Seeking winning solutions in the new NHS
Paul Tunnah interviews Stephen Turley
The UK government is implementing radical changes to the NHS that will decentralise the decision-making powers back to local GP consortia and dramatically change the landscape within which pharma has to engage with its customers. Although these changes reflect some local challenges, the world is watching with interest to see what can be learnt for other regions.
As these reforms move ahead, every UK pharma company is analysing what the likely impact will be in terms of how many GP consortia there will be, who will be making critical prescribing decisions and how to engage with these new individuals. Delivering long term value is going to drive success and many suggest that true customer engagement must now replace the simple representative detail.
Here, pharmaphorum speaks with Stephen Turley, UK Managing Director of specialist pharma company Lundbeck, which is embracing the change with a complete reorganisation of its customer engagement. He explains what the changes mean and how the new Directors of Healthcare Development will be pivotal to ensuring a good outcome for all.
To listen to the full interview, please click on the play button below, with a shortened transcript of some edited highlights shown in print below.
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PT: Steve, thanks for catching up with pharmaphorum today, can you start by summarising your current role please?
ST: My name is Steve Turley and I’m the Managing Director for Lundbeck in the UK.
PT: The changes we’re seeing locally could have implications for the broader global pharma environment, so how do you see the UK market evolving at the moment?
ST: The changes are wide ranging and they’re clearly fundamental, as we look at commissioning arrangements through GP consortia and the advent of the 150 new quality measures. What we’re seeing now is a hugely complex map with multiple changing stakeholders, an increasingly fragmented approach happening against a backdrop of unprecedented financial constraint. So for the pharmaceutical industry, more than ever before we have to be able to demonstrate not only the clinical benefits of our product but also the evidence base that links back to outcomes.
” What we’re seeing now is a hugely complex map with multiple changing stakeholders, an increasingly fragmented approach happening against a backdrop of unprecedented financial constraint.”
PT: What do you think it means for the traditional sales model on the frontline?
ST: Any company that still engages in what you might loosely call the traditional sales model is probably looking very hard at that. It’s clear that for many the traditional sales model is struggling to pay its way, it’s not bringing value to customers from the feedback that we get, and as a result it’s not bringing value to the pharma companies either. The response over the last few years has clearly been for major culls in the numbers of representatives, particularly in primary care. On this occasion though it’s less around reduction, it’s more around doing something which makes better use of our internal resources in a way that actually brings value to our customers as well.
PT: What do you think all this actually means for the current sales reps?
ST: For those people that are prepared to embrace the change, who are prepared to adapt with the environment and learn new skills and knowledge, the future could be very strong. For those individuals that hark back to the past and just want to go back to the days of when it was all about coverage, frequency and key messages, then there might be struggles ahead.
PT: People might say that the UK has very specific issues and it’s different to other countries, so do you see regions where the old sales practices still are useful?
ST: You’ve always got to be cautious around saying that your market is different. There was some interesting work done by IMS Health recently where they looked at the launch profile of a number of products through to 2009. They saw a change in the correlation between promotional noise at the point of launch and sales success, and that correlation was changing across all markets at a variable rate. If we look at Europe, as I recall, the correlation between promotional noise and sales success was still fairly strong in countries like Spain and Italy, suggesting that in those countries the traditional model has probably still got value. It was less strong in countries like Germany and the UK, but one thing that clearly came out from that analysis was that the UK was very much an extreme. IMS were asking “is the UK simply different or is the UK a bellwether for the way that other countries will go in the future?” A lot of headquarters across Europe will be looking very closely for the answer to that question.
PT: How are you adapting to this change at Lundbeck?
ST: We’ve looked back at what we’ve done in the past and at our current environment. Our mission is to be a highly successful medium sized pharmaceutical company and we understand that if we’re going to achieve that then we have to deliver very compelling financial results. We have to do that through bringing value to our customers and, at the same time, be seen to as great place to work. When we take all of that together the conclusion that we’ve reached is that we are going to have to undergo an organisational shift – and that’s a pretty key word. In the past Lundbeck, like many other companies, has simply looked at the sales force and salami sliced down to a size which seems to pay its way – I don’t think that’s going to cut it in future. What we have to do is look at some of wider organisational processes and cultural aspects as well, and implement a shift that puts the changing customer need at the heart of our operation. It’s our fundamental belief that if we produce wins for the customer then that in turn will be what drives success for Lundbeck.
“It’s our fundamental belief that if we produce wins for the customer then that in turn will be what drives success for Lundbeck.”
PT: You’ve currently bringing in some new Directors of Healthcare Development with a regional focus across the UK markets. How do you see these individuals working with the different stakeholder groups?
ST: The new organisation has a number of directors of healthcare development at the heart of it and they’re going to be supported by mental health specialists. The Directors of Healthcare Development will have enormous accountability in working with key stakeholders within the payer and provider landscape, so they must be able to get exceptionally close to customers and work to a true common agenda. At a meeting a while back somebody cited Bob King, the ex chief executive of British Airways, as saying it’s important not just to know your customer, it’s actually important to be entwined with your customer. We very much see the Directors of Healthcare Development being those people that need to be entwined with their customers, but at the same time there has to be an obligation for us to give them accountability, decision making power and the budgets to make that relationship work for both Lundbeck and the customers.
PT: So you’re looking for them to build two way partnerships with the various customers?
ST: Yes, very much. In the past there have been accusations, some of them possibly justified, that the pharmaceutical industry has simply pursued its own agenda, which is not going to bring success. The NHS has got some very strong mechanisms and one could be to effectively shut the door to pharmaceutical companies. So we have to make sure that we are able to work with the customers and not shy from the fact that we’re commercial. At the end of the day we have got commercial aims, however we need to be able to work with the customers to understand what is their agenda, what are their needs and what are the opportunities that fall out of that for both the customer and the industry.
PT: What type of skills do you think are needed to perform will in one of these positions?
ST: Simply put this is very much a three pronged profile. We are looking for individuals who have got excellent customer engagement skills, so somebody who is able to build a good relationship and at the same time achieve commercial goals. Secondly, we need individuals with excellent analytical ability and a strong business mind to be able to construct the business plan. And thirdly, because of the role of the mental health specialists supporting them, we’re expecting these individuals to also have very strong man management skills. So it’s a combination of strong customer engagement, strong analysis and business acumen and strong man management.
PT: Can the traditional sales rep evolve into this role or is it a very different skill set?
ST: A direct answer is that some of them can and some of them can’t. Our success in implementing this new role will determine the overall success of our business model, so we committed that we would not compromise on our ability to get the best people in the job. We’ve asked all candidates, both internal and external, to go through a very stringent assessment and I’m delighted that we’ve been able to make a number of appointments from the internal employee base. A number of those people have been with Lundbeck for many years and have come up through the sales representative ladder. So for those people that have got the right intrinsic ability, the right attitude, the want to learn and the want to succeed then no matter what their background they can become a Director of Healthcare Development.
PT: How have these changes been received by the Lundbeck global management and do they regard this as a testing bed for potentially rolling out in other countries?
ST: The first word I would use would be excitement. When we presented these plans to Copenhagen some months ago there was a huge amount of excitement that what we had was something that could very radically change the direction of the UK business. So they’re fully supportive and will be looking very closely to see what impact it has. As to whether it will be a model to be rolled out in other regions we honestly don’t know, but if it’s successful then I would be surprised if we’re not seeing at least strong elements of it being used across other markets.
PT: How do you see change in the broader UK organisation supporting this new sales model?
ST: Well that’s an excellent question, because this as an organisational shift, not just a structural shift. The easiest thing in the world would be to change the structure of our customer facing approach, our field force, and to say that was the job done. But what we have also looked at are the processes that we employ and the cultural philosophy that we engage in to make sure that the whole organisation understands that the customer is at the heart of what we do. Marketing teams, for example, have to make sure that their campaigns have the value proposition at their heart, because there is no point in the directors of healthcare development or the mental health specialists engaging with customers on one level if either the marketing campaign or the medical support falls down. Or if what we’re doing through public affairs is disconnected with what we’re saying to the customer, or if the customers then want to prescribe a Lundbeck product and the supply chain lets us down. We have to make sure that we have all aspects of the organisation pointing around the same philosophy of being customer focused.
“We have to make sure that we have all aspects of the organisation pointing around the same philosophy of being customer focused.”
PT: Would you see the Directors of Healthcare Development directly feeding back into those other areas?
ST: Very much. One of the reasons why we’re doing this is because the customer really has a local agenda, local needs and local decision making accountability. So we are trying to mimic that and the Directors of Healthcare Development are going to have access to some specific and bespoke roles within head office, who are going to be able to help them service that agenda.
PT: What are the key success factors in implementing this change well and getting it right?
ST: The most obvious one, and I don’t mean to sound flippant, is to recognise that we are a commercial organisation, so one of the components of our organisational mission is to deliver compelling financial results – to increase market share and increase sales. That being said, we believe that the key success factor in delivering this is being customer focused. So the early lead inputs are to make sure that we have the right people and that we give those people the proper training, tools and accountability to be able to do their jobs. Then further on we’re looking to see if customers are getting value from that and subsequently looking to see the commercial flow.
PT: If we play this forwards and it’s working well, where do you see that win-win-win for Lundbeck, the NHS and also the patients?
ST: The starting point for any company looking to engage in this way is to see whether it has the type of portfolio that lends itself to bringing value into the marketplace. Lundbeck is heavily focused around the areas of psychiatry and neurology, we have a tight portfolio, and when we look at the changes that are taking place in the marketplace it’s our assessment that the quality standards that are being introduced over the coming five years are going to be pivotal in getting the outcomes that the NHS is looking for. One of the first three quality standards is within dementia, one of the next ones being developed is in depression and one after that is in alcohol dependency. So we believe we have got products that bring value and can see very clearly that we are operating in areas where the NHS believes there is a healthcare priority. So the win-win-win for us is being able to agree with our customers around where the product brings value and being able to implement it to its absolute fullest potential. Then clearly the patients will win, the healthcare professionals and the wider healthcare community will win and Lundbeck will win as well.
PT: Well Steve, thanks very much and I’ll certainly wish you the very best of luck with achieving those goals.
About the interviewee:
Steve has worked in the pharmaceutical industry for the past 18 years. His career path has followed a strong sales and marketing direction and he is currently Managing Director for Lundbeck UK. Steve is also vice-chair for the European Medicines Group, and a member of the ABPI Board of Management.
Lundbeck are a successful medium sized company, operating in the CNS and Neurology therapy areas, and Steve has been UK Managing Director since September 2009. To find out more about Lundbeck please visit www.thisisexciting.co.uk.
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