Pharma Field Force Excellence Conference Special

                              
                               
                               
                               
                               
                              
                               
                               
                               
                               
                               
                               
                               
                             
                             
                             å
                              
                               
                               
                               
                               
                              
                              
                              
                              
                               
                               
                              
                               
                               
                               
                               
                              
                               
                               
                               
MEDICINMANField Force Excellence
TM
July 2013 | www.medicinman.net
MEDICAL REP
IS KEY TO THE
PHARMA
BUSINESS
FFE 2013was another occasion to showcase the talent of
people who have made Indian Pharma a legend.
The faculty and audience were packed with senior
professionals with significant achievement to their
credit. The keynote address was delivered by Shakti
Chakraborty, president of Lupin, a battle scarred
veteran who has risen from the ranks of field force.
True to his name, Shakti Chakraborty delivered
a powerful but simple message – get your basics
right, know where you are before setting ambitious
growth targets. Shakti Chakraborty was generous in
his praise of Mankind Pharma for getting a single
ingredient – that is: commitment from field force
right. He also talked of the need for senior man-
agement to identify the obstacles faced by Medical
Reps and remove those obstacles, this alone was the
right way to face the challenges and create opportu-
nities for the Medical Rep to perform.
EDITORIAL

Shakti Chakraborty emphasised the need to train Medical
Reps adequately and also equip the Medical Rep not just
with technical information but with the required emotion-
al resilience to face the hardships in the marketplace. Most
Medical Reps quit because their training only equips them
with detailing skills and not with realistic picture of the
marketplace.
Shakti Chakraborty also emphasised the need for set-
ting realistic sales targets. The key point of Shakti
Chakraborty’s keynote address was to reduce the man-
agement layers that do not serve any useful purpose other
than putting pressure on Medical Reps – instead compa-
nies should increase the remuneration of Medical Reps
and FLMs and raise their social esteem.
Shakti Chakraborty clearly highlighted the fact that in the
present commoditized market scenario, the only emo-
tional connect or bonding with brand was through the
Medical Rep and yet very few companies and managers
took this into consideration. The job of marketing accord-
ing to Shakti Chakraborty was to make the work and life
of Medical Reps more interesting and exciting instead
of cramming several pages into the Visual Aid making it
impractical and boring.
Shakti Chakraborty showed facts and figures from Cege-
dim, which clearly showed that while all companies were
failing to get adequate ROI on in-clinic investments, only
Mankind had a 16% higher in-clinic persuasion factor
Vs 1% of other top three companies in cardiology. What
made the Mankind field force so effective? It was certainly
not competence but their character of sincerity and com-
mitment to make 15 plus effective calls on a daily basis.
He concluded by exhorting pharma leaders to rethink
their approach to field force productivity in the light of
current market realities and empower the Medical Rep
to be more effective in front of the doctor - in the one to
three minutes that is available.
Clearly, Indian Pharma needs more leaders like Shakti
Chakraborty, who have not only risen from the ranks but
continue to maintain their touch with the field realties as
experienced by Medical Reps. -MM
                   
                  
                  
                  
                  
                  
                   
                  
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                   
                  
                   
                   
                   
                   
                   
                  
                  
                   
                  
                   
                   
                   
                   
                   
                   
                  
                   
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                  
Editorial: Medical Rep is the Key to Pharma Business | Anup Soans

3 | MedicinMan June 2013
MedicinMan Volume 3 Issue 7 | July 2013
Editor and Publisher
Anup Soans
CEO
Chhaya Sankath
COO
Arvind Nair
Chief Mentor
K. Hariram
Advisory Board
Prof. Vivek Hattangadi; Jolly Mathews
Editorial Board
Salil Kallianpur; Dr. Shalini Ratan; Shashin
Bodawala; Prabhakar Shetty; Vardarajan S;
Dr. Mandar Kubal; Dr. Surinder Kumar
International Editorial Board
Hanno Wolfram; Renie McClay
Executive Editor
Joshua Soans
MedicinMan Academy:
Prof. Vivek Hattangaadi, Dean, Professional
Skills Development
Letters to the Editor: anupsoans@medicinman.net
(L) Chhaya Sankath - CEO, MedicinMan; (C) Arvind Nair - COO, MedicinMan
speak to a delegate prior to the start of FFE 2013.
BEHIND-THE-SCENES WITH TEAM MEDICINMAN AT
FFE 2013
(L) Shakti Chakraborty - Group President, Lupin (C) Arvind Nair, COO - MedicinMan
and (R) Anup Soans - Editor, MedicinMan.
(L) Chhaya Sankath - CEO, MedicinMan felicitating Ameesh Masurekar - Founder
CEO, Pharmasofttech AWACS, sponsor FFE 2013.

4 | MedicinMan June 2013
1. Highlights of FFE 2013........................................5
A brief recap of MedicinMan annual flagship event -
FFE 2013, with a photo essay.
Prof. Vivek Hattangadi
2. Crystal Gazing into Pharma................................9
A look at the trends likely to shape the Indian
pharma industry in the coming years.
Amlesh Ranjan
3. Coaches, Not Bosses.........................................13
Managers, both second-line and first-line, have a
responsibility to coach their teams and not merely
set targets and look the other way.
K. Hariram
4. Marketing and the Art of War..........................19
Pharma marketing is like warfare. How to adapt
and succeed.
Vivek Hattangadi
5. Digital Dose: Best Indian Pharma Blogs.........21
Featuring “Apothecurry” and “Building Pharma
Brands”
MedicinMan
6. Preference Measurement in Economic
Analysis in Healthcare...........................................22
Direct and indirect methods of assigning weights
or ascertaining preferences for different states of
health.
Shafaq Shaikh and Javed Shaikh
LEADERSHIP
IN ACTION
WITH
MARSHALL
GOLDSMITH
Where: Hyatt Regency, Mumbai
When: 15th July 2013
Details on Page 25.
CONTENTS (Click to navigate)

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                         
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                         
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                         
       å                   
                          
                          
                          
                          
                          
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                         
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 å                         
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                         
                         
                         
                          
                          
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                          
                          5 | MedicinMan July 2013
HIGHLIGHTS
FFE 20135
x
10 15 20 25 30 35 40 45 50 55 60
y
Date: Saturday, 8th June 2013
Theme:FieldForceProductivity
Place: Courtyard Marriott, Mumbai
FFE 2013 was hosted by MedicinMan at the Courtyard Marriott, Mumbai on June 8, 2013
FFE 2013 began with a Breakfast Brainstorm with CEOs Registrations: over 70 senior pharma professionals attended
Prof. Vivek Hattangadi is a Consultant in Pharma Brand
Management and Sales Training at The Enablers. He is a
visiting faculty at CIPM Calcutta (Vidyasagar University) for
their MBA course in Pharmaceutical Management.
Prof. Hattangadi is on the MedicinMan Advisory Board.
vivekhattangadi@theenablers.org

6 | MedicinMan July 2013
Highlights of FFE 2013 | Prof. Vivek Hattangadi
B
uilding an effective field force in pharma today
can be a very challenging task. “What are the
barriers to Field Force Effectiveness (FFE)?”
and “How can these barriers be overcome?” were the
questions asked and discussed in a very creative and
interesting way at ‘FFE 2013 - Field Force Productivity:
Opportunities and Challenges’, organized by Medicin-
Man at Hotel Courtyard Marriott, Mumbai on Satur-
day, 8th June 2013.
Getting access to the doctors is getting tougher,
making it difficult for medical representatives to meet
demanding expectations. Negative public opinion
about medical representatives is a real challenge for
the industry. This puts sales force effectiveness on
centre stage for pharmaceutical companies.
Who could be more competent to dwell on this sub-
ject then those who have risen from the position of
medical representatives to become CEOs and Manag-
ing Directors? Mr. Shakti Chakraborty (Group Pres-
ident, Lupin), Dr. Ganesh Nayak (COO & Executive
Director, Zydus) and Mr. Hariram Krishnan (ex-Man-
aging Director, Galderma) were amongst the galaxy of
speakers and panelists at ‘FFE 2013’.
Mr. Shakti Chakraborty kick-started the day’s
proceedings with a thought-provoking examination
of the importance of the human component in the
pharma sales and marketing business process! He
spoke about the ‘human side’ of strategy. The basic
work of strategy implementation - at least the ‘human
side’ of strategy implementation - is knowable. The
most common reason why a strategy fails is because
people at the grass-root level lack clarity about how a
strategy can benefit them at the work place and how it
can help them achieve the organization’s objectives. A
failed implementation can be catastrophic, he added.
At the ‘CEO Roundtable’ which followed (panel
members: Bhaskar Iyer - Abbott, Dr. Ganesh Nay-
ak - Zydus Cadilla, Mr. Shakti Chakraborty - Lupin
and Sujay Shetty - PwC), an insightful remark was
made: “Today, the field force is neither interested in
the carrots nor is it afraid of sticks”. This set the pace
for discussions on challenges to making the Indian
pharmaceutical industry a great place for people to
begin and build a career.
The role of Field Force Automation (FFA) was dis-
cussed. The consensus was that FFA did not address
effectiveness and productivity although it increases
efficiency. It is only the competence and commitment
of the medical representative which will result in pro-
ductivity through effective sales calls, especially as the
doctor is often ‘psychologically sick’ from his practice
when he meets the medical representative.
Keynote Address: Shakti Chakraborty, Group President, Lupin,
emphasizing the ‘human side’ of sales and marketing strategy.
Welcome Address: Anup Soans, Editor MedicinMan, welcomes the
distinguished audience and introduces the agenda.
CEO Roundtable (L-R): Shakti Chakraborty, Group President, Lupin,
Ganesh Nayak, COO & Executive Director, Zydus Cadilla, Bhaskar
Iyer, Head of India Commercial Operations, Abbott, Sujay Shetty,
Partner & Lead, Pharma & Life Sciences, PwC.

Highlights of FFE 2013 | Prof. Vivek Hattangadi
Business Intelligence Panel (L-R): Ameesh Masurekar, Founder
Director - AIOCD Pharmasofttech AWACS, Dr. Viraj Suvarna,
Medical Director, Boehringer Ingelheim, Salil Kallianpur,
Commercial Head - Classic Brands Center of Excellence, GSK.
Employee Engagement Panel (L-R): K. Hariram, Former MD (retd.),
Galderma India, Amlesh Ranjan, Associate Director, Sanofi, Deep
Bhandari, Director, Marketing and Sales Excellence, UCB, Mohan
Sheshadri, GM & Head, Training & Development, Ranbaxy, Anup
Soans, Editor MedicinMan.
K. Hariram, Former MD (retd.),
Galderma India, on ‘Role Clarity
for Field Sales Managers to
Enhance Field Force Productivity.’
Amlesh Ranjan, Associate Director,
Sanofi, on ‘Pharmodelling for
Healthcare: KAM & Market Access.’
Effective sales call, therefore, is the foundation of sales
productivity. It is very important to get the doctor
emotionally involved not only with the brand but also
with the medical representative. The take-home message
from this Roundtable: ‘Field Force Effectiveness is the key
differentiator for performance management. Field Force
Effectiveness will ultimately drive profitability’.
The ‘CEO Roundtable’ was followed by a panel discussion
on ‘Business Intelligence for Field Force Productivity’. Busi-
ness Intelligence helps an organization to get quick and
precise information to plan strategies and win over com-
petition. Without business and competitive intelligence,
it would be difficult to identify and develop new opportu-
nities. Mr. Ameesh Masurekar (of AWACS) talked about
the use of new technologies, processes and applications to
analyze internal and external data, disseminate informa-
tion and present it appropriately.
This session was followed by a passionate panel discus-
sion on ‘Employee Engagement: The New Paradigm in
Field Force Productivity’.
What is employee engagement? Anup Soans defined
it as – “Maximum job contribution and maximum job
satisfaction”. Employee engagement means profits to the
company. Disengaged employees spread negativity. They
harm the organization, because they affect productivity,
the morale of people around and ultimately the profits.
Mr. Hariram cautioned the audience that the pharma in-
dustry is getting, and will continue to get, only ordinary
people, mainly migrants from Tier II and Tier III towns.
In the light of this, increasing employee engagement will
contribute to Field Force Effectiveness. Dwelling on the
strengths of people and putting their strengths to work
will further enhance employee engagement.
Next was a session on ‘PharModeling for Healthcare:
KAM & Market Access’ where Mr. Amlesh Ranjan talked
about the future trends in the Indian pharma industry
where public healthcare spending will dominate private
or personal spending. Key Account Management will
therefore have a new dimension. Marketers will have to
articulate compelling value proposition across stakehold-
ers all along the product life cycle.
Mr. Hariram later made a very interesting presentation
on the ‘Role Clarity for Field Sales Managers to Enhance
Field Force Productivity’. Role clarity offers focus, he said.
He talked about responsibility, relationship, and the areas
of contribution (i.e. coaching for performance).
The inverted pyramid organization structure was a very
interesting concept he discussed. He places the custom-
ers at the top, followed by the revenue generation team
whereas the person giving directions to the whole orga-
nization [MD/CEO] is at the bottom is very pertinent
in today’s scenario where people, especially the medical
representatives, look for emotional protection. -VH
Audience Questions: Sai Kumari, Head - Global Training, Himalaya
Drug Company, puts a pointed question across to the CEOs.

Hosted by www.MedicinMan.net. Organized by Knowledge Media Venturz.
FFE & BRAND DRIFT 2014
ADVANCE ANNOUNCEMENT:
Encouraged by the overwhelming response for Brand Drift
and FFE 2013, we are happy to announce the following:
1. Brand Drift and FFE will be held on consecutive days
in 2014.
2. Tentative Dates: First or Second week of February 2014.
3. Pharma Service Providers are invited to partner with us
for this event.
2014
Your Message HERE at
FFE & Brand Drift 2014
CONTACT
arvind@kmv.co.in | +91-987-0201-422

E
CRYSTAL
GAZING
PHARMA.
The trends likely to shape the pharma sales and marketing
mix in India in the years to come.
H
ealthcare is first a responsibility and then
only an opportunity for pharma. Let us look
at the industry from pharma marketing
perspective, which has a great role to play in fulfilling
the responsibility and optimizing the opportunity.
“Lifebuoy se haath dhoye kya?”
Lifebuoy put this sentence on all the rotis, which got
served at the recent Mahakumbh mela. Keeping in
mind the importance of hand hygiene for health, this
was a great example of optimizing opportunity while
fulfilling responsibility.
It is not a surprise that the foremost management
guru, Peter Drucker said, “Marketing is not a func-
tion, it is the whole business seen from the customer’s
point of view”.
Pharma, in India, has been progressing through the
decades with very aggressive portfolio and sales force
expansion but the industry environment has been
INTO
Amlesh Ranjan
is Associate
Director at Sanofi.
The views expressed
here are personal.

“
Crystal Gazing into Pharma | Amlesh Ranjan
10|MedicinManJuly2013
changing in a big way. Newer stakeholders in the healthcare
delivery space have been gaining ground. The landscape is
stormy with network of influencers – providers, payers, regu-
lators – making their impact.
But as Vivian Greene said, “Life is not about waiting for the
storms to pass… it’s about learning to dance in the rain”. And
rightly so because increasing health insurance and public
funding of healthcare is fuelling growth.
Healthcare infrastructure investment and expansion augurs
well for future. Household healthcare spend will keep growing
through the years. Medical tourism will increase in coverage
– geographically and in therapy areas. Private hospitals will
continue their rapid expansion and improved reach and will
also keep evolving from current critical care to chronic and
primary care. Lifestyle related interventions, niche therapies
and disease management will keep on gaining. All this will
make our healthcare move from being ‘out of pocket’ to be-
coming ‘partly reimbursed’ and finally a ‘majorly reimbursed’
market.
With the above in mind, pharma growth agenda will have to
address the present and emerging opportunities –
áá Opportunities in geography: Driven by growing
urbanization, metro and tier-I towns will continue to be
significant drivers of growth.
áá Opportunities in Economy: Disposable incomes set to
rise significantly in rural areas.
áá Opportunities in Life Cycle Management: Pro-active
approach towards building brand portfolio and aug-
menting the same as you progress through the life cycle.
áá Opportunities across specialty: Targeting GPs, Physi-
cians and Specialists.
áá Opportunities in adherence: Medication compliance has
great impact on health outcomes.
áá Opportunities in Digital Ecosystem: Increasing number
of Doctors and Patients are exploring social media for
healthcare.
Let us have a look at the possible roadmap for a sustainable
growth for Pharma -
áá Multi-segment approach: different indications; across
sectors - clinicians, hospitals, health systems; various
specialities; diverse tiers of geography.
áá Collaborative marketing: evolving from transactional
to relationship-based to finally a collaborative mode of
marketing strategy and operation.
áá Multi-level approach in marketing: share of voice with
prescribers, partnership with providers and participation
with payers.
Household healthcare
spend will keep growing
through the years. Medical
tourism will increase in
coverage – geographically
and in therapy areas.
Private hospitals will
continue their rapid
expansion and improved
reach and will also keep
evolving from current
critical care to chronic and
primary care. Lifestyle
related interventions, niche
therapies and disease
management will keep
gaining.
”

“
Crystal Gazing into Pharma | Amlesh Ranjan
Physician-centric approach needs to transform into health-
care systems involvement. Co-creation of value, through
healthcare network orientation, is the possible answer
where dialogue, access, risk-benefit and transparency are
the key elements. Co-creation approach can result in the
desired outcomes of Choice, Trust, Community and Inno-
vation which will benefit all involved and impacted.
All-round effectiveness is a critical need of the hour which
at organizational level, manifests through Strategy, Cul-
ture and Infrastructure and at individual level – Knowl-
edge, Attitude and Skills.
Commercial Excellence is a key imperative which can be
achieved by efficient integration of customer focus and
growth strategy. Go-to-market strategy needs to flow
seamlessly into sales and marketing.
Sales Model Excellence can be attained by creating hybrid
model of sales force structure which can address varying
customer size and complexity. This will facilitate ‘reach
and penetration’ with portfolio and geography match with
focused BU and sales model supported by appropriate
channel structure.
Sales Force Optimization can be aimed at by 6 critical
elements - resource optimization, segmentation and target-
ing, incentives and rewards, training and capabilities, sales
force planning and measurement.
Key Account Management team will be very important to
harness the healthcare opportunity where the organization
needs to aim for achieving ‘relationship progression’, from
being ‘standard supplier’ to becoming ‘strategic partner’ for
the accounts.
Social Media Engagement will be critical for transparency,
trust-building and patient empowerment. The multi-chan-
nel approach will facilitate two-way and multi-point com-
munication to achieve above.
And we are clearly into an an era of partnerships which
will thrive on ‘co-petition’ and not competition. So joining
hands together is not a one time, one issue strategy, it
should be a norm, now.
Pharma will keep thriving with a ‘healthcare approach’
fuelled by ‘multi-level marketing’ and driven by ‘all-round
effectiveness’. -AR
All-round effectiveness is
a critical need of the hour
which at organizational level,
manifests through Strategy,
Culture & Infrastructure and at
individual level – Knowledge,
Attitude and Skills.
we are clearly into an an era
of partnerships which will
thrive on ‘co-petition’ and not
competition. So joining hands
together is not a one time, one
issue strategy, it should be a
norm, now.
”

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100

I
n the last few weeks I have been in and out of
quite a few FFE/SFE forums that focused on
FLMs as the key linkers and multipliers of sales
people and organizational strategy. In every interac-
tion or a presentation there was much emphasis on
FLMs being the weakest link and that there was an
urgent need for FLMs to be trained and developed.
The FLM ‘ought to’ should not become mere rhetoric
in every forum. So the question is who will do the
training and development of the FLMs?
Obviously, it has to be the SLMs (second line man-
agers). While training can be given at a class room
level, on-the-job learning is what makes a difference.
Just like the FLMs are missing the opportunity to
coach their MRs, similarly the SLMs are losing/miss-
ing the opportunity to coach FLMs. May be the SLMs
are also not being coached by their Sales Manager/
Director/VP.
So, the coaching culture is missing in the whole
hierarchy and for that matter in the whole organiza-
tion. The blame cannot be put on FLMs alone. The
organizational culture has to change and the coach-
ing culture has to be fostered at all levels.
E
COACHES,
NOT BOSSES.
K. Hariram is the former MD (retd.) at Galderma
India. He is Chief Mentor at MedicinMan and a
regular contributor.
khariram25@yahoo.com
“Just like the FLMs are missing the
opportunity to coach their MRs,
similarly the SLMs are losing/missing
the opportunity to coach FLMs. May be
the SLMs are also not being coached
by their Sales Manager/Director/VP.
So, the coaching culture is missing
in the whole hierarchy and for that
matter in the whole organization.
Second-line Managers (SLMs) need to coach FLMs to
be coaches themselves. When managers realize their
roles as coaches the organization stands to reap rich
dividends.
”
E

Coaches, Not Bosses | K. Hariram
“ HAVING SAID THIS LET US TAKE A CLOSE LOOK AT
FLMS AND THEIR SLMS – the Manager of Managers.
These managers of managers (SLM) must select, train, and
hold front-line managers accountable. Alas, many SLMs ne-
glect this fundamental aspect of their job; they do not coach or
teach management skills to their first time managers. Rather,
they ignore all warning symptoms and signs and just let their
managers “sink or swim.”
This poor leadership weakens the line management as many
first-time managers develop shocking managerial skills and
styles. Further, it is a drain on organizational resource as
promising sales people progress into management, only to
dilute themselves without adequate guidance, and then leave
with their career in dumps or contribute to increasing attri-
tion.
WHAT SHOULD BE THE REQUIRED SKILLS OF SLMS ?
1. Focus on the right choice of FLMs. Choosing the right
people to become managers with all the potential for manage-
rial function and not just ‘super sales people’.
2. Train them. More importantly, teaching managerial skills
to first time managers. In addition, the SLMs need to support
and encourage their FLMs while holding them accountable for
their work and also the productivity of their team.
3. Build and manage relationships across the team of FLMs.
This includes allocating resources (money, time, attention,
people) across the team of FLMs. It is very important to
avoid any barriers across the team of FLMs. Simplifying work
wherever possible is a good way of adding to the positive team
environment.
OF COURSE THERE ARE CHALLENGES FOR THE SLM
(Managers of Managers)
The key challenge for the SLM is to evaluate their FLMs’ per-
formance without diluting their authority. They need to know
and be aware of, how their managers are really managing. Are
their FLMs getting results while managing and leading in the
proper way? Or are they so focused on results that they have
adopted that they care less for their team members (a “kiss up
but kick down”) leadership style?
SLMS NEED TO ASK:
1. Are the FLMs available and approachable? Monitor and
observe closely.
2. Do they move around with a purpose? Are they in the
right place at the right time? This will help the SLM to coach
the team members. Caution should be taken to avoid solving
all problems directly. Problem-solving should be left to the
direct FLM as a part of his responsibility. At best the SLM
could use the opportunity to coach his FLM on problem-solv-
ing skills.
The key challenge for the
SLM is to evaluate their FLMs’
performance without diluting
their authority. They need to
know and be aware of how their
managers are really managing.
Are their FLMs getting results
while managing and leading in
the proper way? Or are they so
focused on results that they care
less for their team members
(a “kiss up but kick down”)
leadership style?

“
3. Are you reviewing the daily activities of your FLMs?
On what do your FLMs spend time on? Are they focused on
their own work or on the work of their team? Do they allo-
cate sufficient time for their administrative tasks (reports,
efforts area, KOL meetings, etc) and managerial tasks such
as following-up, coaching, supporting, and training?
EARLY WARNING SIGNS OF ROLE MALFUNCTION-
ING.
If SLMs are monitoring regularly, they can catch the early
warning signals that indicate that either they or their FLMs
are going off the track.
For FLMs:
1. Working alone often (in pharma lingo - ‘individual
work’). Very often doing individual work or continuing to
do the tasks that they most enjoyed in their earlier role.
2. Managing things directly. They do everything on their
own including detailing in every call, taking orders etc.
For SLMs:
3. Inability to delegate. They may have difficulty delegat-
ing and letting the FLMs solve their own problems. FLMs
must be able to give their views and solve their own team’s
problems. No development takes place if the SLM is solving
every problem or making every decision.
4. Absence of any timely feedback. SLMs give little or no
feedback to their FLMs. There is little focus on performance
management (reviews and periodic assessments).
5. No effort by the SLMs to build a strong and diverse
team of FLMs. Keeping a set of weak FLMs or building a
group of managers that are all clones in personality, exper-
tise and leadership style. The team should be diverse with
various strengths and expertise.
6. ‘Us’ vs. ‘them’ mentality. Pitching against each other or
people in the rest of the organization. (Even ‘Us’ vs ‘Market-
ing/distribution’ etc).
7. Lots of ego. Like in any other leadership role one has to
have an attitude and value shift. It is no longer about the
SLM or FLM as an individual performer (“I”); it is about the
long-term success of the team of managers and the team that
the manager of managers (SLM) builds (“we”).
Every organization requires strong front-line managers and
leaders. The job of developing these managers becomes the
direct responsibility of their direct managers, the SLM, who
are “managers of managers.”
It is not what happens in the 3 days of FLM’s joint work-
ing that is important. It is what happens the rest of 27 days
based on what the FLM has coached or trained during the 3
days of joint work that becomes important. -KH
FLMs must be able to give their
views and solve their own team’s
problems. No development
takes place if the SLM is solving
every problem or making every
decision.
Coaches, Not Bosses | K. Hariram

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Methodology
Webinars and E-Learning
All programs are fully customizable. A pre-program questionnaire is used to capture the
needs and expectations of the participants. Company’s may request a demonstration of a
particular module at no expense (except conveyance to venue).
Programs incorporate the principles of adult learning and are highly participative, audio-vi-
sual and activity-based. Important truths are conveyed through games, stories and videos.
Companies are advised to give participants the books on which the programs are based
for continued learning and development. The same may be procured from the author at a
discount.
Company’s may choose to deliver a program as a webi-
nar - giving the advantage of scale and lowering costs.
Audiences are kept engaged using visually stimulating
slides and powerful delivery. Emphasis is placed on
taking charge of one’s success, even in the absence of
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Most recently 1,000 reps of a leading MNC were
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Customized issues of
MedicinMan, with inputs
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MedicinMan currently
reaches 60,000 pharma
professionals.
Interactive Classroom Training
Management Games Audio/Visual
Learning-by-reflectionSimulation
Case Studies
iSharpenMMy Success is My Responsibiliti

I
wanted to join the armed forces and even cleared the NDA
written exams in 1966! But parental resistance, particularly
from my mother, shattered my dreams and I landed up be-
coming a medical representative! To my astonishment, I realized
thatthereisalotofsimilaritybetweenmarketingwarfare(fought
by foot soldiers called medical representatives) and military war-
fare. It is intriguing that many day-today expressions in modern
marketing come from the military lexicon, showing common-
alities between actual military warfare and marketing warfare.
Sun Tzu was an ancient Chinese military general, strategist, phi-
losopher and perhaps one of the forefathers of contemporary
strategic thinking. His book ‘Art of War’.1
is tracked by pharma
marketers even today. They have applied many principles from
this book while building marketing and sales strategies.
Readers would be fascinated to know that some common terms
in Indian pharma marketing have evolved from the military
phraseology coined by Sun Tzu!
法 To start with,‘STRATEGY’comes from the Greek word– stratē-
gia meaning ‘the art of a general’. Strategy means a high level
plan to achieve one or more goals under conditions of uncer-
tainty. Strategy is the science of combining and employing the
means of war in planning and directing large military move-
ments and operations. It is a plan, method, or series of maneu-
vers or stratagems for obtaining the specific goal or result.
MARKETINGAND
THEARTOFWAR.
E
孫子兵孫子兵法
孫子兵法孫子
兵法孫子兵法
孫子兵法孫子
兵法孫子兵法
孫子兵法孫子
兵法孫子兵法
孫子兵法孫子
兵法孫子兵法
孫子子兵法孫
子兵法孫子兵
法孫子兵法孫
子兵法孫子兵
法孫子子兵法
孫子兵法孫子
兵孫子兵法孫
子法孫子兵法
孫子孫子子子兵
法孫子兵法孫
子兵法孫子兵
法孫子孫子兵
法孫子孫子兵
法孫子兵法孫
子孫子兵法孫
子孫子兵法孫
子孫子兵法孫
子兵法孫孫子
兵法孫子孫子
Prof. Vivek Hattangadi

孫子兵
孫子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
法孫
子子兵
法孫
子兵法
孫子兵
法孫
子兵法
孫子兵
Marketing and the Art of War | Prof. Vivek Hattangadi
法 Tactics: Modus operandi to achieve an end, or a goal. “Strategy
without tactics is the slowest route to victory. Tactics without strategy
is the noise before defeat.”1
法 What do we call the people in the field (medical representatives
and field managers) who fight competition in the market place – field
force? In military parlance, it is the armed forces.
法 First mover advantage: It is the competitive advantage which a
brand or the company gets, which pioneers the product. Says Sun Tzu:
“Generally, he who occupies the field of battle first and awaits an ene-
my is at ease; he who comes later to the scene and rushes into the fight
is weary.”1
法 Grabbing the market share: Analogous to the territory which is be-
ing fought over by two armies in a conflict:‘Can we grab a piece of the
enemy land to get a strategic advantage’? (The market pie and how
much share one wants from this pie and the strategic advantage of
having a larger market share)
法 RCPA – Knowing your enemies (getting to know competitors strate-
gies and tactics – James Bond style!): If you know the enemy and know
yourself you need not fear the results of a hundred battles.1
Having said this, marketers apply the principles of military strategy to
business situations against competing firms. This is similar to the two
sides in a military conflict.
Coming back, what is strategy and what are tactics? Many use these
terms interchangeably, BUT THESE TERMS ARE NOT INTERCHANGE-
ABLE. Tactics are the actual means used to gain an objective. Strategy
is a game plan getting towards a goal.2
One of the most brilliant thoughts of Sun Tzu:“The supreme art of war
is to subdue the enemy without fighting.”1
. How to execute this, has
been beautifully explained in the book‘Blue Ocean Strategy’authored
by W. Chan Kim and Renee Mauborgne.3
Having discussed about strategy and tactics let us now turn to the
more important aspect,‘Strategy Execution’.
Says the great Indo-American management thinker, Ram Charan: “Ex-
ecution is the key as this is where the rubber hits the road and is the
toughest part of the innovation cycle from ideation to strategizing to
executing and then measuring the impact and sustaining the same”.4
We shall dwell more on Strategy Execution in the August 2013 Issue of
MedicinMan! -VH
References:
1. SunTzu.“The Art ofWar”.
Pigeon Books India: New
Delhi; 2009
2. Kotler Philip.“Marketing
Management”. Prentice Hall
of India New Delhi; 2001
3.W. Chan Kim Renee
Mauborgne“Blue Ocean
Strategy: How to Create
Uncontested Market Space
and Make the Competition
Irrelevant”. Harvard Business
School Press: Boston; 2009
4. Bossidy Larry Ram
Charan.“Execution:The
Discipline of GettingThing
Done”. Crown Business: New
York; 2002
STRATEGY TACTICS
Strategy is the thinking process required to plan a
course of action.
Tactics are the specific actions taken in implementing
a strategy.
Strategy defines the desired goals and why one
should go about achieving them.
Actions include what is to be done and how it is to
be done.
E.g. the strategy is to become the market leader
in the azithromycin market
Making your brand the lowest price brand can
become a tactic for gaining leadership
E.g. Increase the market share of your brand
through various brand building activities
For this, various tactics can be used; like endorsing
your brand through a celebrity like Sachin Tendulkar.
Strategy is long term Tactics are short term

Best Bl
ogsinH
elathca
re-India
.
For Natives and
Immigrants.
NAME: Apothecurry [apothecurry.wordpress.com]
AUTHOR: Gauri Kamath
NAME: Building Pharma Brands [buildingpharmabrands.com]
AUTHOR: Subba Rao Chaganti
ABOUT: Authored and edited by veteran
healthcare journalist Gauri Kamath,
Apothecurry is easily one of the best
blogs on current issues pertaining to
Indian pharma. Up-to-date and crisp,
Apothecurry gives you the news behind
the news.
NOTABLE RECENT POSTS:
1.“Ponzi schemes in Indian pharma sales a
real problem”: http://goo.gl/vby8W
2.“The Y K Hamied Interview”in Three
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ABOUT: A delightful mix of simple wisdom and
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The author boasts of over 45 years’experience in
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NOTABLE RECENT POSTS:
1.“Medical Advertising: Pletal’s Attention-Grabbing
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2.“1000 Marbles“: http://goo.gl/0rOOA
DIGITAL
DOSE
E









PREFERENCE
MEASUREMENT
IN ECONOMIC
ANALYSIS IN
HEALTHCARE.
W
hat are Preference-based health status mea-
sures?
Preference-based health status measures
are instruments that define an individual’s health state
for use in economic analysis in healthcare. In these
measures, each possible health state is associated with
an estimate of the value (preference or utility weight)
that a surveyed sample of the general population (com-
munity sample) has attributed to these health states.
These preference-based measures are used for estima-
tion of quality adjusted life years (QALYs).1,2
Defining the preferences for the
health states experienced during a
clinical trial.
In a cost-effectiveness analysis done alongside a clinical
trial, researchers elicit subject preferences for the health
states they experience, using direct or indirect methods
of elicitation. With direct methods, subjects in the trial
directly score their preferences for the health states
they experience. With indirect methods, subjects define
the health states they experience by their responses to
surveys about various aspects of their health. These
responses are aggregated into a single score and are
linked through the proprietary scoring algorithms of
the selected system to preference weights established by
surveys of non-patient community samples. Using the
same or similar surveys, population weights for indirect
methods have been established through this survey
methodology and the proprietary scoring algorithms. In
both cases, direct and indirect, these preference weights
are used to calculate QALYs.
Javed Shaikh is a Consultant (HEOR,
Pricing, Reimbursement and Market
Access) at Capita India, Mumbai.
cpnjaved@gmail.com
Shafaq Shaikh is an Associate (HEOR,
Pricing, Reimbursement and Market
Access) at Capita India, Mumbai.
shafaq07@gmail.com
)
Direct and indirect methods of assigning
weights or ascertaining preferences for
different states of health.
E

“
Preference Measurement in Economic Analysis in Healthcare | Shafaq Shaikh Javed Shaikh
COMMON APPROACHES TO ESTIMATING PREFERENCE
WEIGHTS FOR ECONOMIC ANALYSIS ALONGSIDE
CLINICAL TRIALS.
I. Direct Methods
In direct methods, individuals are asked to rate the desirability of
various health states. Individuals rank their preferences, making
trade-offs between health states and alternatives. Individuals
make judgments based on their own relative values for the vari-
ous domains or characteristics of the health state experienced or
described. For example, an individual who values being “medica-
tion-free” over mobility, will rank a health state differently from
an individual who values mobility over freedom from medica-
tion. The standard gamble and the time trade-off methods are
the direct methods used to estimate preference or utility weights
for economic evaluation. Direct methods might be used with
subjects in a clinical trial, or to establish preference weights for
indirect multi-attribute classification systems.
1. Standard Gamble (SG)
The SG asks participants to consider a choice between a gamble
and continuation of life in the current health state. The gamble
offered is the probability of perfect health (p) or certain death (1-
p). The probabilities for the two options in the gamble are altered
until the participant is indifferent between the gamble with the
risk of immediate death, and continuation of life in his or her
current health state.3
The assumption is that in order to transi-
tion into perfect health, people living in poorer health will accept
a higher risk of death than individuals living in good health.
Different procedures are used to determine this indifference
point. The simplest procedure asks participants to state how
much risk of death would make the two options equally attrac-
tive. This can be done in an interview or on paper.4
Another
set of procedures involves repeatedly presenting two options to
patients, adjusting the risk (probability) of death between options
until the participant is indifferent between the alternatives. This
can be done using computer-based utility assessment software.
The risk of immediate death can be adjusted using various meth-
ods to present alternative scenarios.
2. Time Trade-off (TTO)
The participants using the TTO are asked to decide how much
time in perfect health they would be willing to give up in order
to escape their current health.5
The idea is that in order to escape
their current health condition, people living in poor health will
accept a shorter life span in perfect health compared to people
living in good health. The TTO is administered using the same
techniques described above for the SG where alternative years
forfeited are offered.
There are paper-and-pencil versions of both the SG and TTO
available, but computer-based programs have greater consistency
and reliability.
In direct methods for es-
timating the weight of a
health state, individuals
are asked to rate the de-
sirability of various health
states. Individuals rank
their preferences, making
trade-offs between health
states and alternatives. In-
dividuals make judgments
based on their own rela-
tive values for the various
domains or characteristics
of the health state experi-
enced or described.
”


Preference Measurement in Economic Analysis in Healthcare | Shafaq Shaikh Javed Shaikh
3. Visual Analog Scale (VAS)
While the VAS has often been used for direct measurement,
concerns about its validity in economic analysis have been raised.
Drummond and Brazier do not recommend using the VAS alone in
economic evaluation because the method does not give the respon-
dent a choice between two alternatives, and therefore, does not
reflect the strength of preference necessary for economic analysis.6,7
There is also concern that rating scales are particularly subject to
a variety of measurement biases. These include end-of-scale bias,
where respondents avoid the extremes (0 or 100), and context bias,
where respondents distribute responses over the scale or aggregate
choices in certain areas of the scale, regardless of the differences in
health states.
II. Multi-attribute or Indirect Methods
Indirect methods use multi-attribute health status classification
systems to define preference weights for the various health states
experienced by subjects in a trial. Using surveys of a sample of the
population and direct methods (SG, TTO or VAS transformed to
SG), developers of these systems have estimated preference or utility
weights for each defined health state in their system. These surveys
elicited the sample’s preferences for various individual attributes of
health. These attributes might include pain, mobility and self-care
Preference scores for individual attributes of health have been trans-
formed into a preference weight for each health state or combina-
tion of attributes in the system. These preference weights have been
integrated into the scoring algorithms in the classification system.
In a cost-effectiveness analysis using an indirect method conducted
alongside a clinical trial, subjects are surveyed with these multi-at-
tribute systems. These surveys define the subject’s overall health sta-
tus along several domains or attributes of health. Each combination
of findings defines a health state. These health states are then associ-
ated with the preference weights described above. In the cost-effec-
tiveness analysis, the preference weights associated with each health
state experienced by the subjects are used to calculate QALYs.
Preference-based multi-attribute classification systems all mea-
sure generic health status, but they vary by many factors including
attributes, number of attribute levels, the description of the levels,
the severity of the most severe level defined for each attribute, the
number of health states defined, the communities from which the
preference weights were estimated, and the theoretical approach to
modeling preference data into the scoring formula of the classifica-
tion system.7
As a result, multi-attribute classification systems are
not equally suited for all diseases or disorders.
SUMMARY
Estimating preferences for states of health has been an active area of
research in recent years. Unlike psychophysical approaches, which
discriminate levels of health status, preference-based approaches
incorporate values for health outcomes and can be used in cost-ef-
fectiveness analyses to aid resource allocation decisions. - SS JS
REFERENCES:
1. Torrance, G. W. Utility approach to
measuring health-related quality of life. J
Chronic Dis 1987; 40(6): 593-603.
2. Gold, M. R., Stevenson, D. and Fryback,
D. G. HALYS and QALYS and DALYS, Oh My:
similarities and differences in summary
measures of population Health. Annu Rev
Public Health 2002; 23: 115-34.
3. Gold, M. R., Siegel, J. E., Russell, L. B., et
al. (1996). Cost-Effectiveness in Health and
Medicine. New York, Oxford University Press.
4. Ross, P. L., Littenberg, B., Fearn, P., et
al. Paper standard gamble: a paper-based
measure of standard gamble utility for
current health. Int J Technol Assess Health
Care 2003; 19(1): 135-47.
5. Brazier, J., Deverill, M. and Green, C. A
review of the use of health status measures in
economic evaluation. J Health Serv Res Policy
1999; 4(3): 174-84.
6. Brazier, J. (2005). Current state of the art
in preference-based measures of health and
avenues for further research. The University
of Sheffield School of Health and Related
Research, Health Economics and Decision
Science Discussion Paper Series. Sheffield,
University of Sheffield: 1-21.
7. Drummond, M. F., Sculpher, M. J.,
Torrance, G. W., et al. (2005). Methods for
the Economic Evaluation of Health Care
Programmes. Oxford, Oxford University Press.


)

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