Force in the Field

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On Nov. 28, 2006, Pfizer publicly announced a decision that nearly a year later has come to symbolize perseverance in the face of adversity for its pharmaceutical sales force.  

As part of a company-wide cost-saving initiative, executive management decided the time had come to reduce the headcount of its 11,000-member sales force by 20% and implement a plan whereby the company's pharmaceutical operations would be transformed into five sleeker therapeutic-focused units, each with their own dedicated sales forces to drive business.

How would Pfizer's sales reps, long considered best-in-class and one of the company's best assets, respond?

Adaptation to the new business model could have proved debilitating over the short-term, not to mention dangerously alienating to the client base of physicians and healthcare providers Pfizer reps vie to spend time with.

Jake Friedman, VP of sales for the Powers Business Unit, responsible for promotion of products including Celebrex, Lyrica, Geodon, Aricept and Rebif, describes the situation.

“To say the last year has been a challenge might be a little bit of an understatement. It's been tumultuous and quite a bit of a hit to the emotional psyche of the field force as well as the focus of their effectiveness,” he says.

However, Pfizer's well-trained sales core was able not only to roll with the “hit,” the move is now viewed by leaders within the company as a transformation that has become a major competitive advantage.

By becoming a more nimble machine, Pfizer's sales force is now, more-than-ever, acutely attuned to the needs of its prescribing customers. And those customers have taken notice. This October, nearly a year after plans for Pfizer's sales force restructuring were set in motion, GfK Market Measures announced the results of its industry benchmark 2007 “Portrait of a Valued Rep” survey. At the top of the list of the industry's most effective sales forces was Pfizer—the fourth year in a row the company's sales force received the distinction.

Approximately 24% of the more than 1,200 surveyed physicians said that Pfizer has the most effective representatives on a consistent basis. The doctors participating in the survey also said Pfizer's reps tend to be better prepared, more knowledgeable and sensitive to time constraints.
“To be named the most effective field force in the face of this adversity is a testimony to the great leadership of this sales organization,” Friedman explains. “It shows the restructured Pfizer sales organization is a culture of development, execution and professionalism.”

A matter of time
The power of Pfizer's sales force during the past year has been the ability of its sales reps to make the most of their valuable physician interactions in the increasingly complex world of pharmaceutical sales.

“We are in a very competitive environment,” says Rick Burch, SVP, sales of the Pratt Business Unit, responsible for promotion of cardiovascular and metabolic areas of diabetes franchises including Lipitor, Caduet and Exubera.

“Out of the top 10 detailed products in the industry, nine are in the cardiovascular and metabolic therapeutic areas,” Burch explains. “And with generic simvastatin hitting the market, we also have a lot of payor activity…With those two (situations) combined it's extremely competitive.”

The fact of the matter, says Karl Braun, VP, sales, Ophthalmics and Endocrine Care, Pfizer's Specialty Business Unit, is that time is simply running out. 

“I don't see time becoming more available for our physicians,” he says. “So we have had to bring a great message, be informative and address the issues they have. That way we increase our value while being respectful of their time and also being able to assist them with their patients…As we go forward, time is going to be of the essence and of greater demand. The ability to be able to better manage that time and get to the issues the doctor needs to discuss will be paramount.”
Also of growing importance to Pfizer's sales force during its restructuring has been the attention paid to supporting the entire physician's office, Braun notes.

“We have seen the need to make sure that we are doing broad-based calls and touching numerous decision-makers within the office in addition to the physician,” he says.

“Obviously the physician is always the primary call and the key decision-maker but I know that physicians rely on others in their offices as well,” he explains. “We are making it a point to make sure that everybody has the information they need as they interact with their patients in their specific roles.

Better-trained, therapeutically focused
According to Timothy Kern, VP of US field training, Pfizer's recent sales force realignment also required a revamped and widespread training initiative with an intense focus on disease state product knowledge, selling skills and compliance.

Burch, of Pfizer's Pratt Business Unit, says, “Being able to sell with science takes a strong belief in training. I think sales leadership has supported our desire to increase depth of knowledge and skill development…allowing for the necessary time and the investment to assure that everyone is fully prepared to do their role.”

Although Pfizer's sales force business units are new and improved, the company's long legacy of being the best-trained field force in the industry remains intact, says Russ Williamson, VP, sales, Steere Business Unit which is focused on the promotion of urology and respiratory franchises including Chantix, Spiriva, Detrol LA and Viagra.

“Our training has always been tops in the industry,” Williamson explains. “With respect to the changes we recently made—because we are more therapeutically focused—we have in effect made all of the representatives specialty representatives. So, from a Steere Business Unit perspective, when we send a representative into an office, that representative is able to speak specifically to the urology disease and treatment or speak specifically to the respiratory disease and treatment and has an acute knowledge of what's going on medically in that area. They can help bring additional value to the physician understanding of how our medication fits into the treatment algorithm, ultimately helping the physician make the best decision for the patient.”

Follow the sales force leader
After watching Pfizer successfully reconfigure its sales force in 2007, other pharma companies took notice and took action.

This year, AstraZeneca overhauled its sales force structure, reducing the number of sales reps assigned to individual physicians by putting them into smaller teams focused on particular physicians.

So far, the redesign has improved overall rep effectiveness and efficiency and has supported much better relationships within the sales organization, according to Mark Mallon, VP of marketing and sales operations at AstraZeneca.

“Instead of physicians having to deal with lots of sales people, they can deal with just a few and get to know them better,” Mallon tells MM&M.

Pfizer's reduction of reps has also had a ripple effect on the entire industry. Verispan data show that drugmakers AstraZeneca, Eli Lilly, Novartis and Abbott have made adjustments to their sales force size during the past 12 months by cutting back on full-time, part-time or contract sales representatives. 

It's a trend that we can expect to continue as pharmaceutical companies experiment with new strategies to improve their market position, says Mike Luby, CEO of prescribing behavior tracking firm TargetRx. 

“There are very few CEOs that are going to stand in front of Wall Street and say, ‘We think our sales force is too small,'” Luby says.

According to Verispan data, the number of total sales reps in the pharma industry is on the decline, from 101,634 in 2006 to 98,755 in the third quarter of 2007.

“We will now be seeing more companies turning back to a blocking and tackling approach, trying to find ways to focus on the quality of interactions with physicians and measure ways to improve their effectiveness,” Luby explains.

Piloting new approaches
In the new reality of pharmaceutical sales, companies including Merck, AstraZeneca and Novartis are experimenting with new technologies as one way to heighten their sales force effectiveness.
In July, Merck inked a pact with Aptilon Corporation to use the software company's innovative video detailing program incorporating live sales reps to reach physicians via the Web.

“We are making the rep available to the physician when and where they are going online,” Aptilon's SVP, corporate development, Mark Gleason says.

“Physicians are given the choice of whether they want to order drug samples, see an e-detail, do an archived peer presentation or talk to a live rep,” Gleason explains.

Through proprietary technology, the doctors are able to speak with reps one-to-one via telephone in real time, ask questions about therapies, and drive the interaction.

“It's a high service level that's unheard of in the industry,” Gleason explains. Merck's video detailing efforts are earning rave reviews from some physicians, according to GfK Market Measures' 2007 “Portrait of a Rep” survey.

A general practitioner who took part in the survey remarked: “I have been getting e-details for Merck products and I can talk to a live detail. It's done in a very timely, very professional manner. They give you very clear and concise slide presentation information about the medication. You ask for samples and they fax the sample request form right away and as soon as I fill that out they fulfill that sample request immediately…Their reps are very friendly, they are very sensitive of my time and it's a wonderful service that Merck is providing. I cannot say enough good things about them.”

Meanwhile, AstraZeneca has also moved aggressively to leverage interactive detailing among its field force.

“We have two-thirds of our sales force using interactive detailing,” says AstraZeneca's VP, marketing and sales operations, Mark Mallon. “By the end of the first quarter of 2008 we anticipate they will be at 100% interactive detailing.”

According to Mallon, AstraZeneca has already seen significant improvement in a number of measures resulting from its interactive detailing efforts. “For example, we get up to another two minutes on individual sales calls with the interactive detail,” Mallon explains. “We also get a 40% improvement to cover additional products in the first detail…It simplifies and supports what we are trying to do.”

Novartis also has been piloting programs involving electronic media to improve the reach and quality of interaction with its customers, says Alex Gorsky, head of pharma North America and CEO.

“We pilot programs throughout the year to make sure we understand the key drivers of customer satisfaction and productivity,” Gorsky says. “We have a strong focus on the fact that one size does not necessarily fit all with our customers and we are currently  evaluating and testing different selling models based on local market variations, based on the regional, national and district level.”
Those new selling models have helped Novartis during 2007 as the company has managed the launches of the anti-hypertensive Tekturna, high-blood pressure drug combo Exforge, post-menopausal osteoporosis treatment Reclast and the Alzheimer's patch Exeleon.

“The challenge for us has been ensuring that we have the same high quality performance focus that we've always had at Novartis while launching all of those drugs at the same time,” Gorsky adds.

Back to the future
As physicians continue to be stretched for time, according to SVP of GfK Market Measures, Maureen McLaughlin, “The companies who consistently deliver valued efficiencies will be the winners… The representatives who build relationships with physicians through trust and impeccable service, and know how to leverage all the improving technologies will (also) be the winners.”

And although time is tight, an overwhelming majority of doctors still see reps, Target Rx's Luby maintains.

“That's a huge statement. Physicians are getting squeezed by payers. Their margins are tight. They are busy. But the nice thing about a pharma rep is that all the doc has to do is break stride in the hallway…I think the fact the majority of docs still do it is a sign that they value it. I think there's a huge opportunity here for companies to better of a job in looking at the market place and understanding it.”

Chris Nickum, who leads the sales and account management consulting practice at IMS Health, agrees.

“When you take a look at it, the thing having the biggest impact on return is the rep, even if the that primary message is now being delivered from different sources,” Nickum says.  

Meanwhile, Pfizer plans to build on the success it has had during the past year by remembering that its magic has always been its message.

“I have been with Pfizer for 28 years,” says Friedman of Pfizer's Powers Business Unit. “To this day, I'm completely convinced there is nothing as effective as a strong, credible representative standing toe-to-toe live in front of the doctor. I don't think you can ever replace that. There's tremendous value and impact in that. Of course, there are a lot of caveats. They have to be good, they have to have the doctor's respect, and they have to be consistent in what they deliver. But, as I said, absolutely, nothing can replace that.”

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