observer and then a solution provider to the problems faced by a M.R. An A.S.M. has to differentiate between product training (hard skills) ROLE training (soft skills) to add value to joint work. This can be achieved by periodic induction. (paraphrased) Deb B. It has been my personal experience that it is the FLM / SLM ( 80—20%) responsible for a company's fate. In every cycle meet, I personally allot a day for product knowledge developmental activity. Accordingly, each FLM/SLM has to come fully prepared with presentation on assigned ONE product each, and take class in detail. It works wonderfully. All FLM, SLM, ZSMs are made to mandatorily visit and work along with subordinates on permissible regular intervals. The visit plan must include Dr's (at least 2 of Pramod Sharma each specialization, so as to ensure promotion of maximum available/ stocked products), C&F, Stockists and Retail visits. Besides, even senior managers should follow the laid guidelines during their visits, so as to set examples and help take appropriate decisions if problems exist. (paraphrased)
  • 16. ← Home MedicinMan November 2012 >>> Hot on Linkedin | Page 16 A Field Manager, before going to field work with medical rep, should visit the stockist/super stockist and find out the product movement. Examining the medical rep's tour program he must find out which areas have poor performance. Then the Manager should visit the poor performing areas with the medical rep and analyse the reason for poor sales. After that he should find a solution for the problem and hand over the area to MR. In his next visit again he should visit that area and see the results. With this exercise the sales will increase and R. Shetty MR will be happy because AM has solved his problem. Also AM will build a personal bond with MR. The basic objective of the FLM is to develop his MR, be it by demonstration, direction (training if required), observation and delegation once ready. I would be a little concerned if the FLM is sorting out problems of the MRs regularly, he should not be a solution provider but a solution facilitator. Kultaran SS Its true that the field managers go to field without any preparation and just become passengers on the bikes of medical representatives. They go to doctors along with the medical representative and hijack the call, become a ―super representative‖, try to boss over the poor Medical Representative and go home with false satisfac- tion. This is true, not only for the line managers, but also most of the bosses of the medical representatives. They feel delighted in doing super-MR's job. As a result, a good MR, who may need coaching or support or Manas Dash delegation, feels depressed and remains disengaged. He simply waits for his so-called bosses to return to do his job after 15 days or a month and does all the manipulations to achieve numbers. Finally, getting disappointed, he leaves the organization with a hope that, someone, somewhere will take care of him. But it remains same across the companies and across the management community. It can only be changed if, the bosses change their mindset from doing to observing, giving proper feedback and caring for their subordinates. “ ” What are the priority areas? What do you think an SFE Manager/Analyst should focus on first? Is it segmentation and targeting? Or maybe call frequency optimization? Or maybe the sales incentives program? - Krzysztof Lasocki The starting point always is the company's objective. Then you analyze and look into the sales process: from target- ing to segmentation to segment strategies to execution. Once these details are all coherently driving and pointing towards the company objective, you look into the call process. (Re to "objective" please look here.) The effect of incentives (in mature markets) in any case is disputable. In general anything you measure must match Hanno Wolfram and drive objectives. SFE in this context should be defined as getting more for the same or the same for less. In my experience the Key Driver of any SFE initiative is communication and buy in. If the field sales force does not understand the objective of the initiative then the data captured (if using a CRM system) can be manufactured to "Hit the Number". As stated in Hanno's post the Objective must align with the process but the understanding of the Value James Buck must be communicated and all stakeholders in agreement.
  • 17. ← Home MedicinMan November 2012 >>> Hot on Linkedin | Page 17 Assuming that we are leading a start up organization and the primary objective is to generate productivity from the budgeted re- sources from day one, then applying the 4S principle will help. 1. Structure - Deployment of field force on the basis of customer, coverage and competition . Also consider their alignment basis channel of distribution. 2. Systems - set clear KRA, KPIs, sales targets, daily/weekly reporting formats/CRM. 3. Skills - KAM, multi stake holder selling. 4. Spirit - Reward/incentive and recognition. Finally lot of discussion is happening on CLM and if implemented correctly the yield could be above average. - Arupendra Das Prescriptions are not only the reflections of one's sales behaviour but the reflections of one's beliefs. One of the main drivers of SFE sould be to address this belief. High technical skills and conceptual skills are always impart- ed. But what is neglected is the human part. In a highly competitive environment it is important that people should be made to believe what an organization considers as "Effectiveness". If the indicators are "profitability & target achievement‖ then we are missing the core of SFE. Many universities teach subjects ranging from history Govindrajan D. to economics to Marketing but only few are really coaching people for "Sales‖. The curriculum should be fo- cused on "Communication & Sales Behavior‖. I like that Govindaraj has mentioned "profitability and target achievement are not the key indicators of effectiveness". This would bring us to the question of what is meant by "Effectiveness". Would you consider a field force person who has very good knowledge of the product and can communicate with the doctor very well, but cannot get the extra prescription that his manager demands as ―effective‖ or would you consider a street smart rep who can discuss everything under the sun with the customer and get the extra prescription? I think before we even discuss the drivers of effectiveness we should understand what effectiveness means for various levels of hierarchy in Pharma. For the frontline manager who has to keep his team‘s commitments it is totally sales and target driven, for the brand manager it is totally strategy and campaign management driven and for product manager it is by the feedback on the key messages that he creates every cycle. And the one person who has to keep everyone plus his doctors satisfied is the poor rep. - Venkatesh Annadevara Following Venkatesh's request let me quote Peter Drucker, THE Management Teacher of the last century: ―Effectiveness = doing the right thing. Efficiency = doing things right‖ The problem in pharma is to know what is "right"! 1. I fully believe that "right" varies by company, by product portfolio and even by market place, There is noth- Hanno Wolfram ing like an interchangeable "best practice" (another one of those buzzwords) like a "one size fits all". 2. If "right" at all is defined in and for a company it is defined "inside-out": right for our revenue, right for our bottom line or our fame etc. 3. The client perspective, be it prescribers, be it nurses or even patients is widely neglected. In our daily life we are offered perceptions, solutions, concepts, feelings, ideas and not (no longer) products! (e.g. iPad, Coke, BMW or Viagra). We are asked and offered to make our individual choice and no one "sells" something to us. All products we ever buy or purchase meet our expectations and we have a preference, which was triggered by the marketing efforts of the re- spective company. SFE in pharma at the end of day could mean: Change perspective and look at your company (brand?) or product outside-in, acknowledge what you see, hear and feel and then decide what is the right thing to do. Once this is done, identify the right way doing it.
  • 18. ← Home MedicinMan November 2012 >>> Industry Insight | Page 18 India’s Health Policy: Flip-flops Indian Health Care and opaque policy shifts. Salil Kallianpur “ he directive from the Drug Controller General of India‘s (DCGI) office to all State Drug Controllers to issue trademarks for generic names instead of brands Over the years despite knowing of – even if it was just to resolve trademark issues - is its multiplier effect on GDP, India yet another display of confounding decision making never attached great importance by the Union Government that has been plaguing the country in general and the health care sector in par- to the improved health of its pop- ticular. ulation. Policy lapses witnessed Over the years despite knowing of its multiplier ef- the private sector stepping in to fect on GDP, India never attached great importance address a fast rising demand for to the improved health of its population. Policy laps- health care creating one of the es witnessed the private sector stepping in to address a fast rising demand for health care, creating one of most privatized medical systems in the most privatized medical systems in the world. As the world. a consequence, India is confronted with the problem of meeting growing expenditure on health care which is heavily skewed towards out-of-pocket expenses for its citizens, driving large sections into poverty. India chose to begin its journey towards UHC with India‘s future lies in its demographic dividend – the one step - to provide free medicines through its pub- advantage of having a young, healthy and productive lic health system. The Centre released approximately work force. And to reap the benefits of this work Rs. 30,000 crores to the States to fund the procure- force we have to achieve decent health and education ment of medicines over the next 5 years (2012-17) outcomes for the majority. India averaged 8% p.a. under the ongoing NRHM. After the Supreme GDP growth rates over the 11th Plan period. And Court‘s intervention and with the five public-sector yet, its public spending on health has hovered around pharmaceutical companies lying in shambles, the an abysmal 1-1.2% of GDP, one of the lowest in the government quickly approved the new drug pricing world. The Approach Paper to the 12th Plan declared policy that led to the inclusion of 348 medicines an increase to only 1.58% by 2017. And how is this (approximately 30% of medicines and 60% of the possible, given the government‘s recently vocalized market) into the National List of Essential Medicines desire to move towards universal health care (UHC) (NLEM) and effectively under a price controlled not for not just its citizens but its residents that include by the market, customers and competition but by the millions of illegal immigrants as well? government.
  • 19. MedicinMan November 2012 India’s Health Care - flip-flops and opaque policy shifts. | Page 19 Simultaneously, in an ostensible effort to make medi- cines affordable to its residents (not citizens), the gov- ernment did two other things: 1) allow foreign direct investment into brown field projects in the sector with caveats such that foreign companies who invest in India “ The only group that will benefit (from the DGCI’s recent directive) are the middlemen – the traders – who will control the supply of medi- will produce stipulated quantities of essential medicines and invest in local manufacturing and R&D 2) demon- cines and make unholy profits in strate that it will use compulsory licensing more as a the bargain. weapon of choice than as one of need. Both these steps make sense in the short term thus providing political capital to the government for the On one hand, India signals that it will welcome much upcoming general elections in 2014, but harm the fu- needed FDI into the sector. But on the other it threat- ture of India as a preferred destination in the long term, ens to disregard product patents, invoke compulsory thus depriving the opportunity to create economic capi- licensing, discontinue issuance of marketing licenses tal. What vindicates this point is that to this date, there to trademarks while controlling prices on essential has been no effort from the government to invest in drugs and also considers controlling prices for patent- creating the infrastructure required to deliver superior protected innovative drugs as well. Such indecisive- health outcomes to the population despite it being the ness about policy bodes ill for a country that faces the root cause for the inflow into the private sector despite daunting challenge of enrolling, financing and provid- all its societal evils. ing acceptable health outcomes for 1.2 billion citizens However, all this pales in comparison to the DCGI di- and millions of other residents, illegal or otherwise. rective to state drug controllers to not issue marketing For such largesse, it could actually do well with help it licenses for trademarks or branded drugs but in their can garner from all quarters. generic names alone. While the technicality of this de- Why then is the government alienating itself both from cision alone warrants a separate column, it suffices to the domestic industry as well the international society? say that this makes no sense whatsoever. Authorities These policy flip-flops are confounding! Why would are expected to regulate or legislate to help either the the Indian government risk global criticism by openly industry, traders or end consumers. This decision helps demonstrating clear indecisiveness? Is this driven by none of these groups or anyone else. All it does is com- an argument about poor public sector performance in moditize the industry thus threatening to wipe out small delivering health care? Undeniably, it has been lack- and medium players who lack the financial strength to ing, which reflects in the dismal health outcomes in the compete with MNCs who despite severe pressure on country. Or as noted academic scholar, Kaveri Gill profit margins will survive. The consumer has little or wonders in a blog post, is this seemingly open decision no knowledge of the brands of medicines and therefore -making process merely a dangerous opaque shift in is unlikely to benefit from the decision. The only group policy, which has very little to do with evidence and that will benefit are the middlemen – the traders – who even less to do with broad-based consensus? ▌ will control the supply of medicines and make unholy profits in the bargain. Under harsh criticism, the DCGI Salil Kallianpur is a health care market- recently clarified informally that this directive was ing professional based in Mumbai, India. more to resolve trademark issues. Apparently, too He is an avid reader and follows the many similar sounding trademarks confuse doctors and health care industry, its politics, strategy retailers. If it really is the reason, the decision is laugh- and current affairs and writes on the able. Isn‘t it easier for similar sounding trademarks to intersection of health care and life in be denied by the regulators, thus pushing the onus back general at his blog “My Pharma Reviews”. The views in this on the industry to decide on clearly differentiated trade- article are his own. His twitter handle is @salilkallianpur. marks?
  • 20. | Page 12 ← Home MedicinMan November 2012 >>> Social Media | Page 20 IS IT THE END OF THE ROAD FOR THE INDIAN PHARMACEUTICAL INDUSTRY? INDIA‘S MOVE TO VANILLA GENERICS: DON‘T HOLD By Vivek Hattangadi YOUR BREATH Is it the end of the road for the maturing pharmaceutical industry in India? By Gauri Kamath (apothecurry.wordpress.com) The signs are ominous. If the DCI goes ahead with its plan, (as reported in By now, the news that India wants to move away Times of India of 16th October) to have only generic drugs in India, it will from branded generics and encourage vanilla gener- sound the death knell of the industry. The market than will be dominated by ics to bring down drug prices has gone around the the militant middle men who already enjoy very high profit margins – over world. But all those who think a structural reform of 35% - much higher than any other industry. The middle men are already the Indian drug industry is around the corner : stop. sucking blood from those who need blood transfusions – the critically ill! And breathe. Read the complete article HERE. Read the complete article HERE. Digital Dose For Natives and Immigrants Dinesh Chindarkar This series will help you gain an insight into social media and will help you get comfortable with new media trends, We are living in the Tech Age. The world is changing every identify various opportunities in this segment and inform second. The quest for faster, better, more and beyond is rever- you about some successful digital media strategies in the berating throughout the globe. We are breaking barriers, reach- Pharma space. In this part we are going to understand the ing across borders and exploring new dimensions in every term Social Media. field, be it medicine, space travel, communications or enter- tainment. Going Digital is the new mantra. What is social media? In this rapidly changing world, the concept of marketing is To put it in simple words Social media is an interactive rapidly undergoing a paradigm shift. The emerging digital me- means of social communication with the world. Newspa- dia has not only attracted many marketers but growing number pers or TV are also informative medias but are not inter- of consumers are also getting hooked onto it. In developed active channels – it is a one-way communication. So these markets, even Pharma marketing is following the techno path. traditional media are like a one way lane, an article can be This pattern is also being replicated in India as increasingly read but your views on it cannot be expressed simultane- aware patients are seeking more information. Indian medical ously or a television programme can be viewed but not community is fast climbing on to the digital & social media influenced in any way. On the other hand, social media is bandwagon apart from just browsing through studies on the like a two way lane in which information is given and net. Hence, Digital marketing opens up a Pandora's box and feedback is taken simultaneously. It is both informative as also throws up newer opportunities to marketing & sales to well as interactive. At the core of Social Media lies connect with the customer & the consumer. ‗instant gratification‘. Hence we are initiating this series of articles – ‗Digital Dose The next part in this series will cover Facebook.▌ for Indian Pharma‘. Dinesh Chindarkar is Co-Founder ‗Digital Dose for Indian Pharma‘ – is a series that will take & Vice President - Operations at you step by step through the varied properties of Digital and MediaMedic Communications and Social Media world. We understand that social media is not is Country Head for Global just about Facebook or posting Videos…its much more than HealthPR. that.
  • 21. ← Home MedicinMan November 2012 >>> Pharmacology for the Rep | Page 21 Pharmacology essentials: pharmacokinetic parameters Dr. Amit Dang ontinuing with the topic of Pharmacokinetics, this section Steady state: Immediately following the initiation of drug covers some of the remaining important definitions. therapy, the rate of drug entry into the body is much great- As mentioned in the earlier sections, liver is the major site er than the elimination rate, therefore the drug concentra- of drug metabolism, and the initial metabolism of drugs tion in the blood increases. As the plasma concentration in the liver is referred as Hepatic First Pass Metabolism. increases, the rate of elimination also increases, because When a drug is absorbed across the gastro-intestinal sys- this rate is proportional to the plasma drug concentration. tem, it enters the liver before entering the circulation. If Steady state is reached when the two rates are equal. the drug is rapidly metabolized by the liver, the amount of Loading dose: After administration of the drug, plasma unchanged drug that gains access to the systemic circula- concentration increases, but distribution of the drug leads tion is decreased. Many drugs like propranolol undergo to a decrease in the concentration. This decrease can be significant biotransformation during a single passage significant for the drugs with high volume of distribution. through the liver. The drugs given by the oral route un- So, it takes four-five half-lives to achieve the therapeutic dergo significant hepatic first pass metabolism whereas concentration. Sometimes, a ‗loading dose‘ or a higher drugs given by parenteral route (e.g. intravenous or intra- dose is administered (or injected) as a single dose to muscular route) do not undergo hepatic first pass metabo- achieve the desired plasma levels rapidly. lism, thus achieve a higher a bioavailability. So, certain Maintenance dose: The loading dose is followed by an drugs which are efficiently inactivated in the liver like infusion to maintain the steady state and this is referred as lidocaine cannot be given by oral route and have to be the maintenance dose. given parenterally. All these parameters are important while deciding the dos- Another concept about the metabolism and excretion ki- ing schedule of drugs.▌ netics is the order of elimination i.e. first order or zero order kinetics. Most of the drugs demonstrate first order kinetics in standard therapeutic doses, i.e. the amount of drug that is metabolized or excreted in a given unit of time is directly proportional to the concentration of drug in the systemic circulation at that time. On the other hand, a small number of drugs e.g. phenytoin and aspirin demonstrate zero order kinetics or saturation kinetics in which the clearance rate remains constant despite increas- ing plasma drug levels. This can result in dangerously elevated plasma concentrations of the drug with a small increase in the dose of the drug. Figure 1: First order kinetics and zero order kinetics Some other clinically important definitions include bioe- quivalence, steady state, loading dose and maintenance dose. Dr. Amit Dang is Director at Geronimo Healthcare Solutions Pvt. Ltd. Bioequivalence: Two related drugs are said to be bioe- quivalent if they show comparable bioavailability and This article is 3rd in a series of pharmacology similar times to achieve peak blood concentrations. Two for the Medical Rep. related drugs with a significant difference in bioavailabil- ity are said to be bioinequivalent.
  • 22. ← Home MedicinMan November 2012 >>> Key Account Management | Page 22 Key Account Management Is it a new sales model? Ralph Boyce, Ken Boyce, Tony O’Connor “ KAM is more of an evolution any people think of key account management (KAM) as a new sales model, developed as a strategic solu- tion to the changing business needs of the healthcare towards a more appropriate market. Do we restructure our whole organisation around some new grouping of customers and move sales approach and does not completely away from the favoured coverage and frequency model, which increasingly is being shown require radical change to be to no longer work? effective. Perhaps, more ac- KAM is more of an evolution towards a more appro- priate sales approach and does not require radical curately, KAM can be viewed change to be effective. Perhaps, more accurately, KAM can be viewed as a distillation of the various as a distillation of the various aspects of the promotional mix. While the pure aca- aspects of the promotional demic theory of KAM promises one account plan per key account regardless of therapy area, brand or ser- mix.” vice, is this feasible (or even sensible) within the pharma industry structure? The KAM process Account identification According to Dr Brian Smith, Open University Busi- The first stage of the KAM process is account identification, ness School, ―KAM is a contingency model, which profiling and segmentation. Who or what is our customer means that there is no single best way of doing it, but and what is a key account? This is a familiar question be- rather a number of ways which work best in different cause, as an industry, pharma has been profiling, segmenting circumstances‖. and targeting its customers in various ways. All that the Whatever your approach, it is important to accept that KAM approach seems to add is the need to break these cus- KAM is a process and not a simple one-off exercise. tomers down into account groupings and then designate In order to implement a KAM strategy, the process some of them ‗key‘ to the business. must be clearly identified and metrics put in place to For some industries, identifying the customer is a straightfor- monitor progress, success and what remains to be ward task. However, in pharma, the question of who is the done to achieve defined objectives. customer always meets with the answer ―it depends‖. For In simple terms, KAM can be considered in three pharma, the first step in the KAM process is to agree to the basic steps, each of which requires further subdivi- mission and purpose of the required KAM implementation sion to suit specific circumstances. and accept that different therapy areas will probably require
  • 23. MedicinMan November 2012 Key Account Management - a new sales model? | Page 23 different but philosophically aligned KAM processes. and plans. There are many experts who can help with Once what needs to be achieved has been established, producing meaningful, relevant and actionable key ac- we can move on to defining what constitutes an account count plans. or ‗core unit‘. This can be almost anything depending An individual customer contact plan will also need to be on the objective, ranging from a Cancer Network and designed to achieve objectives within the existing finan- linked primary and secondary care bodies for an oncol- cial, legal and operational constraints. Once this is done, ogy sales team, to a purchasing group of pharmacies for the structure to deliver on the plans will be ready for a commercial sales team. implementation. A pharma company that correctly identifies the account or ‗core unit‘ it needs to influence and then segments Implementation the most important ones as key accounts will greatly The ability to successfully implement a KAM approach increase its chances of success. The familiar depends upon the company fully understanding its situa- ‗Pareto/80:20 rule‘ is once again an important factor in tion, developing a relevant proposition and process for determining the actual number of accounts that should achieving its objectives and supporting the implementa- be considered as key. tion with the appropriate business tools. Strategic and tactical planning Analysis of different therapy areas will produce com- The next step in the process is to identify the individu- pletely different key accounts. Correctly identifying the als in the various parts of the key account and assess account/core unit and applying realistic metrics to deter- how they interrelate. Often these individuals will work mine its importance are critical first steps. There is no in different locations within the key account and have ‗one size fits all‘ solution in the implementation of specific but related roles, such as financial, advisory KAM. Another major driver for a successful KAM im- and clinical. There is then a need to repeat the profiling plementation in the pharma industry is the seniority/ and segmentation process at an individual level within maturity of the key account managers responsible for the key account, and construct the required processes the implementation. Key Account Management Implementation Process in Pharmaceuticals Purpose & Mission Key Account Planning Profiling & Segmentation Key account Selection Organisation Structure Recruitment, Allocation & Training of KAM’s Key Account Plan Key Account Execution Information & Intelligence Resources Management Relationship Development Process Implementation Process Implementation Tool Process Performance Monitoring Process © Pharma MI 2008
  • 24. MedicinMan November 2012 Key Account Management - a new sales model? | Page 24 “ The old sales model of simply selling products to custom- ers no longer applies. In a successful KAM approach de- The KAM approach is a veloping a ‗win-win‘ proposition for the key account, where the key accounts see the value of working with pharma, will be a critical success factor. However, KAMs sales process that has are commercially astute people who have the company‘s objectives at the forefront of their minds and who can logical, time dependent interact persuasively and credibly with the customers identified as key accounts. sequential steps.” It must also be accepted that the KAM approach is a sales process that has logical, time dependent, sequential steps which, if followed correctly, will lead to success. Follow- ing and tracking progress through the process with appro- priate KAM business tools is another critical success fac- tor. However, it is evident from practical experience that many of the CRM tools pharma companies are familiar Operational Performance Indicators: with are no longer appropriate as they cannot adequately The following are important indicators of performance, support the implementation of KAM. i.e. they show the direction of the business as opposed to what the business has done, such as other systems like Measuring KAM effectiveness corporate dashboards and the balanced scorecards do. Implementation of any KAM process requires the capture Activities report - shows the current status of a key ac- and review of a number of performance indicators. These count plan or opportunity as compared to plan Late task report - shows the current status of all tasks as fall into two categories: operational performance indica- compared to planned completion tors (OPIs) and key performance indicators (KPIs). It is Key account relationship index report - tracks the sta- important that they are ―indicators‖ of the direction the tus of the supplier / client relationship over time business is moving in and not ―measures‖ of what the Key contact relationship index report - tracks the status business has done. This becomes crucial at the KPI level. of the KAM / client contact relationship over time Decision making unit (DMU) report - tracks the status From a performance management perspective, in order to of the DMU status and relationship over time measure effectiveness it is essential that OPIs and KPIs Key account sales tracker - tracks sales by key account. are derived together. KPIs must represent a summary view of OPIs in order to maintain continuity of measure- Key Performance Indicators ment. KAMs mainly use OPIs to support their actions Time allocation analysis - tracks time allocation by cate- when seeking to achieve high performance. They allow gory over time the individuals concerned to record the achievement of the Key account relationship tracker - summary of equiva- various stages in the implementation plan and flag areas lent OPI Key contact relationship tracker - summary of equiva- that still need to be improved. KPIs pull these OPIs to- lent OPI gether and are used by the KAM management team to Decision making unit - summary of equivalent OPI monitor the performance of the business unit as a whole. Key account sales tracker - summary of equivalent OPI. Conclusion KAM is not as revolutionary as some suggest. Yes, it is a departure from the traditional sales model, but it is only evolving away from an approach that is failing. The phar- Ralph Boyce, Ken Boyce, Tony O’Connor are ma industry‘s traditional relationships with its customers Directors at Pharma MI are changing and, in response to this, progressive compa- nies have adopted and successfully implemented KAM . This article was previously published in Pharma- If the healthcare market continues to change as predicted, ceutical Marketing May 2008. the companies that are waiting and watching may find that not only are their multiple sales forces no longer required, Published in MedicinMan with the permission of but that they are unable to put a meaningful proposition to authors. their customers.▌
  • 25. ← Home MedicinMan November 2012 >>> Book Preview | Page 25 Book Preview: Pharma Front-line Leader to CEO by Vivek Hattangadi The ost exciting characteristic of the pharmaceutical industry in India is that many CEOs have started their careers as humble medical representatives. By the time they became first-line leaders, the ambitious amongst them dreamt of reaching the top. This book is a guide for such forward looking people! The book has been written in a unique style – the entire book is in the form of a conversation between a budding First-line Leader Vinod Kamat and his Mentor. The les- sons which the Mentor gives are the take-home messages for the reader. Prologue to the book. We all know that in 1999 India won the Kargil war against Pakistan. The sacrifices of the jawans and officers set many a young heart on fire. One of them was Vinod Kamat, the only son of his parents. Vinod, who was then barely 13 years old, declared his intention to join the armed forces via the National Defence Academy route and serve the country. His mother was in a state of shock when she heard this. She spared no efforts to dissuade him from taking up this risky career. However Vinod was firm; nothing could shake his determination. He stud- ied hard for the entrance examinations and passed with flying colors. No sooner had he received a call for an in- talent and invited him to join Capella Pharmaceuticals as a terview than his mother went on a hunger strike to dis- medical representative; he was offered Ahmedabad as his suade him from attending it. After she went for three days headquarters. Vinod was delighted and accepted the offer. without food or water, Vinod‘s stand softened and he Capella Pharmaceuticals was a very fast growing organi- bowed down to the wishes of his mother. zation which had acquired licenses to market some of the He joined Bhavan‘s College, Andheri, Mumbai to pursue top brands of various MNCs. Vinod decided to excel in B.Sc., but his heart was not in studies. He scraped this company with an ambition to reach the top and be- through B.Sc. examinations with just 37% marks. And come a CEO one day. who would give him a decent job with this ‗brilliant‘ aca- Unfortunately for Vinod, his district manager at Ahmeda- demic record? bad was a new incumbent. His behavior was more like His first job was as a shop-to-shop salesman selling medi- that of a super-medical representative. Vinod could neither cated cough drops introduced by a well-known FMCG. get any guidance from him nor learn anything from him. His customer audience included retail chemists, general Day in and day out he bragged about his success stories as stores, grocery shops and even ‗pan-bidi-wallahs‗. Selling a medical representative. Vinod and his colleagues often the stuff packed in polythene bags, he was accompanied heard him saying, ―If I were you, I would have done this, by a cycle-rickshaw puller carrying the wares. A chance and I would have converted this doctor to our brands. I encounter with the regional manager of Capella Pharma- converted a key opinion leader, Dr. Sharma, to our brand ceuticals changed his destiny. While in the field and within three visits.‖ Instead of leading the team forward, working at retail chemists, this gentleman spotted his he was boasting about his successes all the time!