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While the pharmaceutical industry cannot adopt mass customization in the manufacture of its products, it can adopt mass customization in the marketing of its products to physicians, enabling sales reps to impart added value in presenting product information to the customer: physicians. Research shows, for exam ple, that emphasizing select product attributes and clinical data based on physicians’ real interests delivers higher perceived value and physician satisfaction. Mass customization provides a solution to pharma companies searching for ways to improve inperson sales visits and effectiveness. Partha Anbil, adjunct professor of market ing, Fox School of Business and Management, Temple University, and John Moran, director of strategic planning, management consult ing, IMS Health, explore strategies for identi fying opportunities for highvalue rep/physi cian engagements, as well as cultivating learning relationships with physicians by using anonymized patientlevel data (APLD) to profile physicians and inform call plans. CONTEXTUAL DETAILING: MARKETING PRACTICES FOR THE NEWREALITY Traditionally, pharmaceutical firms have taken a sellercentric view of the market. Here, sales representatives attempt to capture physi cians’ attention, address each prescriber’s unique concerns, and gain respect as a trusted advisor — all while delivering a static message. It is no wonder that: . Physicians perceive only one out of every three sales calls as helpful; . More than 20% of physicians shut out pharma reps; and, . 87% of rep/physician interactions last less than two minutes. Decreasing physician availability com bined with more stringent restrictions on sales representatives’ interactions are now forcing marketers to identify new methods for captur ing physicians’ attention. One method — the physiciancentric approach — aligns a company’s best products and best information to the physician, enabling sales representatives to adapt promo tional offers and detailing messages to each customer’s unique profile and preferences. The result is contextual detailing that will deliver information about new drugs to the right physician at the right time. Contextual detailing involves the conver sion from contextinsensitive to contextaware value propositions, which facilitates physician decisionmaking (See Fig. 1). The objective is to provide customized services to each cus tomer according to his or her personal prefer ences, whether expressed or inferred. Partha Anbil John Moran Success for providing physicianspecific selling guidance to reps through APLD can be measured by changes to new patient starts,switching levels,and patient adherence. In addition, the strength of the physician relationship can be measured and attributed to reps being more informed about the physician context. In our experience, reps who are active users of such guidance achieve prescription growth above the national average. PARTHA ANBIL IS ADJUNCT PROFESSOR OF MARKETING,FOX SCHOOL OF BUSINESS AND MANAGEMENT,TEMPLE UNIVERSITY, AND FORMERLY SENIOR PRINCIPAL, IMS MANAGEMENT CONSULTING. JOHN MORAN IS DIRECTOR OF STRATEGIC PLANNING,MANAGEMENT CONSULTING AT IMS HEALTH. PHYSICIAN MESSAGING Mass Customization USING ANONYMIZED PATIENTLEVEL DATA TO DRIVE PHYSICIANSPECIFIC VALUE W of 78 J un e 2 008 PharmaVOICE PV0608 Layout FINAL2 5/20/08 12:47 AM Page 78 This method follows from knowing the customer well enough to establish a dialogue and foster a bond between the rep and the individual physician, allowing the rep to bet ter detail interactions based on each physi cian’s profile and preferences, helping cus tomerfocused detailing to become second nature for the sales team. VIEW on physician messaging The benefits of delivering engaging mes sages and materials to welldefined segments of the physician and healthcare communities, includes: . Increased control over the duration of the rep/physician interaction; . Improved integration of clinical and mar keting content related to physician special ties and interests resulting in greater satis faction and loyalty toward the brand and/or company; . Better implementation related to physi cian segmentation; and . Improved collaboration between sales and marketing disciplines within the organiza tion. The process, once started, becomes selfsus taining, enabling market research to quickly gather feedback to analyze rep success. This, in turn, provides insight into the customer that ultimately drives more effective sales interac tions in the future. And, as prescribers benefit from more personalized service, they become willing to provide new information about their situation and needs. INSIGHT INTOTHE PHYSICIAN PRESCRIBING PSYCHE Clearly, if pharmaceutical reps are to understand the context surrounding physi cians’ prescribing behavior, they must have insight into the physicians’ practice character istics, their patterns of behavior, and their apparent predispositions toward treatment alternatives. But how can pharma companies improve their ability to understand physician behavior? Creating customized messages for distinct physician segments requires the use of more insightful customerlevel data. Three data sources in particular enable more impactful custom messages: . Anonymized patientlevel data (APLD); . Managed care influence metrics; and . Physicians’ desired value (customer value metrics). APLD captures encounters by individual patients with the healthcare system and includes details on prescriptions, diagnoses, procedures, physician visits, hospitalizations, and lab tests. Patients are assigned a deiden tified number to maintain their anonymity; each time they interact with the healthcare system their experience is recorded. Longitu dinal patientlevel data go one step further by specifying which patients — via deidentified numeric codes — get which therapy from which physician, providing improved granu larity. There are numerous applications for longi tudinal patientlevel data in the pharmaceuti cal industry, such as measuring compliance Manufacturers have come a long way since Henry Ford declared:“People can have the ModelT in any color, so long as it is black.”Many books and articles have chronicled the evolution of business competition from mass markets to markets where consumers are given a unique end product when,where,and how they want it. FIGURE 1: DIMENSION OF PHYSICIAN CONTEXT . Physician treatment regimen . Line of therapy preferences . Physician adoption rate . Perception of insurance coverage SITUATION Who is the customer PATIENT Who does the customer treat PRACTICE SETTING Where the customer is . Patient type (as defined by the disease) . Demographics . Product preferences/Understanding . Decision maker/Caregiver status . Large or small group . Affiliations to hospitals and clinics . Presence of a KOL FIGURE 2: FUNCTIONAL SUPPORT FORMASSCUSTOMIZATION ACHIEVING (PROGRAM) REQUIRES THE ABILITY TO DELIVER The right messages To the right customers Through the right mix of channels At the right time/frequency Marketing Analytics and KPIs Maximize value of segmentation based on attitudes and responsiveness Key Customer /Event Management Accelerate adoption, understand competitive SWOT Field Force Effectiveness Focus reps on appropriate messaging to targets while collecting new insight Customer Interaction/ Contact Center Positively reinforce interested customers’potential behavior changes Data Management Accelerate availability of accurate, actionable customer insight Sales Administration Minimize nonessential distractions to focus field on core selling activities Content Management Provide consistent, reinforcing messages to associates and customers 79 PharmaVOICE J un e 200 8 PV0608 Layout PROOFS 5/22/08 11:38 AM Page 79 VIEW on physician messaging and persistence, developing treatment algo rithms, and tracking length of therapy. Newer and more advanced applications of these data include: . Identifying physician influences; . Quantifying spillover from hospital pre scribing to retail prescribing; . Measuring the effectiveness of directto consumer/directtophysician campaigns; . Sales forecasting; and . Salesforce sizing, alignment, and compen sation. Managed care influenced metrics, which score the physician’s ability to write reimbursed products, given the degree of prescribing con trol exercised by the managed care organization, are a second data source that enables effective messaging. Messages can be tailored to physi cians who inaccurately believe that certain brands are not reimbursed. Similarly, managed care data can be used to identify physicians who are more likely to prescribe products that have relatively lowmarket access. Customer value metrics are an additional data source that enables personalized messag ing. These metrics, developed by IMS, assess the strength of the relationship between rep and physician and identify factors that physi cians value, enabling highly targeted, cus tomerled interactions. THE PROCESS OFMASS CUSTOMIZATION Insights gained from APLD about a physi cian’s prescribing habits — switching rate, adoption rate, use of concomitant therapy — apparent treatment preferences, and practice population can be used to redefine the pharma rep/physician interaction. The combination of precise market segmentation, new salesforce technologies, and improvements to the exist ing selling process help companies ensure that messages are customized and synchronized to the physician’s context. Through mass customization, the physi cian market can be segmented along any num ber of critical prescribing behaviors or events by product, market, or therapy area, and time, including: newtobrand starts (N2B) high lighting heavy prescribers important to the brand; new therapy starts to give an indication as to where a brand’s total prescription volume is headed; and continuing therapy. From this, matching rules can be used to determine which message should be given to which physician, enabling the sales rep to cre ate a personalized sales experience with mes sages that are relevant to the information needs of each physician. Technology also exists to provide reps with physicianspecific selling guidance that can be refreshed as things change in the marketplace. These metricbased alerts give reps guidance on what actions to take based on a prescriber’s situation. For example, a sales representative might receive a message that a particular physician’s new therapy starts are suggestions for an appropriate selling resource, such as: delivering a particular core message; connect ing the physician to a local key opinion lead er; asking a probing question to understand the reasons for the dropoff in prescribing; or providing emphasis around a core visual aid. MEASURING SUCCESS Success for providing physicianspecific selling guidance to reps through APLD can be measured by changes to new patient starts, switching levels, and patient adherence. In addition, the strength of the physician rela tionship can be measured and attributed to reps being more informed about the physician context. In our experience, reps who are active users of such guidance achieve prescription growth above the national average. Not coincidentally, active users of such physician insights and direction also: . Report an improved understanding of how to impact prescribing behavior; . Assert that they can engage in more pro ductive dialogues with physicians; . Believe alerts help them respond quickly and decisively to changes in market trends; and . Confirm that alerts maximize their time with prescribers, enabling them to deliver more valueadded messages. Implementing an effective alerts program requires the input and cooperation of numer ous functions within the organization. (See Fig. 2.) And, several factors are critical to the suc cess of sharing monthly alerts with the field force, such as: . Having sufficient time to assess perfor mance (usually four to six months for changes in prescribing behavior to be detectable). . Close collaboration between the brand team and sales leadership. . Use of qualitative and quantitative metrics to assess the success of a field alerts pro gram for delivering the expected return on investment for the organization. . Positioning of alerts as recommendations for use in key situations. . Coaching of reps on messaging use and demonstration of benefits, as well as com municating positive results. In executing field messaging, the identi fied outcomebased success metrics at both the strategic and operational level can be used. Strategic topline success metrics: . Comparison of TRx share increase between test and control territories. . Comparison of N2B Rx increase between test and control territories. . Comparison of switch script increase between test and control territories. Operationallevel success metrics: . Number of calls required to produce a change in prescriber behavior. . Frequency of refreshes required to prevent staleness of message, which could result in marginal diminishing returns. . Willingness of reps and district managers to use and see value in alert messaging. . Ability to respond rapidly to changing market trends. Mass customization offers an organized, costeffective means of delivering varying messages to different prescribers — without overwhelming the salesforce. It could be the industry’s answer to coping with limited sales resources, restricted access to physicians, and reduced credibility of sales reps. By using APLD to understand each physician’s practice, companies can ensure that their interactions with physicians are relevant and thus offer the kind of value that will forge longterm rela tionships while driving brand loyalty.# PharmaVOICE welcomes comments about this article.Email us at email@example.com. Creating customized messages for distinct physician segments requires the use of more insightful customer level data. Three data sources in particular enable more impactful custom messages: . Anonymized patientlevel data (APLD); . Managed care influence metrics; and . Physicians’desired value (customer value metrics). Research shows, for example, that emphasizing select product attributes and clinical data based on physicians’ real interests delivers higher perceived value and physician satisfaction. 80 J un e 2 008 PharmaVOICE PV0608 Layout FINAL2 5/20/08 12:47 AM Page 80