November 2008
	Sales Force Effectiveness – 2008 Well, it is that time of year again. GfK Market Measures recently reported the findings of the large-scale quantitative project it conducts annually to determine physician perceptions of sales force activities. Looking at this service year to year, I believe, helps significantly in keeping tabs on the effect – both positive and negative – that our Pharmaceutical Sales Representatives (PSRs) have in the field, and thus helps us fine tune this very important, and very expensive, promotional resource. Because of the robustness of the findings of this project, I will not attempt to cover them all here, let alone duplicate the elaborate charts included in this study. Rather, I will simply attempt to give you my overview on how these findings differ from previous years and how they should direct our efforts in the year to come. For more detail and specifics, I would refer you to the GfK Market Measures professional with whom you work most closely. Methodologically, let it first be noted that, as always, Market Measures included a large number of physicians in this study, with more than 800 doctors from 12 key specialties participating. Results are weighted up to represent the number of physicians in the specialty, with the result that we can place firm value in these outcomes in our decision-making processes. Only those physicians who personally see PSRs are included in the sample, based on the line of reasoning that those who do not permit such encounters have little to say that would be of value in providing guidance as to how to direct our representatives. Interviewing was conducted during the third quarter of 2008. Without a doubt, but with hardly any surprise, an extremely valuable addition to this year’s study was a latent class analysis that permitted us to examine physician reactions to various aspects of PSRs’ approaches through the eyes of their particular segment. For example, the largest segment encountered was that of the “Hometown Altruist.” This segment of physicians, among other characteristics, viewed PSRs as valuable colleagues, and approached prescribing on a patient-centered and pragmatic basis. But before we examine such details, it is important to call out the big pieces in which clients are typically most interested, including which company has the most effective detail force. As in several past years, Pfizer continues to win this top slot as seen by physicians overall. Read the related article in this month's Topline. Underlying this might well be the fact that the Hometown Altruists report that they place high value on positive professional attributes and product knowledge, no doubt extremely beneficial in helping them make their flexible and patient-centered prescribing decisions. Relatedly, most doctors in most of the physician segments found details to be approximately as valuable as they were last year. Somewhat circularly, however, the two segments most pro-industry, ”Industry Enthusiasts” and “Patient-Overloaded Independents,” offered up 16 percent and 21 percent of their members, respectively, who actually found detailing to be more valuable in 2008 than 2007. A key insight here is that while much ado is made of the increasing number of “no-see” doctors and others expressing negativity toward PSRs, a reasonable number of physicians, facing rising pressures from other quarters, increasingly rely on representatives to provide them with assistance they need in their practices. Across segments, moreover, the percentage of physicians who felt that the value of PSR interventions had dropped over the last year was extremely low, i.e., mid-single digits at most, indicating that perhaps the practice of rep-bashing has hit bottom, and/or perhaps that the quality of the sales call had actually improved. For those doctors reporting significant changes in detailing, it is interesting to note that most such shifts centered around the perceived reduction in gifts and other services being provided by pharmaceutical companies and their representatives, and the increased impact of guidelines on the ability of companies to provide such goodies. Approximately 15 percent of physicians reporting any significant change in detailing noted each of these related trends, taking them to the top of the list of shifts noted. More substantively, physicians pointed out, as is always the case, that they are looking for two things from PSRs. Primarily, they want the representatives to provide them with product information, while giving them research data and scientific findings falls into second place here. As usual, physicians are more prone to trust what the representatives say about their own products, and less prone to trust what they say about other, especially more scientific, matters on which they are seen as being less versed. As in recent years, physicians were once again found to decide whether or not to see a particular representative based on his/her respectful use of the doctor’s time. Those who bring value to the doctor and do so on a timely basis are typically and not surprisingly welcomed, while those representatives who do not make good use of physicians’ time increasingly are being turned away at the door. An interesting dichotomy exists in terms of physicians’ valuations of patient materials provided by pharmaceutical companies. While some segments of physicians place high value on such materials, especially those physicians who carry a high volume of patients and those who have harnessed the resources of the pharmaceutical companies to help them with their practices, other physicians who are more traditional or participate in corporate-like practices have little regard for these materials. One of the most informative findings of this year’s research is about the role of the computer, in the hands of the PSR, in providing information to physicians. To simplify the findings here, while doctors report relatively extensive use of such electronic support for presentations, those who perceived it brought any genuine value to the detail call were extremely low in number. In a similar vein, approximately 50 percent of physicians prefer maintaining contact with pharmaceutical companies through personal channels, while another third prefer to maintain such access through both personal and e-channels. Put another way, only about one in 10 doctors prefer to rely exclusively on the Internet for their exchanging of information with pharmaceutical companies. This should not be taken, however, as an indication that physicians do not rely extensively on the Internet. Two-thirds to three-quarters of physicians use the Internet to search for information concerning diseases and drugs, and to complete their medical education requirements. On the other hand, while much conversation is heard these days about “social marketing,” only about 15 percent of physicians use the Internet as a way of exchanging information with key opinion leaders. In summary, the findings in the GfK 2008 Study on Sales Force Effectiveness demonstrated that, not surprisingly, physicians are still seeking the same benefits from their interactions with pharmaceutical companies as they have in the past, i.e., information concerning drugs, research findings and services that will help them deal with their practices in an efficient manner, e.g., patient information materials. Importantly, doctors also remain adamant that in delivering such information and services, PSRs not waste the practitioner’s time and are mindful of situations in which physicians are so busy that rescheduling a visit is a more beneficial strategy than is an attempt to wedge into an already overloaded workflow. The 2008 research also revealed that, as expected based on previous years’ findings, the electronic media are being used by most physicians in “pull” mode, i.e., to seek out information on drugs and diseases, and as a convenient way to meet continuing medical education requirements. Attempts to use the computer in “push” mode, e.g., employing tablet computers to facilitate sales presentations, were reported this year to be increasing in frequency, but as relatively useless in bringing any additional value to the detailing interaction. Similarly, the move toward social marketing, which among other things puts average practitioners in direct contact with key opinion leaders, is apparently just starting to gain traction. Looking ahead to 2009, there is little doubt physicians will report in our next wave that they are noticing there are fewer representatives calling on their offices and less frequently. It is also likely that the new regulations governing interventions with prescribers will also have an impact that is noticed by physicians in the form of reduced freedom on the part of PSRs to provide gifts, services, meals, etc. Computer-powered details will still likely not bring much to the party, although doctors will continue to rely increasingly on the Internet as a source of information and continuing medical education. Finally, it should be noted that the information presented above constitutes only a brief overview of the data uncovered in this year’s project. For a far more thorough drill down, you should contact Stacy Vaughn. One of the most important additional pieces of information she can provide to you is the relative size and characteristics of the various segments that this year’s study uncovered in terms of the way physicians perceive and relate to PSRs. While former waves of this project have dealt in averages, this year’s segments give pharmaceutical companies and their PSRs the information necessary to tailor their approaches to physicians in these various segments. It’s worth talking to Stacy about this project just to get insights into this key new perspective. Detailing, as everyone knows, is the most important and expensive channel that we utilize in communicating with our customer base. Tap into the full information provided by this year’s SFE study and think long and hard about how it can be used to better direct your company’s sales efforts. Richard B. Vanderveer, Ph.D. Group Chief Executive Officer GfK U.S. Healthcare Companies