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Managing constant pharmaceutical sales: Kick-starting prescriptions

Managing constant pharmaceutical sales: Kick-starting prescriptions

A cursory glance at the sales figures may not reveal any obvious reason for the plummeting sales. Why should the sales team, which has a good hold over the market, lose control even when the competition has not changed? Has it got anything to do with a doctor’s or MR’s presence or absence?
By Dr Rajan T D, Pharma Consultant & Practising Dermatologist |

Once a pharmaceutical designcompany sets up a sales promotion team comprising a Zonal/Regional Manager, Area Manager and Medical Representatives (MRs), the regular methods of drug detailing and building rapport with physicians are finalised. The team is trained to understand its mix of products and the expected focus brands of the season are identified. In most cases, companies which have the right mix of products at the right price do well if the sales team has understood physician preferences and the degree of competition involved.
General practitioners and consulting specialists who find the brands genuine, start prescribing, once the brand names are committed to memory. Depending on the efficacy, its ease of availability as well as the performance of the brands in the market the sales graph rises. Some of these go on to become market leaders. Over the years, the sales graph continues to soar even if the field sales representatives become a little lax. Major national and multinational pharmaceutical companies in particular hold a good sway over their brands due to their professional approach as well as superior sales promotion techniques.
What causes the sudden plummeting in sales?
Pharmaceutical factors
There are several reasons for this situation. The common factors are usually related to attrition among field sales representatives’/area managers and administrative problems with production/distribution of brands. When field staff resigns, the local chemists and distributors are left unattended. Physicians do not get regular reminders of certain brands and the brand slips away from his/hermemory.
These difficulties are similar to sales issues in other consumer markets and should be tackled with better management skills and ‘human’ relations with the various strata of marketing staff. Providing better working conditions, higher incentives and providing a healthy atmosphere to the staff allowing them to thrive are the main methods of retaining talented MRs and managers and getting a better output from them.
The absence of the MR from the field for prolonged periods creates an atmosphere of uncertainty about the availability of specific brands. This allows the physician to prescribe competitor brands, whose MRs have been making regular visits to the doctor. Similarly, if the MR is regularly visiting but the brand in question is unavailable for prolonged periods, the physician is forced to switch brands and this about turn may be irreversible even after his ‘favourite’ brand returns
to the market.
Physician support
It takes time for a busy doctor to start prescribing a new brand. However, after the initial months of its launch if he finds that his patients increasingly find that drug effective and meet his requirements, the physician’s faith in the brand rises.
Over some time, the brand is well entrenched in the physician’s pen and the visiting MR has very little to do but to show his face and ensure that things go on smoothly.
Occasionally, when the physician is away from the clinic for long periods, he or she may lose continuity and the memory of some of the recent brands may slip away. Discontinuation in practice or breaks in the clinic occur due to various factors:
Winding up
Very senior physicians may develop sudden illnesses making them unable to continue their practice. In such a case, a locum doctor may be appointed or the practice may be handed over to a younger physician. Although the new doctor may take prescribing tips from the senior, he may not necessarily adhere to the brand preferences of the original physician. Companies that have been receiving massive support from such clinics tend to face major brunt of the loss.
For the pharmaceutical company, the new physician could be a goldmine due to the ‘running’ nature of the clinic but to get the physician to prescribe its brands is an all new ball game. Only once this hurdle is crossed successfully, can the brand regain its glory. If the sales team manages to convince the new doctor to prescribe its brands then they have the added advantage of having two supporters when the regular doctor returns to practice!
Health issues
Physicians themselves may suffer or have ailing parents battling major illnesses which force the former to stay away from clinics for extended periods of time. Family members on dialysis, chemotherapy, ICU admission, disability, etc preoccupy the physician with repeated visits to hospitals. This interrupts their thought processes even while they are in the clinic.
Maternity leave
Young lady doctors who have built up a healthy practice in the late twenties and early thirties may stay away from clinics for prolonged periods when they are in the family way. While most women would like to continue to practice till almost the eighth month of pregnancy, like those attending to office work, physicians may be kept away earlier by the family to avoid the risk of catching unwanted infection from their patients. Like in the case of the elderly or ailing physician, the locum then decides on what is prescribed to his patients.
Sabbatical leave
Newly evolving surgical fields like organ transplant surgery, robotic surgery, ‘keyhole’ spine surgery etc are increasingly being performed in the West and local experts go abroad to learn these techniques or sharpen existing skills. Dermatologists and plastic surgeons from the interiors visit training centres in major cities or the US to learn laser surgery. Physicians, too, seek fellowships from universities in Europe and America to enhance their academic knowledge. Most of these courses last for periods ranging from 6 weeks 6 months. The clinic is usually run by a locum doctor during the interregnum.
For the pharmaceutical company whose brand the physician supports very well, it should be a matter of great concern when the doctor is away for a long period. Some of the major factors, which create a drop in his sales figures are:
Regular patients of the physician who are aware of his non-availability tend to find alternative physicians during the period if the clinic remains closed. Even if there is a replacement ‘locum’ he or she will have fewer patients to treat. The number of prescriptions will consequently plummet.
The interim doctor who runs the clinic may not have the same drug preferences as the senior doctor. Even if the same drugs are actually prescribed in large numbers by him, the brands chosen could vary.
Once the regular physician returns to the clinic after a long break, it will take some time for his ‘crowd’ to return. This will continue to hit the brand sales.
The physician on his return to practice may find newer brands to prescribe owing to his recent training that he has undergone. He may change the nature of his practice and may focus on a different segment of patients.
A physician retuning after a maternity break or after recovering from an illnesses may lose grip on some of the brands she was prescribing earlier. Competitor brands which are now introduced by newer MRs may find favour if the latter pitches its promotion well.
The physician will require a ‘cooling’ period of a few weeks before the practice picks up. His patients of too may stay away or find another physician to treat them. For the pharmaceutical manager whose eyes are on the sales graph, this can be a setback. Moreover, the physician may not develop loyalty to the earlier brands if he is now influenced by some competitive brands. This is a major challenge to the MR and his bosses to try to get the physician back on his track!
The pharmaceutical manager has role to play in moulding the prescription of the locum doctor. Besides, he has to ensure that when the original physician returns after the six or twelve month break, the same support is provided to her favourite brands as before. When the MR encounters a doctor who has just returned from a long break, he has to redouble his efforts to get the physician to select his brands. If the doctor is a senior person with a high ‘market value,’ the representative should bring the Zonal Manager and the National Marketing Manager for sweet talking. Just like a new launch is planned very meticulously, the efforts to bring a physician returning from a holiday also requires sufficient manoeuvring so as to ensure that the company gets the same support it used to get earlier.
Dr Rajan T D, Pharma Consultant & Practising Dermatologist
rajantd@gmail.com

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