eyeforpharma Barcelona day one blog

As day one of the eyeforpharma Barcelona event takes place, Paul Tunnah provides regular updates, sponsored by IMS Health, on the sessions and issues discussed.

View the summary from day one here

Day one - 18th March 2014

17:45 CET

That's it for day one at eyeforpharma Barcelona. I hope the live blog has been useful and hope to see you back tomorrow morning at 9am CET for day two. Thanks for reading!

17:40 CET

Petersen says true customer-centricity is not about the blank sheet, but about stopping and adapting when you are not giving the customer what they want. He sees this as very common with, for example, travel websites or sites like Amazon, that adapt what they present to you based on your preferences. He concludes by asking - are you willing to stop pushing branded messages to doctors who won't want them? Or are you willing to tell doctors when they shouldn't use your product?

17:31 CET

Mark Petersen (Boehringer) talking now in the final session on multi-channel marketing. He states that pharma is very product, not customer, centric, but so are many great companies, e.g. Ford (any colour as long as it's black) and Apple - which he thinks took the Ford model of build product, sell it and spin it round. However, customer-centricity has the same aim as product-centricity - successful, profitable business. But his deeper point is that the customer is not always right so cannot develop great products just by listening to them (e.g. Henry Ford and people wanting a faster horse). Definitely some truth there. 

@Haider_Alleg tweets: If you can't change in your environment you disappear - pharma dinosaurs? #e4pbarca

17:17 CET

Nilsson expands on how to enable leaders to drive change and specifically what they have done in Biogen Idec, where they have implemented games to connect the leaders with other team members and immerse them in how to change / win. Once again proof that gamification techniques are extremely powerful and not just about iPhone / iPad apps. However, he also highlights the dangers of the 'valley of despair' where change becomes painful and where leaders need to keep driving change forwards. Great closing quote about change - "when you think you're finished, you've just started".

17:07 CET

Mikael Nilsson (Biogen Idec) now talking about how to drive change in pharma and highlights how we are creatures of habit. Apparently, only 2% of our thoughts each day are new, 98% we have had before. Change is not therefore natural and requires several things - urgency, leadership, vision, winning (early success) and making it stick (removing obstacles).

16:57 CET

Hjelmsoe preaches that technology can enable a highly tailored approach but at a cost that is more akin to bulk commoditised sales and marketing. Certainly there is something compelling about empowering the rep for better interactions, but probably also needs shift in KPIs away from simple quantitative metrics, e.g. call volume, and towards lower volume but more substantive engagement, in my view. Now conducting a live demonstration via an iPad, which is always brave!

@SpringerHealth tweets: MCM track - Agnitio -Technology allows for the best of both worlds: bespoke tailoring of campaigns at the mass production costs #e4pbarca

16:47 CET

Hjelmsoe: iniitally we have gone from paper to glass (detail aid to iPad detail), then started exploring closed-loop marketing but this increased the volume of presentations due to trying to capture information so a step back. The real challenge for pharma is now collecting information on customers in a non-invasive, simple way. He is quoting the example of the Obama campaign at the last US Presidential election as good big data use for tailored interaction (in this case with voters). The overarching message though is that pharma needs a mindshift towards empowered CLM, not restricted or controlled at a high level - empower the reps.

16:41 CET

Now back and sitting in on the multi-channel track. Morten Hjelmsoe, from Agnitio, paints a tough picture of access (or lack of) to doctors and the new information requirements they need - pharma must focus on individualised communication. Doctors don't want to be classed as types or segments and are having to react to informed patients.

15:00 CET

Mackintosh explains the rabbit in the headlights analogy for KAM. Some people will get 'run over', some will run away, but some will react in the right way and learn from it.

Heading into pharma-only workshop sessions, so live coverage will recommence at 16:30 CET. Meanwhile, you can monitor live tweets from the event via the pharmaphorum homepage: www.pharmaphorum.com

14:50 CET

...so Grunenthal moved away from KAM...but then back towards it and it's working much better for their second product. One key result is that they are no longer shouting messages at their customers, but enjoying genuinely constructive engagement. The challenges have not, and will not, go away completely but the company has learned how to deal with them. He feels that driving this change takes a long time as it involves changing fundamental behaviours.

Key lessons from Mackintosh: create your own vision of KAM (don't do it by textbook), secure support from all high level stakeholders, develop a fully aligned cross-functional implementation plan to break down silos and use new, creative ways to drive change. This means robust account plans / CRM, good learning and development teams, identifying internal champions and realistic timescales / success KPIs. KAM isn't built in a day - Grunenthal are four years in and probably half way to getting it right.

Finally, don't hide failures and do celebrate success!

14:41 CET

Mackintosh explains how the Grunenthal model of KAM based around MSLs, market access managers, pain sales managers and business account managers has remained the same, despite several ups and downs. We come back to the rose-tinted spectacles - people initially had really optimistic views of KAM at the start, but senior management did not really understand it and the four roles operated in a siloed way (e.g. hospital reps refusing to support on primary care products). In addition, the organisation was growing quickly so cracks started to appear and there was reluctance to push ahead. I'm guessing the story gets better...

14:32 CET

Allan Mackintosh following on to talk about his experience (positives and negatives) of key account management (KAM) implementation. Audience show of hands suggests pharma does see the real value of KAM but no-one thinks they have got it exactly right just yet. He shows images of rose-tinted (but broken) spectacles, a rabbit in the headlights and a rollercoaster - all of which reflect his experiences with KAM!

Tweet from @KayWesley: #e4pbarca why shouldn't companies monitor SM and respond in real time? Surely this is exactly what we should be doing?

14:26 CET

Dabbs delivering some key messages around agile technology and also ensuring the field force are involved / can provide input - an age old message that was certainly true ten years ago when I was working in sales and marketing effectiveness. The point is don't drive technology solutions onto reps, instead involve them so they see it as enabling them to do their jobs better. This can be forgotten when the focus is on how cool the technology itself is. Interesting to hear also how social media was used as an initial listening tool to flag areas to focus on for downstream implementation of the commercial program, e.g. compliance picked up as an issue and woven into messages. I suspect more companies are starting to do this than are actively talking about it.

Response to question around getting people to use technology - Aspen conducting extensive activities to ensure benefits are communicated and the WIIFM factor is explained to reps. Sales force effectiveness technology is only good if it is used by the reps.

14:18 CET

Gareth Dabbs now talking from IMS Health and explaining about a case study with Aspen - a southern hemisphere generics company. Cost per rep staying fairly consistent at circa 100 Euros per call, but efficiency (return) dropping and needs to be improved. Key account management was identified as an approach that could ensure right messages were delivered in an efficient way, linked to local-cloud technology tie up, with local being mobile device based CRM and cloud side being management analytics. Interesting that the case study is a generics company as their margins are smaller, which, in my opinion, often equates to tighter commercial processes than big pharma. I wonder if lower margin generics will lead pharma in effective technology implementation? 

14:11 CET

Crowther explains how technology can be used to enable pharma at every stage of the drug lifecycle - from R&D right through to late commercialisation, even though focus here often on the latter, plus elaborates on how some interesting things happening in the broader healthcare space here beyond pharma, which can be learned from. Interesting high level view from IMS Health on driving non-personal (e.g. text, apps) and personal (e.g. reps) interactions with social networking and devices / search engines sitting in between.

14:05 CET

Barry Crowther (IMS Health) kicks things off by stating that people don't want loads more information, but they do want digestible chunks that help them understand what is going on. First, a bit of background - more complex specialist portfolios, more healthcare stakeholders and more channels available so pharma got more complicated! Despite cutting costs, Crowther feels that external pricing pressure means more needs to be done - estimates $35-$36bn more costs to remove for the industry to maintain efficiency. New technology solutions can help but they are often piecemeal and not necessarily therefore the most cost-effective solutions.

14:01 CET

Back from lunch and sitting in on the sales excellence session, featuring IMS Health and Grunenthal...

12:23 CET

With apologies to Tyrone Edwards, am going to do an early summary and then find a socket to charge my weary laptop. His key messages: listen to your customer to tell you what your sales teams should be doing and recruit / coach accordingly. The focus has to be on people skills.

Lunch is at 12:30 CET and then back just before 2pm!

@garethdabbs tweets: Insight is key, or should be, to everything we are talking about - the key is a diverse range of sources and robust process!

12:19 CET

Different language being used by Edwards around pharma sales. Terms like the 'purchase experience' and 'customer journey' are more common to the B2C sector and his message is that pharma needs to think that way - sales teams must impact valuable information, not messages. Apparently there are 44 skills that make a difference to how this is practically implemented - yikes! Pharma does not currently hire versus these skills, so Edwards is calling for change in sales personnel that do not fit. Not sure any front line sales are here in Barcelona but they would be looking nervous right now. It is also about going beyond thought leadership into 'commercial insight'.

12:10 CET

Final speaker before lunch is Tyrone Edwards, formerly of Merck, covering what the right sales model looks like for pharma. He starts by explaining that some of the areas he could cover have already been covered, so he will focus more on the people side. Does pharma have the right people with the right skills? Edwards feels this has to be driven by customer feedback, not internal abstract strategy. Some research coming up... 

12:01 CET

Schmidt: First line managers are really important to enabling rep performance - they must themselves be performing and spend adequate time coaching their teams. Again, the message is to not reinvent the wheel, but understand the behaviours of your high performing reps and expand across organisation. Actelion has assessed this like a clinical trial, comparing good and bad (less good, if we're being politically correct) performing reps to analyse activities. Nice to see an equal focus on people skills versus process / technology - it's what you do with it that matters.

Summary: SFE has become more complex and holistic, spanning people skills and technology. Learn from success.

@NAllcock tweets: Reps/KAM are just a channel. They are vital but need to be part of a marketing mix. #e4pbarca

11:50 CET

Schmidt: commercial excellence is about aligning process and utilising technology better, but on the front line it is ultimately about improving the quality of interactions with customers. Lots of technology on show in Barcelona that is very focussed on that latter point - quality of engagement is definitely the key phrase. But also an important point from Schmidt being made about essentially not reinventing the wheel - Actelion 'went shopping' to assess and integrate existing best practices (within and beyond pharma) across different countries, then integrated into the right processes using the right technology.

11:44 CET

Christoph Schmidt now up and says sales force effectiveness is back, but then questions has it ever been away? A quick overview of Actelion being presented and excused as a pitch because it is definitely a company worth looking at in more detail. Organisations focussed on rare diseases hold a lot of lessons for other pharma, in my opinion. They tend to be very close to all their customers. 

@wilf66 tweets: #e4pbarca Initiatives should be like formularies: when you add a new one an old one has to go

11:34 CET

Wandelt clarifies that improved commercial effectiveness is not all about saving money. Sometimes it is about investing in certain areas / markets to increase sophistication provided it delivers increased value. Certainly a message that will be well received by providers who bring solutions that they know can help improve efficiencies, although the message is that they may not always be needed in their entirety across the entire organisation, so a modular approach is key.

His conclusions: flexibility, empowerment, governance and motivation are all important, but stopping doing the wrong things as you do new things and senior management buy-in to this is critical for success.

Note: updated times as was quoting GMT not CET, now corrected. More coffee needed...

11:23 CET

Good to hear Wandelt placing 'simplicity' as the number one priority around marrying together global alignment with local flexibility on commercial activities - complexity is the enemy of implementation. He is describing how people tend to fall into two groups - the 'locals' or the 'globals', with pharma swinging between these two groups as the leader over the years as anyone who has been through several reorganisations will know. His solutions involve better operations, governance and perspective. On 'perspective' Pfizer has measured what proportion of promotional materials developed are actually used - about 26% of materials account for 80% of usage. Welcome back Pareto! The first job is to not produce these 'redundant' materials in the first place.

11:14 CET

Back from coffee and Andreas Wandelt presenting on commercial effectiveness - specifically how new solutions are being brought to bear on the old problem of matching global efficiency with local specificity. He is quoting examples of different company operations on a Boston Matrix of globalisation (strategic alignment) versus flexibility, with the default being high flexibility but little alignment (everyone doing their own thing). Does pharma have any new solutions to this challenge? I guess we'll find out...

10:42 CET

Bergstrom concludes that the rate limiting factor with better innovation is access to data - it's like being stuck behind a slow lorry! But the only differentiation for new medicines versus generics is to be targeted and very specific, which requires data post-approval and from clinical trials. We will see more EU collaboration and close coordination between payers and regulators at this level, prior to local pricing. But the flip side of this is that governments must reward true innovation.

A short coffee break coming up and back shortly!

@AnneClare tweets: Regulators and payers are frustrated at lack of industry coordination around real world data. #e4pbarca

10:35 CET

Bergstrom favours the term 'precision medicine' over personalised medicine, with the precision of application increasingly being driven by real-world evidence(RWE) rather than clinical trial data. The regulators are watching RWE data very closely and both they and the payers are talking to EFPIA about post-approval studies, but there is currently frustration as there is little coordination here. This will change. My thoughts - expect to see regulators and HTA bodies blend together at some point in the future. Bergstrom highlights how the success of precision / targeted medicines depends on having the right tools to ensure they are working in the real world / being given to the right people - we are not there yet.

10:26 CET

Bergstrom reinforces how the aim, with serious diseases like cancer, is about ensuring people can live with the disease in a manageable way long term, not on immediate cures. A chart is shown detailing how pharma innovation has largely aligned with areas of unmet need, although some gaps in the CNS space, but the R&D model is evolving. More outsourcing to CROs etc. but now heading inot a new phase of collaboration, and he quotes the Sanofi R&D Head on saying 'pharma has to stop playing solo'. The Innovative Medicines Initiative is cited as an example of such collaboration. One key point from this - integration of payers (HTA) with regulatory experts in development - expect to see more of this.

10:19 CET

Richard Bergstrom from EFPIA now talking at eyeforpharma Barcelona. He starts with a plea that, among all the talk about patient-centricity and how pharma engages around new medicines, we should not forget the scientists and there are some exciting things happening in the R&D space. "A personalised medicine strategy is not driven by management consultancies, it's driven by scientists!"

10:13 CET

Dewulf - don't assume that talking to patient organisations is the same as talking to patients. It's a bit like expecting to understand what it's like to have children by speaking to friends with them rather than experiencing yourself (see below). Speaking to patients will not only tell you what they are doing, but also critically why. However, he does stress that a compliance process is really important when engaging directly with patients as confidentiality, adverse events etc. must be addressed. Also, unplanned versus planned patient engagement has different compliance rules.

His summary: Understand the process behind developing patient-centricity and know that insights are only useful if turned into solutions.

10:05 CET

We're into analogies with Greek tragedies from Lode Dewulf now, around how new ways of working are adopted. It ends with a 'Chief' being appointed who has no clue what to do initially. His point is to know this pathway is going to happen and it's OK - go through this with patient-centricity but you will eventually learn and get there, before he draws an analogy with having children. First, you know you want them, then you see your friends having them and know more and finally you have them and experience it yourself. Parents are nodding (and looking tired).

@KayWesley tweets: #e4pbarca remember the golden rule - he who has the gold makes the rules. Increasingly, the patient.

09:58 CET

Dewulf hates the way the label 'patient' is used. Patients are people living with a medical issue, they are people who have a medical need and they are consumers and customers, adding that disease impacts on family, friends and carers just as much as the patient. So patient-centricity = customer-centricity as with any other industry. Pharma has been late to adopt customer experience / customer service approaches common to other industries.

09:52 CET

Lode Dewulf steps up to speak as Chief Patient Affairs Officer for UCB, probably a role that will appear in more companies. He describes how the rise of patient centricity is driven by 5 Es - the Enabler (internet), Economics (patients having to pay more for medicines), Empowered patients are driven by this, who Engage and then patient Experience drives choice. Patients are choosing doctors like they choose hotels on TripAdvisor.

09:39 CET

Jane Griffiths closes by expressing her frustration that pharma's reputation is so poor, feeling the industry should be revered as an important partner in healthcare. A survey by PatientView is quoted which shows only 34% of patient groups trust the industry. Pharma can only change this by having a true patient-centric strategy and being transparent - around data and interactions with doctors. J&J recently announced it is going public with clinical trial data.

@garethdabbs tweets: Compliance is a huge issue for the industry and for patients - Jane Griffiths #e4pbarca

09:28 CET

A really important point from Jane Griffiths - a focus on market access is great, but access to medicines is not the same as patients taking medicines. Compliance is a big problem and pharma must also address this to ensure good outcomes on all sides. Poor compliance = wasted money for healthcare systems, lost revenue for pharma, poor health management for patients. The solution to this must be a collaborative multi-stakeholder approach, with some Janssen led initiatives being presented, e.g. care4today, which was built as a separate project and not around a drug.

09:20 CET

Jane Griffiths takes to the stand and outlines how value = efficacy + efficiency + effectiveness, showing slides from EFPIA around health improvements made in recent years. Within EU27 between 1950-2010 average life expectancy increased by 14-17%, with about 5% of this directly attributable to medicines. Despite this, there are big variations across Europe of the order of a decade's worth of life expectancy - Spain at the top and Romania coming out worst. She feels the message must be communicated to governments that investment in healthcare equals investment in GDP growth, so worth it. As a percentage of healthcare spend, drug spend has gone down, but this is the wrong decision and pharma must communicate this better.

09:12 CET

Brooksby says some big pharma will "stick to their knitting", but more tech-oriented companies will take over and partnerships will become more prevalent to create true integrated healthcare. George Merck quoted - "healthcare is for people. It is not for profits. The profits follow..." 

09:05 CET

Nigel Brooksby asks the question, "following the decade of doubt, what is the future for pharma?", quoting $500bn destroyed between 2000 and 2010. R&D spend increased (10% revenues to 16%) but R&D return dropped and now pharma has to think long-term, restore trust and ensure delivering real value to payers and patients.

08:50 CET

eyeforpharma opens proceedings, highlighting that the need to create value for patients is the underlying theme behind triple track discussion around partnerships, sales excellence and multichannel marketing. Looks like some survey results around this topic will be announced throughout the conference.

08:30 CET

It's a warm, sunny day here in Barcelona and the event is about to kick off. The attendees are gathering, coffee is being consumed and old friends are catching up. First presentation is at 08:45 CET by Nigel Brooksby. Stay tuned...

For links to other outputs from eyeforpharma Barcelona, including live blogs, please visit:

https://pharmaphorum.com/articles/eyeforpharma-barcelona-media-hub