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Best practices in planning and targeting and conducting office calls, as well as management of relationships, samples, programs, and salesforces are explored. These include the use of automated for mulary data and thoughtleader information to develop sales messages that anticipate formulary restrictions and opportunities,and the integration of activity triggers into annual planning calendars to prepare sample staples and sales messages in advance of key illness periods,such as cold and flu or allergy seasons. According to the report, best practitioner reps estimate that it takes at least one to two years in any new territory to develop relationships with local doctors and office staff. Reps can accelerate this tran sition and increase personal productivity by leverag ing the work of their predecessors. Key relationshipbuilding techniques cited in the report include: . Having the departing rep send out thankyou notes that introduce the new rep to the doctor, providing a sense of continuity and demonstrat ing the previous rep’s respect for the physician. . Having the depart ing rep personally introduce the new rep to the doctor, helping to eliminate the awkwardness of the new rep’s first solo calls. . Learning doctors’ hot buttons and interests through facetoface meet sch, Ph.D., a visiting professor of marketing at Duke University’s Fuqua School of Business and chaired professor of marketing at Erasmus University Rot terdam in the Netherlands. “Marketing can actually spur doctors and patients — and doctors and drug reps — to have more informative conversations about the benefits and side effects of drugs. Mar keting isn’t about buying off physicians.” According to the study, coauthored by Dr. Stremersch and Sriram Venkataraman, Ph.D., assis tant professor of marketing at the Goizueta Busi ness School at Emory University, doctors are more likely to respond favorably to market ing for a drug that’s proven more effective than others in its class, while excessive marketing of a lesseffective drug can actually reduce the likelihood that the doctor will prescribe or dispense samples of the drug. Interestingly, marketing efforts for drugs with a higher number of side effects were found to have a positive effect on prescriptions writ ten and samples dispensed.The study suggests this could be because infor mation provided dur ing the detailing call helped clarify the physician’s questions about the drug’s side effect profile. “There is evidence that physicians rely on science while prescrib ing,” Dr. Venkataraman says.“If a drug has many side effects, it’s best to have a sales rep explain those side effects directly to a doctor rather than bypass ing medical professionals with ads aimed at patients.” The study also notes that when patients ask their doctors for a more effective drug, or one with fewer side effects, the physician is more likely to accom modate the request. The rise of directtoconsumer advertising in recent years has resulted in more patients request ing specific medications from their doctors, prompt ing regulators to keep a closer watch on both physi cian and patientdirected marketing efforts. Sales Practices DISTINGUISHTOP PHARMA REPS Regardless of whether pharmaceutical compa nies are growingor shrinking their salesforces,the fun damentals of selling remain constant: planning, tar geting, relationship management,and goalsetting. But it is the specific practices that representatives follow within these areas that separate the top per formers from the pack,according to Best Practices in Pharmaceutical Sales, a report from business intelli gence firm Best Practices. Study Shows MARKETING INSPIRES DOCTORSTOWEIGH BENEFITS,RISKS of Drugs Prescribed Marketing pharmaceuticals directly to doctors or patients is often perceived as adversely affecting public health by emphasizing potential benefits and downplaying potential risks of drugs. But new research shows that phar maceutical marketing actually encour ages physicians to base their dispensing of samples and prescriptions on a drug’s scientifically proven safety and effective ness. According toThe Debate of Influenc ing Doctors’Decisions: Are Drug Charac teristics the Missing Link?, patient requests and pharma marketing efforts such as detailing and symposia do affect physician decision making differentially across brands, but the responsiveness of physicians’decision making to marketing efforts and patient requests is heavily influenced by a drug’s effectiveness and sideeffects profile. The authors of the report say it may have impor tant implications for policymakers and authorities exploring the way marketing affects drug dispensa tion. “Drug marketing has been portrayed like some scary movie where pharmaceutical firms are shoving drugs in our veins for the sake of profits, but that doesn’t gibe with our results,” says Stefan Stremer PHARMA TRAX SALES, MARKETING, AND R&D TRENDS AFFECTING THE HEALTHCARE INDUSTRY Marketing can spur doctors and patients to have more informative conversations about the benefits and side effects of drugs, says Dr. Stefan Stremersch of Duke University. Dr. Stefan Stremerch # Continuously probe physician’s office culture, policies, and preferences to create a customized sales approach. # Build rapport with physicians by openly discussing goals, office service needs,and physicians’needs. # Manage and allocate samples to physicians according to prescription volume and by coaching doctors on the use of samples. # Create relationshipbuilding programs to meet specific customer needs and preferences. # Manage sales reps by developing measurable goals, budgeting sufficient resources, and providing continuous coaching. # Empower reps to align planning, targeting, and scheduling activities to reflect their personal selling approaches. BEST PRACTICESTO INCREASE REP EFFECTIVENESS Marketing efforts for drugs with a higher number of side effects have a positive effect on prescriptions written. It takes at least one to two years in any new territory for sales reps to develop relationships with local doctors. PV0308 LAYOUT 2/14/08 5:43 PM Page 76 77 PharmaVOICE M a r c h 2008 PHARMA trax ings with the predecessor rep, giving the incom ing rep a considerable head start in building rela tionships with physicians in the new territory. The report also discusses ways to reclaim neglected territories through techniques specifically designed to regain doctors’ trust. Suggested prac tices to achieve this goal include: . Beginning the relationship with a brief apology and a conciliatory attitude toward doctors in the affected territory. . Building continuity through a consistent route plan that ensures the doctors in the previously neglected territory are visited at regular intervals. . Fostering goodwill through a temporary increase in the number of samples provided to physicians in the affected territory. EXPERT,PEERS ARE PATIENTS’MOST TRUSTED SOURCES for Healthcare DecisionMaking A recent study shows that when making healthcare deci sions, patients turn to healthcare professionals and their families and friends for information and advice, and they value personalized com munications over more general ized treatment information. Patient Power, a study fielded by RyanTrueHealth in partnership with ICOM, gives marketers insight into the key elements that influence the patient’s decision making process. The online study surveyed more than 25,000 patients with at least one chronic health condition as to how and why they make healthcare choices. Key findings of the study include: . Despite differences in chronic conditions, patients refer to the same trusted information sources when making healthcare decisions. . While healthcare professionals and experts are still the most trusted sources, peers, spouses, and friends are the secondmost trusted source for healthcare decisionmaking. . Advocates play a highly influential role in moti vating other patients because they are natural information gatherers and disseminate what they learn. . Authentic communications with patients helps marketers meet patients’ needs for trust while they look for authenticity. . Spiritual beliefs are an important source in patient decision making. . Patients want information that is personalized. Marketers who deliver the right information to the right customer at the right time create opportunities for ongo ing communications. The study seeks to challenge the one dimensional nature of most pharma and biotech patient market ing, which tends to focus on product fea tures and benefits while ignoring the end result that the treatment can deliv er. “The results reveal that patients are more alike than dissimilar in their healthcare decision making process,” says Alfred O’Neill, senior VP of Ryan True Health. “From patients with high blood pressure to those suffering daily with rheumatoid arthritis, the human condition trumps the disease condition.” On Ryan TrueHealth’s Web blog, Mr. O’Neill says the study shows that brands should be focusing more budget and effort on developing electronic customerrelationship management programs tai lored by patient stage and patient influencer, what the company calls electronic patient medical educa tion (ePRM). “Companies should use these expert and peer influencers to communicate what patients really need to know, versus pushing what brands think they should know, to create more informed and empowered patients,”he says. Engaging patients with pharmaceutical prod ucts means marketers must provide both personal perspectives and valued, accurate information from professional sources. Importantly, patients want information that is clear and jargonfree. Connected Physicians Using SOCIAL MEDIA Onethird of online physicians use blogs, profes sional networks, forums,and message boards to con nect with other physicians or content they have cre ated monthly, according to JupiterResearch’s report DirecttoPhysician Online Marketing:Benchmarking and Leveraging Physicians’Adoption of Social Media. These “connected physicians” are intense con sumers of media compared with unconnected online physicians. According to the report, 63% of connected physicians participated in various pharmaspon sored marketing programs monthly, including online detailing, versus 53% of unconnected online physicians. Connected physicians were also more likely to use branded Websites and manufacturers’ Websites than were their counterparts. Further, twothirds of connected physicians for warded useful content to colleagues, while 58% rec ommended specific sites to patients. Patients are more alike than dissimilar in their healthcare decision making process, says Alfred O’Neill, Senior VP of Ryan TrueHealth. Alfred O’Neill 1. Money matters so understand how incentives can address compliance. 2. Use the power of experts and add a human touch, investing in some form of call center, live nurse, or callin line. 3. Identify patients’circles of influence, encompassing their psychographic and lifestyle profile, medical conditions, treatment,and approach to working with providers to make healthcare choices. 4. Implement a “patient attraction and engagement strategy,”using survey information to hone messages. 5. Create a compliance connection by communicating with patients on an emotional level to build trust. 6. Create tools that encourage and empower,ensuring patients have the tools to make informed decisions about the risks and benefits of medications. 7. Identify measurable responses and accurately track ROI through specific actions that can be measured and adjusted based on results. BEST PRACTICES,Chapel Hill, N.C., is a research and consulting firm that studies the best business practices, operating tactics, and winning strategies of worldclass companies.For more information, visit bestinclass.com. DUKEUNIVERSITY’S FUQUA SCHOOL OFBUSINESS,Durham,N.C., is one of the top U.S. business schools.For more information, visit fuqua.duke.edu. GOIZUETA BUSINESS SCHOOLAT EMORYUNIVERSITY,Oxford,Ga.,offers leadership development programs.For more information, visit goizueta.emory.edu. JUPITERRESEARCH,NewYork,provides research, analysis, and advice to help companies profit from the impact of the Internet and emerging consumer technologies.For more information, visit jupiterresearch.com. RYANTRUEHEALTH,Wilton,Conn., the healthcare communications division of Ryan Partnership, provides relationship marketing solutions for pharmaceutical, biotech, and health insurance companies.For more information, visit ryantruehealth.com. Follow up SEVEN STRATEGIES FOR EFFECTIVE RELATIONSHIP MARKETING Brands should tailor customer relationship management programs by patient stage and patient influencer. PV0308 LAYOUT 2/14/08 5:43 PM Page 77