GlaxoSmithKline's Dierdre Connelly peeled back the curtain on the company's sales force incentives revamp in a speech to the Pharmaceutical Regulatory and Compliance Congress, and pleaded for recognition that the industry had cleaned up the sketchy practices of the Blockbuster Era.
“Trust is a two-way street,” said Connelly, who is president of pharmaceuticals for North America at GSK. “We need those we serve, and those who make sure we conduct our business appropriately, to accept that we've changed … Continue to hold us accountable, but accept that we operate differently today.”
Connelly said trust is “the currency of our industry” and said that with the changes to reimbursement and rules around physician-industry contacts taking hold as part of the Affordable Care Act, “the companies that are trusted will be the ones doctors and medical institutions will want to work with.”
“Right now, I think it's fair to say our customers don't have a lot of trust in our industry,” said Connelly. “A demonstrated and committed focus on values and compliance can change that and get us where we need and want to be.”
What's not helpful, she added, is “the argument that the industry won't get it unless someone goes to jail.” “Fines and settlements do matter,” said Connelly, noting that the company's $3 billion July settlement
with the government, for off-label promotion of Paxil and Wellbutrin and withholding safety data for Avandia, wiped out a quarter's-worth of profits, and that implementing a Corporate Integrity Agreement is no walk on the beach. Moreover, “it damaged our reputation and it hurt our morale,” said Connelly. “That matters.”
GSK has been second to none in getting out in front of the push for greater transparency in physician-drug company contacts. Two years ago, the company introduced a new compensation model
for sales reps, dubbed Patient First, in which reps would be compensated based on metrics other than prescription volume. Connelly said that came out of a discussion with reps in New York.
"As we talked about the need to apply our values in our business, the discussion moved to building and maintaining trust with our physician customers,” said Connelly. “From the group, the view emerged that our sales incentive system wasn't aligned with our value of focusing on the best interest of the patient. They pointed out that their goals for prescription volume were not necessarily aligned with the physicians' goals for their patients. In short, our model was not helping them build trust with their customers."
Connelly came up under the old model, created to drive prescriptions of blockbuster drugs through primary care docs.
"Gradually, as the industry grew," Connelly recalled, "and as we launched more medicines, we increased the size of our sales forces and we also implemented bonus systems based on scrip volumes. It's a practice that was common in other industries, was fairly easy to implement and provided a quantifiable way to measure and evaluate our sales representatives. But, over time, I would argue, it caused us to lose our way and to lose sight of our responsibility to focus on the best interests of patients."
To make amends, she said, “hundreds of people in our organization spent over a year developing a robust methodology for gathering data that enables us to evaluate the sales competence and performance of our sales reps. We do this on a common basis across geographies and business units, and in a way that also takes into consideration different job grades.” That methodology incorporates physician feedback and other measures of the scientific and business knowledge of reps, as well as their ability to plan, to ask insightful questions and to engage in “patient-centered dialog” with docs.
“And, because they are sales professionals, we also assess their ability to ask customers to prescribe GSK products for appropriate patients consistent with the product label.”
Shortly after the announcement of the $3 billion settlement, Connelly said, a GSK rep called on a “no-see” doc. “The doctor had seen our news and came out of his office to speak to our rep,” said Connelly. “He was angry and started letting our rep know exactly what he thought about GSK. The rep listened, and explained that what the doctor was hearing in the news did not reflect the company we are today. He told the doctor about the changes we had made to our sales incentive compensation program. That made a difference. Today, that GSK sales professional is the only one that doctor will see.”