What happens to your products at the end of the line?

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Screen time


I joined pharma after 14 years in the NHS and was immediately fascinated by sales tactics, account working and the practical detail of prescribing. Fortunately, I had a legendary old-school sales manager to guide me. He constantly emphasised the importance of “the last three feet” in front of a customer.

My colleague introduced me to a community pharmacist, which led to revelatory discussions around the practicalities of FP10s, formularies and the early impact of IT systems. 

Subsequently, as I worked through a dozen launches, this became invaluable. With each new product, I put a line of sticky notes along the wall, working through the challenges we needed to overcome in order to be successful. I worked backwards, starting with the moment a patient walking into the chemist with a prescription.

Over the next 10 years I saw the line get longer, as NICE emerged and GP practice IT systems developed. Additional sticky notes kept coming – APCs on the left, QOF in the middle and the workings of online prescribing and dispensing on the right.

It strikes me that pharma has become increasingly fascinated with the things furthest away from the endpoint; NICE, SMC, formularies and high-level reimbursement. These are clearly important, but the immediate risk is that companies have sometimes assumed that NICE endorsement or formulary acceptance translates to scripts.

Companies are becoming less familiar with the things that matter around the point of prescribing exacerbates the problem. In general, I see companies which are more familiar with NICE than what happens when a prescriber whacks Acmemed 10mg into their computer.

It is rare to meet someone who has seen what unfolds when their product is entered into the a main practice’s IT systems, or who understands how those systems are set up and edited.

Then you have the ‘advisory’ prescribing management systems to comprehend, diagnostic ordering to understand and, especially, the impact of templates that guide HCPs as they move through on-screen algorithms during consultations.

Templates are fundamental to primary care, so ask a GP or nurse to show you one and, I promise, you’ll be amazed. Any product manager, sales person or clinical advisor needs to understand how such systems guide HCPs. It is no longer ‘the last three feet’ that can decide your business, but the last three screens.  


Meaning what?: Mind-boggling abbreviations solved

FP10: Prescriptions purchased by NHS organisations, such as hospital trusts, and distributed free to medical and non-medical prescribers.

APC: Area Prescribing Committees oversee the development of prescribing and medicines management in specific regions.

QOF: The Quality and Outcomes Framework is a voluntary annual reward and incentive programme for all GP surgeries in England.

SMC: Scottish Medicines Consortium provides advice to NHS Boards and their Area Drug and Therapeutics Committees.


David Thorne is Chair, Washington Community Healthcare and Non-Executive Director, City and Vale GP Alliance. Go to blueriverconsulting.co.uk