Neeraj Singhal, Cegedim Dendrite

	During the last few years, a shift has occurred within sales organizations at global pharmaceutical companies. Instead of focusing all their sales reps’ promotional efforts on individual prescribers, the companies have become more interested in how they address key accounts, such as managed care organizations, government agencies, institutions, and long-term care facilities.

This change in focus from a Primary Care field force to Key Account Management is occurring for three main reasons: 

 The landscape of healthcare providers, as well as the accompanying payment structure outlined in insurance companies’ formularies, has evolved significantly over the past few years. One reason for this is that the U.S. government is the largest payer for healthcare, paying about 15% of GDP or about $2.16 trillion annually (HHS data). As the average life expectancy continues to rise, government’s tab for healthcare will only increase. Hence, as the biggest payer, the government is increasingly becoming a major influencer in all healthcare matters. 

 As more brand prescriptions come off patent and fewer blockbuster drugs enter the marketplace, there is increasing competition among the existing players for market share. With generics playing an increasing role in the U.S. marketplace, the pressure on brand prescription products to command a higher price is much more intense. Generics comprise 67% of prescriptions and accounted for 20% of dollars spent on prescription medicine. 

 Most pharmaceutical companies are changing their portfolio to include biopharmaceutical-based products in their portfolio mix. As a result, a new type of prescriber has emerged, and a different skill set is needed to interact with these types of prescribers, where the nature and frequency of interaction are much different from Primary Care sales calls. 

This confluence of factors is forcing pharmaceutical companies to reevaluate their sales organization structure and business models, so that they can effectively meet the needs of their major accounts and markets. As is the case with any major change, there have been (and will be) challenges along the way, but it is clear that pharmaceutical sales organizations are evaluating, experimenting and embracing innovative Key Account Management solutions.

	Traditionally, Primary Care models have been "efficiency based," focused on structure, hierarchy, direction, and execution. Planning meetings are held, and the home office develops the call plans, sometimes in conjunction with the field sales reps, who are then expected to execute the plan. Field reps are compensated based on their performance, and it is very much a tight execution-based, hierarchy-driven environment. 

The sales model for account management is different. Because the external environment is more complex—always evolving, and more problem-solving in nature&mdash;a team-based, less-hierarchical structure needs to be adopted. By nature, such teams are more collaborative and communicative and focus on joint problem-solving. 

For pharmaceutical account-management organizations to collaborate internally and with other departments, it is essential to create a flexible account-management framework with a clear set of ground rules, such as centrality of all information, sharing of information (based on need), and protecting investments in both existing and future solutions. The framework must be flexible and extensible and support the key business processes of the account managers. Cegedim Dendrite has worked with multiple clients globally over the past two years and developed a framework to support the account management function (See Fig.1).

	Key components of the framework are defined below. 

 Our view is that an account can be an individual or an organization with many different individuals working in various departments. In certain complex cases, an account can be a combination of individuals and an organization. Therefore, in our framework, the definition of an account is flexible and depends on the role of the account managers and the customers with whom they are interacting. 

How can an individual really be an account?

 If he or she is a key stakeholder in the business decisions that affect the overall business. For example, in the case of a long-term care facility, a visiting medical specialist, who visits multiple nursing homes or clinics, can be an account. 

 The list of account categories can be quite extensive, such as commercial, institution-based, government accounts, long-term care, employer, and trade-based customers. Other companies align their teams based on geographical areas or based on a combination of accounts and individual prescribers (hybrid teams). The solution should be flexible to accommodate different types of accounts, as well as the differences in the hierarchy of the account teams who support those accounts. 

	Although account teams are business-oriented and self-driven, as well as more relationship-oriented than conventional sales organizations, they still must meet the organizational objectives that their business leaders have set. These objectives must be executed in collaboration with other team members, who may or may not be part of the same function or division. As a result, planning is a critical element of an account management function. 

Planning occurs at the macro, or business/account, level, but also will happen at the micro level in terms of planning tasks (or using already defined tactics), establishing milestones and setting up interactions with account team members. Account managers perform this planning and execution on a daily basis, but the mode of execution of the plan could be varied and different. Historically, account managers have relied on email and phone conversations, but that created “information silos” that were not the property of the company, but instead lived and moved with the account managers. Therefore, if an account manager left the company, there could be a huge loss of valuable relationship information that could take months to gather and build from scratch. 

In the successful Key Account Management framework, centrality of information and collaboration are necessary to allow a structured way of managing information and using it in the planning, execution and measurement process. It also helps account managers track performance against their plan and change their tactics as business realities change in the marketplace. This real-time monitoring and analysis leads to more immediate plan changes, especially if business drivers or the accounts’ plans change. If executed properly, this framework promotes collaboration within departments or between departments and ensures that common information is shared across the company, even if it comes from different people. The framework also provides a software-based firewall that protects the information that does not need to be shared. 

This centralized information is of tremendous value to the organization, the account teams, and the account managers for several reasons: 

 Instead of preparing management reports in different formats for different audiences, account managers can spend their time more productively in managing their business, thus allowing multiple stakeholders (including senior management) to access and use the information, as they need. 

 Account teams can apply the information and learning to other similar business situations. 

 Transitions are much simpler when team members or managers leave the company, or transfer to other parts of the company. 

This centralized information also benefits the accounts, or customers, themselves because their success depends on feedback from pharmaceutical companies to their changing business needs. Customers also do not want to spend any time in explaining the same information to a different set of people from the same company over and over again. On a regular basis, customers want to know about the impact of pending legislation, how a particular business situation can be managed, or what new products have entered the marketplace. Centralized information can be used to create best practices and scenarios for various business cases, which can be used and modified as needed. The learning and knowledge gathered is never wasted and experience stays within the company. 

Cegedim Dendrite’s Mobile Intelligence tool has an integrated Key Account Management solution, based on the framework described above. This solution has been built by factoring in the flexibility needs of a changing business climate and the need to configure the nuances of individual pharmaceutical companies. It promotes almost real-time message-sharing between various sales forces, which is unparalleled in the industry, and can provide pharmaceutical companies with first-mover advantages that can lead to valuable time-saving. The framework standardizes processes, stabilizes the entire sales organization and has a major impact on where the sales organization is heading. 

While sales organizations may establish and operate Key Account Management programs somewhat differently, there is just one cautionary note: Make changes to your Key Account Management in phases because it is almost impossible for pharmaceutical companies to make the switch in one fell swoop. PC 

Neeraj Singhal is Senior Director, CRM Product Management and Strategy at Cegedim Dendrite Bedminster, NJ; Neeraj.singhal@dendrite.com). He is responsible for product management and strategy for the CRM suite of products for the Americas market. He has extensive experience in product implementations in the life sciences. 

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Reorganizing a sales force into key account teams requires more planning and coordination. Access to real-time account information enhances the team effort.