The key issues influencing traditional sales force structure

Paul Simon author of The key issues influencing traditional sales force structure

Paul Simpson, Head of Contract Sales and Medical Solutions at IQVIA, explores the key issues impacting and influencing the traditional sales force structure.

Aside from the current uncertainty pharma faces on the impact of Brexit for UK and EU launch plans, a constant challenge for industry centres on questions that seek to determine how to make the most impactful use of promotional resources:

• How can we launch effectively in the current UK healthcare environment?
• How should we navigate the payer and clinician interfaces to ensure the right patients get access to appropriate medications?
• How can we make the sales team more efficient?
• And, once a patient starts on therapy, how can he/she be supported?

In short: how do we use true insight to shape a commercial strategy that means having the right people in the right place doing the right activities?


These are the general trends impacting sales force structure and design:

Increasing levels of governance: Top-down pressure on spending and increasing assertion of control over prescribing-choice by policy makers/payers means a more complex interaction between policy maker and prescriber.

Less time for traditional personal selling: Pressures on clinical time and a proliferation of new information sources have reduced face-to-face time and driven a general change in the way in which both physicians and patients consume healthcare information.

‘Beyond the pill’ support: Innovation continues to move away from large population blockbusters in Primary Care to more specialised medicines (e.g. medicines for severe asthma, orphan diseases, oncology, etc.) which are initiated only in secondary care and typically subjected to stringent NICE or NHS England Clinical Commissioning Policies. This trend often requires adaptation or complete re-engineering of existing service design to ensure patients get access to the right medications. So, is it still logical to deploy traditional sales resources, or are there better ways of meeting the needs of the target healthcare professional (HCP) audience? In particular, how does pharma move away from ‘selling’ to ‘serving’ – and realise the aspirations of improving health care outcomes?

Pharma ROI: Downward pressure on prescribing of new and high-cost products in the market conflicts with the need to drive revenues that will fund future innovation. So how do we invest commercial resources wisely to ensure optimum patient care through access to new medications, while also generating the revenue needed to support the research and development that will advance healthcare?

Considering that the cost of deploying a single traditional sales representative averages around £80,000 a year, will this investment deliver a positive outcome in the environment described above?

• What does the next-generation of customer engagement really look like?
• What kind of skills mix is required?
• What kind of activities must pharma deliver in order to reach the desired outcomes?

“Deeper insight into the patient journey and which decision points must be influenced is needed to properly understand the impact of your sales team.”

Data driven insights: Answering these important business questions well requires a strong evidence base. This starts with converting the best quality data into deep insights about the market environment, understanding your patients’ journeys, and being clear on where and how your brand can have the greatest positive impact. Achieving this level of insight will help you design an evidence-based solution that makes optimal use of your promotional spend, and in particular the sales force deployment element of that budget.

Flex for success

Designing and implementing the right commercial organisation requires a shift away from the ‘one size fits all’ mindset of the past. The variation in how local healthcare environments are managed means that the next-generation commercial organisation must be able to flex and adjust to local conditions to be successful.

Take the example of a Clinical Commissioning Group (CCG) or Integrated Care System (ICS) which runs its catchment area with strict formularies, driving GP practices’ adherence through either prescribing incentives or restrictions. If your brand is not approved on such a strictly controlled formulary, the deployment of any traditional sales force would produce no significant return on investment, and effort would be better spent working at a CCG/ICS level to effect change in policy.


Once positive policy has been achieved in the same CCG/ICS, the commercial organisation must flex to a different deployment model: traditional sales people, customer service specialists, and/or nurse educators who can educate and support patients with adherence issues, understanding their disease and its potential progression.

The analysis underlying these decisions has evolved as well – higher quality data and better analytical approaches can produce very different and more effective solutions than simple sales force sizing analyses. If you understand the needs of your customers and their stakeholders better and have a more complete view of the market potential, then you can build solutions with a more appropriate mix of skills that yield better outcomes for lower cost.

So, where in the past the decision may have been to deploy 40 traditional sales people, understanding the above could perhaps enable a team of 20 traditional sales people to achieve improved outcomes if patients and HCPs are supported by 10 service specialists, two nurse educators, and two market access specialists.


Key skills

As with analysis and insights, the skills mix required for salespeople to succeed in today’s environment has also moved on. HCPs now routinely operate in an interconnected healthcare delivery system (with ScriptSwitch and medicines optimisation dashboards now commonplace) and consume their information through many different channels. As a result, there is a greater requirement for account management skills and an ability to use multiple channels for sharing information, rather than just relying on face-to-face contact.

Having the understanding and capability to orchestrate these different channels effectively will undoubtedly have a strong impact on the acceptance and adoption of medicines. Whilst much of this skill must lie with the sales force, there is much that technology can do to help salespeople to understand how, where, and when to use the available channels to fit the information needs and preferences of the HCPs they interact with.

Further complexity arises when trying to monitor the performance of a sales team. Simple sales lines may not be the complete metric of success they once were – deeper insight into the patient journey and which decision points must be influenced is needed to properly understand the impact of your sales team.

In summary, time and effort invested up front to understand the environment and dynamics of a therapy area and marketplace can deliver a more complete promotional effort, tuned into the needs of the broader range of interconnected HCPs, resulting in greater effectiveness and higher efficiency.


Paul Simpson is the Head of Contract Sales and Medical Solutions at IQVIA.
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