Less detail, more retail

The prospects for pharma companies to develop a commercial trade channel across Europe could hardly be greater.

Few headlines capture the essence of a subject as succinctly as that donning the latest report from A T Kearney on the commercial trade channel (CTC) opening up for pharma companies across Europe. But while compelling arguments can be made for engaging in strategies that involve less detail and more retail, there remain a lot of grey areas for companies that want to take a more commercial approach.

Pablo Moliner, a partner in the company’s Madrid office, told a breakfast meeting in London on March 21 that a more directly commercial approach can increase sales of mature drugs by between five and 25 percent. The wide range in potential gains stems from factors such as the kind of drugs, the different opportunities presenting from the varying remuneration arrangements for pharmacists across Europe and the fact the CTC involves relatively new thinking for pharma.

But he was confident the gains were there and growing. “The CTC will grow significantly,” he said while pointing to three main drivers. One is the emergence of new distribution models as pharmaceutical wholesalers have consolidated not just nationally but regionally. In 2010, the top three wholesalers in Sweden, the UK, France, Australia and the US had nearly 90 percent of the market between them.

The second major driver happens at the point-of-sale with the transformation of the pharmacist from dispenser to healthcare provider and the increasing trend of pharma companies to implement their own direct distribution models to thwart both counterfeiters and parallel traders as well as forge a closer relationship with the retail pharmacist.

The third driver is the better informed patient who, especially in the US, is expected to foot a larger share of their healthcare costs through higher co-pays.

He then outlined the main areas where a pharmacy channel strategy can increase drug sales via, for example, simple measures such as ensuring a company’s product is actually stocked and if prescriptions are written by international non-proprietary name (INN) as payers increasingly insist then improving the chances of that product being dispensed.

Pharmacies can also expand the patient pool, Moliner said, by increasing diagnosis rates and bolstering patient adherence. “There is not a lot the pharmacist can do with oncology drugs,” he adds saying the scope lies in the large primary care markets such as chronic obstructive pulmonary disease (COPD), anti-diabetics, vaccines and cardiovascular disease.

But pharmacy owners vary enormously within a country and between countries, falling within three main behavioural types:

– The traditionals, the typically independent pharmacy owner for whom income stability and business continuity are the priority.

– The health professionals who fulfil all the requirement of the traditionals but who are also keenly interested offering pharmaceutical care to their ‘patients’.

– The traders where profit maximisation is key and healthcare per se is of less importance.

Pharma’s challenge lies in knowing how to work with pharmacists. The report highlights how Pfizer has teamed up with the pharmacists’ association in the Spanish region of Navarre to train members in active dispensation to patients addressing topics such as indications, interactions, adverse effects, patient monitoring and compliance. In France, meanwhile, 30,000 of the country’s 47,000 pharmacists subscribe to a wealth of information on MSD’s online portal, Univadis, in exchange for their professional and contact details. And the Spanish company Almirall now offers online courses to help pharmacists and their staff improve their management and commercial skills.

Moliner stressed that pharmacists need training, recognition as critical agents in healthcare and a sense of belonging. “They don’t like pilots,” he said adding that they tend to only get involved in projects that can be scaled up. And they don’t want to work with lots of different companies, which presents first-mover advantages for companies that can move resources away from traditional detailers to the kind of pharmacy sales reps that can build real collaborative working relationships with pharma companies.

Much of the discussion following the presentation focussed on adherence and, specifically, the lack of information on how anyone, pharmacists included, can make significant inroads into how rates averaging out at just 50 percent can be raised. But in disease awareness initiatives and improving diagnosis in areas like COPD and diabetes where the patient pool is estimated, again, at just 50 percent of the potential, extra sales can seem more viable. And there are also opportunities for pharma-pharmacy collaboration in disease management, medicines therapy management and immunisation.

The scope in this space is still relatively untested but with payers and evidenced-based medicine curbing the power of doctors to prescribe as they want, any move from detail to retail would seem to have the potential to pay real dividends.


Less detail, more retail



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