Behaviour change on the frontline of pharma

Abbvie to acquire Allergan

Dr Pamela Walker discusses behaviour change on the frontline of pharma.

Never before has pharmaceutical sales been as competitive or as complicated. Prescribers are often spoilt for choice. They have a plethora of entrenched preferences and habits. Regulations on what can and cannot be discussed are increasingly tight.

Understandably, this presents a significant challenge for pharmaceutical sales representatives at the pivotal point of brand launch. How will they be able to communicate effectively about new treatments so that patients receive the right ones and achieve the best possible outcomes?

A challenge

Given the highly evolving pharmaceutical market and regulatory dynamics, honing the representative/healthcare professional (HCP) conversation in a meaningful way, focused on the patient, and within a tight timeframe, is the ever-present task at hand. A challenge indeed, but not an impossible ask. Leveraging the following factors can pivot the conversation in a more purposeful and successful manner:

  1. Put the patient at the centre of the story.
  2. Understand the needs of the specific HCP and leverage behavioural biases accordingly.
  3. Frame the conversation effectively to get to the point – fast.

Ultimately, it’s about the patient

We are in the business for improving patients’ lives – how they feel, how they live. Oftentimes, overly data-focused representative/HCP conversations reduce patients to numbers, and this is not effective for building an interpersonal relationship, or for creating the right environment to make certain patients are treated as effectively as possible.

A specific patient with meaningful clinical and psycho-socio characteristics must be communicated quickly, simply and clearly at the outset of the visit. For example, a treatment regimen that matches a patient’s lifestyle desires and needs can have a dramatic impact on wellbeing. This regimen is as important, if not more so, than the drug treatment itself as the quality of life fit with the patient cannot be underestimated.

A narrative can be helpful for engaging, connecting with, and embedding the specifics of the right patient for the right treatment. Demonstrating credibility through the patient conversation works to bring the evidence to life in a meaningful way. Numbers do not create an emotional connection with the HCP, a narrative with vivid patient-focused language will.

Questioning is a useful technique to further identify the right patients for a given treatment. Exploring with the HCP which patient might be appropriate versus not makes the scenario more tangible and increases the likelihood of positive treatment experience. Furthermore, this approach can be most effective when linked to specific challenges with existing treatment practices and options.

Much work is done internally at pharmaceutical companies prior to brand launch to identify a product’s clear points of differentiation as they relate to specific unmet needs. This information must be communicated in a clear way in response to real challenges discussed within the representative/HCP conversation. Tying this to implications for the patient is then key to bringing the narrative full circle.

HCPs are people, first and foremost

HCPs have a whole host of behavioural biases based on experience, perceptions and mental shortcuts. Because of this, it is important to know not only the segment of prescriber you have in front of you, but also what makes them tick, what is driving their habits and behaviours.

Most brand teams carry out prescriber segmentations of some description prior to launch. Those that do not, often rely on a combination of intuition and salesforce feedback to craft a framework for planning. But this isn’t simply an internal planning tool. Effective segmentations should and can be used by sales representatives to craft more focused, meaningful and strategic conversations with prescribers. Knowing the likely preferences and drivers of decision-making prior to a sales call, means that the representative can more effectively tailor their conversation for success.

As part of this, there will be key behavioural biases that pertain to specific segments. Knowledge of these can help both planning for and speaking with HCPs. It is well established and widely discussed that unconscious biases drive decision-making. This is intimately linked to what is often called System 1 versus System 2 thinking [Kahneman, 2011].

System 1 drives less conscious, quick decision-making and instinctual interpersonal reactions. Emotion and experience heavily feed into these as mental short cuts, heuristics. As people are creatures of habit (indeed an important evolutionary advantage), change is effort and so resistance can be high. When HCPs are seeing many patients a day with limited appointment times, it is understandable that relying heavily on default decision-making helps them do their job more efficiently.

System 2 is often referred to as ‘rational decision-making’, a much more laboured, conscious and slow process. This mode of thinking is used less frequently than System 1. Yet, in pharma, we are obsessed with data and this can cloud the way in which new treatments are discussed with and described to HCPs. There are, of course, hygiene factors and clear statistics that must be addressed, but overall, it is the impact on the patient that counts. Appealing too much to System 2 rather than System 1 can be a stumbling block in any representative/HCP conversation.

Create the frame

How the conversation is framed, how specific elements of the conversation establish common ground, and working within the contextual environment can effectively be used to steer the conversation in a productive direction [Conger, 1998]. In doing so, framing builds on principles of transactional analysis, anchoring, and persuasion.

As transactional analysis underpins interpersonal communication, establishing equal footing during a sales call is important. Maintaining an ‘Adult-Adult’ tone within a conversation facilitates alignment on the topic and a productive result. It also means that challenges and difficult objections are handled effectively without either party feeling on the back foot or defensive. Focusing on the benefits within this context is still key. That said, leveraging the consequences of loss effectively can be used to add weight to the benefits of the product in question.

An example of this would be referring to a recent successful treatment experience one of their respected colleagues achieved. This will anchor the conversation on a positive behaviour of someone they respect, making it easier for them to believe they could do this themselves. Hinting that they wouldn’t want to miss out on such success for the patient, will help to put the action into perspective.

At its core, effective framing brings to the fore the benefits most important to the HCP. Using these as anchors for the conversation helps to control the tone and pace. By grounding the treatment in tangible benefits that are clear and meaningful, the representative effectively ‘anchors’ the product perceptions to something that is real for their counterpart.

Framing involves careful and considered planning to meet the needs of the audience and result in a successful outcome for all parties. Persuasion requires a collaborative discussion, routed in evidence, credibility and mutual respect. Personal traits such as trust, consistency, and likability contribute to an impactful dynamic.

By taking this multi-faceted approach to sales calls, representative can be on equal footing with HCPs. Careful planning, framing and a credible, vivid patient narrative will undoubtedly lead to a dynamic conversation, rooted in common ground.