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SALES FORCE EFFECTIVENESS SUPPLEMENT

Call Planning that Delivers on
Brand Strategy
New Information Sources Determine Prescriber Value
BY MATTHEW LINKEWICH AND JAY MARGOLIS, IMS HEALTH

The challenge of optimally reaching physicians with resonating
messages is an involved process. Each stage along the way is
dependent on the precision of the one before. Creating a call
plan may be a rather mechanical last step, but its impact hinges
upon the thinking that has gone into the overall strategy — most
particularly in the segmentation and brand strategy phases much
further back in the overall process.
THE CASE FOR CHANGE
About 75 percent of pharmaceutical companies are
still determining which physicians they’ll call on —
and how often — just as they did ten years ago
when the name of the game was “reach and
frequency.” Even in a time of increasing financial
pressures, thinner profit margins, a migration to
specialty products and physician backlash against a
waiting room full of pharmaceutical reps, companies
still continue to allocate their sales resources on the
basis of physicians’ prescribing volume and market

share alone.With leadership focusing on improving
field force productivity, it only makes sense to
rethink the way sales efforts are directed.
For a product to have the best opportunity to
win in the marketplace, there must be a seamless
progression from market intelligence and analytics
to brand strategy and finally to sales execution.
When a call plan is developed narrowly on the
basis of physicians’ prescription volume and brand
market share exclusively, the resultant plan is not

not simply update it. constellation of prescribing behaviors and attitudes are conducive to supporting the brand goals. One sure sign that it’s time to overhaul the call plan. being downstream from segmenting and identification of prospects. In many cases. . Call planning. Other triggers include a major market event (loss of exclusivity). As such. but also can be widely inefficient given unseen or unaccounted market pressures such as managed care. Reps’ success in the field hinges on how well companies identify the physicians that hold the most potential for a brand — however that potential is defined. use of these additional insights has aided representative inputs to the overall process.only a divergence from the brand strategy. in many cases raising their satisfaction with the insights delivered by the home office. brand strategy should be continually reevaluated and therefore the call plan should be revised to reflect the new marketing approach. is totally dependent on the thoroughness and accuracy of these earlier steps. Even without involving primary research to uncover physician attitudes. let’s review the information components currently available from secondary data sources for segmenting and selecting physicians before we cover the call planning process itself. segmentations based on secondary data sources can identify — and subsequently the call plan can direct reps to — physicians who: • Support the brand. is if sales efforts are not gaining any traction in the marketplace. IDENTIFYING THE RIGHT PHYSICIANS The secret to a good call plan is a highly refined prospect list. Companies that are in the habit of viewing physician potential through the rather restrictive lens of prescription volume and share can also benefit from developing new call plans derived from more sophisticated market segmentations. And the secret to a good prospect list is choosing the right variables upon which to segment the physician universe in the first place. and in the case of a new brand are early adopters of new treatment alternatives • Respond positively to promotion • Generate true new business (as opposed to repeat prescriptions) • Frequently switch patients to/from the brand • Treat patients fitting the product’s profile • Have a greater patient compliance and persistency than the market average • Are in a position to prescribe the product from a managed care perspective • Follow the product’s dosing guidelines • Stand to become more valuable to the brand over time • Support the right mix of products for the company’s portfolio goals Fortunately. It only stands to reason that reps’ success in the field hinges on how well companies identify the physicians that hold the most potential for a brand — however that potential is defined. the call plan directs reps to those physicians whose practice characteristics. there are solutions available to help companies capitalize on these additional insights in their call plans. pharmaceutical companies should be refreshing their call plans about twice a year. When properly conceived and configured. WHEN TO REFRESH CALL PLANS In general. representatives will find themselves executing an errant plan that does not maximize their full potential. For that reason. change in the company’s product portfolio and a change in a competitor’s product mix.The bottom line is that as products advance through their lifecycle and market dynamics shift.

173 6.683 1.055 10.785 1.While this 8 2 1 5 15 97 483 705 196 1.This will become clear as we move through the other information components.156 13.874 1.663 771 363 150 25 1 55. Therefore.566 3.464 346 28 4 6.115 5.828 970 161 7 166.This rich information source can be leveraged to hone in on physicians whose prescribing behaviors and practice profile are compatible with brand strategy.382 2. all are readily available and provide insight into the brand potential that resides within each physician’s office: STANDARD PRESCRIBING VOLUME AND MARKET SHARE METRICS Measures of what physicians currently prescribe are decidedly important in determining a physician’s value to a brand.175 2.530 based on TRx deciles analysis is frequently conducted by many larger brands.746 2.462 1.937 8.203 365 49 1 1.310 were TRx decile 5 or higher While the industry is not yet broadly using many of the behavioral information components on the following list. only a few progressive companies have ventured to use anonymized patient-level data (APLD) in segmenting physicians.924 7.801 14 60 111 192 429 762 1.927 3.394 98 279 541 939 1.546 600 85 2 395 957 1. • New to Brand Prescriptions Longitudinal analyses of physician prescribing can filter out new prescriptions that continue or restart therapy.193 docs in top 3 deciles. physicians do not respond uniformly to marketing promotion.Deciling prescribers only on prescriptions that are “in play” can lead to different physician selection decisions when compared to deciling prescribers on market TRx volume TRX Decile New to Brand (NBRx) Decile 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 148.109 14. But they should not be the only metric used to evaluate physicians (as they are for the vast majority of companies).093 21.852 79.028 3 3 17 65 109 450 1.The resulting measure of New to Brand prescriptions (NBRx’s) serves as an important indication of which physicians are generating the most true new business for a brand — an especially .683 2.391 3.692 2.162 2.614 3. PROMOTIONAL RESPONSIVENESS Similar to consumer buying behaviors.027 2.064 10 1 30 117 477 625 213.231 1. leaving only the volume of prescriptions generated for patients who have been prescribed a brand for the first time. 1.125 16.249 5.336 972 141 11 4.126 317.382 28. it is rarely infused into the resource allocation and call planning process.649 11.096 NBRx results in more focused physician selections with 3.770 10.042 515 62 2.504 9 1 1 5 15 161 505 376 1.357 601 166 28 7.022 1.197 1.419 1. compared to 6.928 36. it is important to delineate those physicians that value representative detailing activities by longitudinally tracking call activity and physician prescribing behavior. PHYSICIAN PRACTICE AND PATIENT CHARACTERISTICS FROM APLD To date.445 3.266 More than half of all TRx deciled prescribers did NOT initiate or switch therapy.

• Patient Compliance and Persistence Patient compliance and persistence varies dramatically from one physician to another. When deciles are created based on the number of prescriptions truly “in play” compared to using total prescribing volume. • Product Switching It may be valuable for companies to look beneath new prescription volumes to understand what percentage of a physician’s prescriptions that initiate therapy actually represent switches to or from a given product. In certain drug classes. • Patient Age and Gender Depending on the therapeutic area and the product’s attributes. such characteristics of a physician’s patient base may be important in determining the best physicians to reach.086 high potential prescribers Segmentation Variables Prescribing Universe: 317. a company marketing a therapy delivered via a transdermal patch may want to concentrate its sales efforts on physicians treating patients who are predominantly over age 65. Compliance and Persistency 32.234 Physicians in NTB Decile 0-1 Dosing.862 Physicians in NTB Decile 2-10 Responsiveness % New to Brand Adoption Behaviors Excluded 246. For instance. brand managers can actively target those areas with higher persistency rates to understand prescribing dynamics which ultimately can be used for the development of promotional messaging in other areas of the country.096 Physicians Market Volume & Product Share High Potential Segments S1 S2 S3 S4 S5 S6 Portfolio Value Included Managed Care Favorability 70. the call plan can look dramatically different.086 Physicians in 6 Segments Physician Lifetime Value important piece of information for products treating a chronic condition in a market where brand loyalty is high. • Dosing Particularly for products with dose-dependent pricing. Companies with a product for a chronic condition in a market in which persistence is generally low would want to identify those physicians whose patient base is above average in this area. . Additionally. the price difference associated with various doses can be hundreds of dollars per patient per month/prescription. it could be valuable to identify those physicians who are dosing appropriately.This is particularly beneficial if brand strategy is built on the premise of competitive detailing.Bringing further segmentation variables to bear produces six segments and identifies 32. atypical anti-psychotics for example.

commercial insurance. doing so is impractical. the sales force cannot hope to support the brand strategy with any degree of precision. PORTFOLIO VALUE A physician can easily be a valued prescriber for one brand in a company’s portfolio and not for another. physician profitability based on their method of payment dynamic (cash. when managed care “level of control” is factored into the physician segmentation.The next is to perform a “work load build-up” to determine the capacity needed to reach the most valuable physicians and understand how that compares to the current sales force constraints in place. AFFILIATIONS AND INFLUENCE A physician’s membership in a group practice or degree of influence over other practitioners may When a call plan is developed narrowly on the basis of physicians’ new prescription volume and brand market share exclusively. Although many companies have the ability to push managed care information out to sales reps. which to exclude. The first step is to plot the physical location of all prospects to see how they are distributed among existing territories. A computer program then tests various scenarios. Another option would be to consider the profitability characteristics of physicians in the marketplace.While a physician may not generate many prescriptions directly. LIFETIME VALUE OF PHYSICIANS It may be worthwhile to calculate and consider the anticipated lifetime value that a physician represents to a brand. Knowing this is important when trade-offs have to be made between finite resources. it is taken into consideration automatically in creating call lists. to determine the optimum number of calls for each physician and the best order of the product details. calls made to that physician will not be effective from an ROI perspective. Some physicians who have a low portfolio value today may be on a trajectory to become a valuable portfolio prescriber in a matter of a few years. When a physician is not in a position to prescribe a company’s product because of formulary restrictions. without reps having to worry about it. all physicians in the universe are assigned a “score” based on their estimated value to the brand. also be valid criteria for segmentation. how many calls should be directed at each individual and in what order products should be discussed. territory by territory. Depending on brand strategy. retain and make use of information about formulary status in relation to individual physician practices. Reps can become overwhelmed trying to access. Depending upon where a product is in its lifecycle and the company’s pipeline. Now.MANAGED CARE AFFILIATIONS Few would dispute the importance of understanding the role that managed care policies and affiliations play on a physician’s prescribing. CALL PLANNING MADE EASY Following the segmentation exercise (which ideally was conducted on an array of variables). Medicaid. Medicare Part D). he or she may indirectly influence many high prescribers.They are then segmented based upon their overall portfolio valuation. could be considered so sales representatives spend time in physician segments where the pharmaceutical company’s bottom line is maximized. it may make sense to identify these physicians and cultivate relationships with them today. It is important at this stage to look across the portfolio and to make trade-offs according to what will be most beneficial . However. it’s a matter of determining which segments to include.

. this will lead to a greater ability to effectively implement brand strategy and drive portfolio performance. the more confidence they will have in their new direction. Sales for the company’s product were relatively flat. once a new initial filtering process and segmentation parameters were applied to the universe of physicians the prospect list dropped to a much more manageable 32. Given its market situation. it might explain that one physician who is a high volume prescriber is nevertheless to receive few calls because of his or her managed care status.000 in the universe to approximately 71. For each scenario.to the company overall. The company’s initial volumetric deciling exercise reduced the number of prospective physicians for their product from more than 300.000 — still too many for the company to reach given the size of its sales force. Ultimately. how often and in what order to detail products. the plan might indicate that a physician is particularly responsive to promotion and that is why he or she is to receive a higher volume of calls. the computer model will estimate the expected impact on sales associated with each level of effort. physician access) • Refresh the data every six months and make ongoing refinements to the plan as market dynamics change help in creating a call plan that would allow it to compete effectively against much larger companies. product by product. It can also help reps adjust to the changes — sometimes dramatic — that they see in their call plans when factors other than prescribing volume and share are taken into consideration. Or. individual call plans can also indicate the reasons behind the instructions for each physician. it could specify that a given physician frequently switches patients from the company’s brand.To find the best approach for the company. While not all companies want to share this level of detail with reps. The more reps understand about why decisions were made. A PRIME EXAMPLE One company operating in a chronic therapy market with a relatively small sales force needed STEPS TO CREATING AN EFFECTIVE CALL PLAN • Start by segmenting physicians along variables that relate to your brand strategy • Create a workable prospect list from the segmentation • Generate a call plan from the prospect list that makes the best trade-offs from a resource and portfolio standpoint • Determine how much information you want to share with reps about the reasons each physician is on the call list • Educate reps on the strategy behind your new call plan • Give reps an opportunity to make adjustments based on their field experience (for instance. Or. the analysis must take a holistic approach to evaluating the portfolio mix and promotional allocation. the company realized that its success depended upon capturing market share within physician’s offices that may not be on the radar screen of its larger competitors. Depending upon how much information the company wants to share with reps and on the capabilities of its sales force automation system. However.The new plan may ask them to forego calling on physicians they’ve always regarded as their top priority and suddenly begin calling on relatively unknown physicians.000 physicians. A BLUEPRINT FOR FIELD SUCCESS The resulting call plan provides each rep with a road map that specifies which physicians to call on. only 11 percent of its market growth was coming from new patients and persistence was low across the class. For instance. it is potentially important because the reasons for channeling effort to two physicians in the same decile might be completely different.

Sales & Account Management Consulting IMS Matt Linkewich and Jay Margolis are Engagement Managers in the Sales & Account Management Consulting practice at IMS. helping pharmaceutical and biotech clients of all sizes develop and execute sales strategies designed to maximize brand and market performance. MONEY ON THE TABLE Traditional volume-based call planning has been utilized for years due to its simplicity and ease of implementation. The real issue is the money on the table. . better overall use of promotional resources or through sales increases.imshealth.com respectively. Sales & Account Management Consulting IMS Jay Margolis Engagement Manager. this has come at the expense of brands’ ability to capitalize on their strategy and positioning. • Matt Linkewich Engagement Manager.imshealth.com and jmargolis@us. the use of these new information resources can provide a more precise. product share. Physicians were selected for in-person promotion based on their new to brand volume. Matt and Jay have developed and delivered mission-critical solutions to clients in the areas of customer segmentation. informed and focused call plan.Whether it is sourced via potential expense reductions.The reasons for channeling effort to two physicians in the same decile might be completely different. resource optimization. promotional response level and managed care influence. the sales force. Their collective background includes nearly 25 years of pharmaceutical industry and consulting experience. However. They can be reached at mlinkewich@us. incentive compensation and call planning. Companies that fail to take advantage of the new information resources available are ultimately sacrificing brand success by not properly equipping their largest promotional investment.

So you can make changes with minimal risk. FOR MORE INFORMATION. powerful allocation models and deep knowledge of local markets will identify the best allocation for you. And our 1.IS IT TIME TO RETHINK THE SIZE AND STRUCTURE OF YOUR SALES FORCE? THE BEST WAY TO KNOW.imshealth. All Rights Reserved. We have a point of view.com or visit www.com/ask ©2007 IMS Health Incorporated or its affiliates. Our global information sources capture the facts. and consulting expertise to master the market. email precisionsalesforce@us. Only IMS has the information. Our analytical tools extract their meaning. analytics. Our detailed prescribing information. . And the assets and expertise to optimize your sales resources with precision.000 business consultants deliver solutions that are based on evidence and forged by experience. ASK IMS. And make the most of every sales call.imshealth.