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KEY CHALLENGES AND PRIORITIES IN SALES TRANSFORMATION : INDONESIA PRESPECTIVE

Key challenges and priorities in sales transformation indonesia prespective

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Page 1: Key challenges and priorities in sales transformation  indonesia prespective

KEY CHALLENGES AND PRIORITIES IN SALES TRANSFORMATION INDONESIA PRESPECTIVE

UNDERSTANDING THE MAJOR TRENDS TO 2016 GLOBAL PRESPECTIVE

Mature markets facing low growth more cost containment

Pharmerging markets to have high growth with mixed fortunes for Originators

On patent brand sales to decline as generics aspire to +- 80 dispensed prescriptions

Growth will come from specialist driven markets particularly biologics but with biosimilars making little impact to 2016

Europe is under pressure with severe hospital debt and austerity measures

Consolidation within the industry and diversification by originators changing the playing field

Global Pharmaceutical Market and Generics IMS Kyoto presentation

MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020

Copyright copy 2014 Evaluate Ltd All rights reserved

WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)

Copyright copy 2014 Evaluate Ltd All rights reserved

GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018

comSource EvaluatePharmaTM June 2013

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 2: Key challenges and priorities in sales transformation  indonesia prespective

UNDERSTANDING THE MAJOR TRENDS TO 2016 GLOBAL PRESPECTIVE

Mature markets facing low growth more cost containment

Pharmerging markets to have high growth with mixed fortunes for Originators

On patent brand sales to decline as generics aspire to +- 80 dispensed prescriptions

Growth will come from specialist driven markets particularly biologics but with biosimilars making little impact to 2016

Europe is under pressure with severe hospital debt and austerity measures

Consolidation within the industry and diversification by originators changing the playing field

Global Pharmaceutical Market and Generics IMS Kyoto presentation

MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020

Copyright copy 2014 Evaluate Ltd All rights reserved

WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)

Copyright copy 2014 Evaluate Ltd All rights reserved

GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018

comSource EvaluatePharmaTM June 2013

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 3: Key challenges and priorities in sales transformation  indonesia prespective

MORE THAN ONE TRILLION DOLLARS OF WORLDWIDE PRESCRIPTION DRUG SALES EXPECTED BY 2020

Copyright copy 2014 Evaluate Ltd All rights reserved

WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)

Copyright copy 2014 Evaluate Ltd All rights reserved

GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018

comSource EvaluatePharmaTM June 2013

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 4: Key challenges and priorities in sales transformation  indonesia prespective

WORLDWIDE PRESCRIPTION DRUG SALES (2006-20)

Copyright copy 2014 Evaluate Ltd All rights reserved

GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018

comSource EvaluatePharmaTM June 2013

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 5: Key challenges and priorities in sales transformation  indonesia prespective

GLOBAL PRESCRIPTION DRUG REVENUE 2004minus2018

comSource EvaluatePharmaTM June 2013

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 6: Key challenges and priorities in sales transformation  indonesia prespective

PHARMERGING MARKET GROWTH IS DRIVEN BY GENERICS ANDNON-BRANDED PRODUCTS

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 7: Key challenges and priorities in sales transformation  indonesia prespective

ASEAN TOTAL HEALTHCARE SPEND ndash OVER $ 68 BILLION

Data from World Bank 2011 (latest available)

605 million people

Average age lt 27yo

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 8: Key challenges and priorities in sales transformation  indonesia prespective

0

5

10

15

20

25

30

35

40

45

50

200

7

200

8

200

9

201

0

201

1

201

2

201

3

201

4

201

5

201

6

201

7

201

8

201

9

202

0

202

1

202

2

202

3

Pharmaceutical Sales In South East Asia (USDbn)

Indonesia

Thailand

Vietnam

Philippines

BruneiCambodiaMyanmarSingapore

Laos

CAGR = compound annual growth rate Source BMI

84 CAGR

64 CAGR

141 CAGR

64 CAGR

71 CAGR119 CAGR94 CAGR

144 CAGR88 CAGR

Malaysia 78 CAGR

REGIONAL MARKET FORECAST

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 9: Key challenges and priorities in sales transformation  indonesia prespective

REGIONAL OUTLOOK ASIA

Health and pharma spending growth rapid but

slower Pharma expected to rise faster than overall

healthcare spending

Expansion will be driven largely by China thanks to

the rollout of public health programmes

By 2016 Chinarsquos pharmaceutical market will be

bigger than that of Japan where growth will be

minimal owing to rising use of generics and market

competition

India Indonesia Malaysia South Korea and

Thailand will also see double-digit growth despite

efforts to bolster cheap local production and reduce

drug prices

Global outlook Healthcare March 2014 The Economist intellegent unit

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 10: Key challenges and priorities in sales transformation  indonesia prespective

NEW GLOBAL CENTER OF OPPORTUNITY IN ASIA PACIFIC

The Asia-Pacific region including China Japan India Australia and Korea is projected to be the single largest contributor (46) to global pharmaceutical market growth through 2015 But the shift wonrsquot come without new challenges

Without the margins to support large sales forces in the long-term Asia will be where we crack the code on remote selling

80000

90

Number of sales reps in China making it the largest

pharma sales force in the world

Level of deep discounts imposed by some

governments on healthcare products

Pharmafocus Mark Mallon regional vice president Asia-Pacific and president China AstraZeneca 2012

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 11: Key challenges and priorities in sales transformation  indonesia prespective

THE EVOLVING STAKEHOLDER LANDSCAPE

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 12: Key challenges and priorities in sales transformation  indonesia prespective

THE EVOLVING STAKEHOLDER LANDSCAPE CONTrsquo

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 13: Key challenges and priorities in sales transformation  indonesia prespective

EVIDENCE IN 2014 PATIENTS BECOMING MORE LIKE CONSUMERS

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 14: Key challenges and priorities in sales transformation  indonesia prespective

OFF-INVOICE REBATES AND DISCOUNTS WILL REDUCE NET MANUFACTURER SALES GROWTH BY APPROXIMATELY 25

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 15: Key challenges and priorities in sales transformation  indonesia prespective

DECLINING CONTRIBUTION FROM OTC DRUG SALES

175 175 179 184 193 199 204

377 394 400 405 411 416 421

448 431 421 411 397 385 375

2009 2010 2011 2012 2013 2014 2015F

Patented drug Generic drug OTC

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 16: Key challenges and priorities in sales transformation  indonesia prespective

BARRIERS TO GROWTH

Kpmgcom

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 17: Key challenges and priorities in sales transformation  indonesia prespective

INTRODUCTION INDONESIA

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 18: Key challenges and priorities in sales transformation  indonesia prespective

Investment Gateway into Indonesia Deloitte

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 19: Key challenges and priorities in sales transformation  indonesia prespective

RISING CONSUMPTION

wwwtomcatfuturistcom

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 20: Key challenges and priorities in sales transformation  indonesia prespective

LIFESTYLE-RELATED DISEASES IN INDONESIA (2014)

Source WHO

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 21: Key challenges and priorities in sales transformation  indonesia prespective

INTRODUCTIONWHY IS INDONESIA AN ATTRACTIVE MARKET FOR HEALTHCARE

Source Frost amp Sullivan

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 22: Key challenges and priorities in sales transformation  indonesia prespective

LARGE POPULATION

Source Frost amp Sullivan

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 23: Key challenges and priorities in sales transformation  indonesia prespective

PRIVATE AND PUBLIC HEALTH CARE EXPENDITURE ( OF GDP) IN 2013

Source World Bank and OECD

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 24: Key challenges and priorities in sales transformation  indonesia prespective

WHAT DOES THE INDONESIAN HEALTHCARE MARKET OFFER

Source httpukreuterscom Frost amp Sullivan

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 25: Key challenges and priorities in sales transformation  indonesia prespective

UHC (UNIVERSAL HEALTHCARE) POLICY TRENDS

Instead Public hospitals strongly support patients with free essential drug Source Global Data Country Reports 2013-2014 (2011 to 2013 data)

Public Healthcare Coverage in Asia

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 26: Key challenges and priorities in sales transformation  indonesia prespective

WHO WILL BENEFIT THE MOST FROM NATIONAL HEALTH INSURANCE

Source Frost amp Sullivan

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 27: Key challenges and priorities in sales transformation  indonesia prespective

IMPROVED ACCESS TO HEALTHCARE

Source MOH Indonesia BPJS Frost amp Sullivan

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 28: Key challenges and priorities in sales transformation  indonesia prespective

UNIVERSAL HEALTHCARE COVERAGE (JKN) ROADMAP

(2012)

764 m

30coverage

(2014)

142m

56 coverage

(Aug2015) 150m

63 coverage

(2019)

270m 100 coverage

Source Roadmap to National Health Insurance 2012-2019 DBS Vickers

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 29: Key challenges and priorities in sales transformation  indonesia prespective

HAS THE PATIENT VOLUME INCREASED AS ANTICIPATED

Source Standard Chartered 2014 Frost amp Sullivan

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 30: Key challenges and priorities in sales transformation  indonesia prespective

HOW CAN THE PRIVATE INVESTOR BENEFIT FROM THE JKN SCHEME

Source Frost amp Sullivan

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 31: Key challenges and priorities in sales transformation  indonesia prespective

INDONESIA HOSPITAL BEDS CLASSIFICATION 2010

Hospital (General and Specialty)

Public Hospital

Class A (gt400 beds)Extensive specialist medical services +

extensive sub specialist

Class B (100-400 beds)Extensive specialist

medical services + limited sub specialist

Class C (50-100 beds)Has minimum of 4 basic

specialist medical services

Class D (lt50 beds)Provides basic medical

facilities

Private Hospital

PriorityGeneral medical services

+ specialist and sub-specialist

MadyaMinimum 4 specialists

medical services

Pratama General medical service

Journal of Hospital Administration 2013 Vol 2 No1

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 32: Key challenges and priorities in sales transformation  indonesia prespective

TREND NO OF HOSPITAL IN INDONESIA BASED ON CLASS (2012-2015)

43 56 56 60

217 256 295 344

447631

742901

251

416

517473

761

724618 684

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

A B C D N Class

h1048597 psirsbukdepkesgoid

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 33: Key challenges and priorities in sales transformation  indonesia prespective

TREND NO OF HOSPITAL IN INDONESIA BASED ON CATAGORY (2012 -2015)

1371 1608 1718 1935

348 475 510 527

0

10

20

30

40

50

60

70

80

90

100

2012 2013 2014 2015

General Hospital Specific Hospital

h1048597 psirsbukdepkesgoid

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 34: Key challenges and priorities in sales transformation  indonesia prespective

HOSPITALS BEDS GREW AT 206 CAGR (IN FOUR YEARS)

Source Ministry of Health DBS Vickers

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 35: Key challenges and priorities in sales transformation  indonesia prespective

INDONESIA HOSPITALS - BREAKDOWN BY OWNERSHIP

Private 6140Govt

(provincialdistrictmunicipal) 2870

Ministry of Health amp other

ministries 170

Military amp Police 680 State-owned 260

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 36: Key challenges and priorities in sales transformation  indonesia prespective

INTRODUCTION OF UHC TIMELINE

All hospitals refer to p ublic hospitals (which must register with BPJS) and private hospitals which are not required to d o so

Source BPJS website Kompas Tempo and Indonesian Public Health Insurance website

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 37: Key challenges and priorities in sales transformation  indonesia prespective

FACT 2015

httpwwwbpjs-kesehatangoidbpjsindexphphome

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 38: Key challenges and priorities in sales transformation  indonesia prespective

THE RATIO OF PHYSICIANS TO POPULATION ALSO MASKS SIGNIFICANT INEQUITIES AMONG URBAN AND RURAL AREAS

Source KKI 2008

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 39: Key challenges and priorities in sales transformation  indonesia prespective

HEALTH CARE INVESTMENT REGULATIONS THE NEGATIVE INVESTMENT LIST (2013 AND 2014)

Source Negative investment list mdash Presidential Regulation No 392014

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 40: Key challenges and priorities in sales transformation  indonesia prespective

BENEFITS COVERED BY UHC IN INDONESIA THAILAND AND THE PHILIPPINES

Source BPJS PhilHealth WHO

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 41: Key challenges and priorities in sales transformation  indonesia prespective

TREND OF GENERAL PRACTITIONERS (GPS) AND SPECIALIST DOCTORS IN INDONESIA(2010 ndash APRIL 2014)

Source Ministry of Health (see Appendix H) Future need EY rough estimate

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 42: Key challenges and priorities in sales transformation  indonesia prespective

NUMBER OF HEALTH CARE PROFESSIONALS BY TYPE (2010ndash2014)

Source Ministry of Health

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 43: Key challenges and priorities in sales transformation  indonesia prespective

PHARMACEUTICAL COMPANIES MUST ADAPT TO CHANGINGLANDSCAPE

Compulsory use of generic drugs whenever possible Patients under the JKN scheme (including COB) do not have much choice otherwise they will not bereimbursed by the scheme

The cap on ceiling prices of generic medicines have been set under Ministry of Health Decree no 092MENKESSK112012 which means that pharmaceutical companiesrsquo margins are dependent on governmentrsquos pricing policies

Shift in distribution channel as registered hospitals and clinics slowly take over as the main distribution channels from physicians and pharmacies In addition the introduction of e-procurement for generic drugs by the government will aid this apparent shift too

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 44: Key challenges and priorities in sales transformation  indonesia prespective

KEY 20152016 HEALTHCARE MARKET PREDICTIONS

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 45: Key challenges and priorities in sales transformation  indonesia prespective

SALES MANAGEMENT BEST PRACTICES EXECUTION ASSESSMENT

Sales Management 20 Optimizing Sales Performance 2010 ndash Volume 3

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 46: Key challenges and priorities in sales transformation  indonesia prespective

THE SALES FORCE SYSTEM FRAMEWORK

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 47: Key challenges and priorities in sales transformation  indonesia prespective

INDUSTRIES AND SELLING ENVIRONMENTS WITH VARIED SALES PROCESS COMPLEXITY

Journal of Personal Selling amp Sales Management vol XXXII no 2 (spring 2012) pp 171ndash186

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 48: Key challenges and priorities in sales transformation  indonesia prespective

SHARE OF ATTENTION ndash ONCOLOGY SALES REPRESENTATIVE BRAND DETAILS BY COMPANY (2009 ndash 2014)

5th Annual Outlook on the Biopharmaceu1048597 cal Promo1048597 onal Landscape February 2015 Edition | Vol 9 Issue 2

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 49: Key challenges and priorities in sales transformation  indonesia prespective

IN EACH PHARMERGING COUNTRY COMPANIES HAVE A WIDE SET OF CHOICES TO DEFINE THE APPROPRIATE STRATEGY

Key strategic choices

Global pharma market outlook -Elisabeth Beck copy 2013 IMS HEALTH

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 50: Key challenges and priorities in sales transformation  indonesia prespective

SALESFORCE STRUCTURE AND SALES ROLES ACROSS A BUSINESS LIFE CYCLE

copy 2014 WorldatWork All Rights Reserved For information about reprintsre-use email copyrightworldatworkorg | wwwworldatworkorg | 877-951-9191

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 51: Key challenges and priorities in sales transformation  indonesia prespective

UNDERSTANDING WHAT PHYSICIANS VALUE

Physician Prescribing Trend

What Doctors expect from Medical Sales Reps

httpblogmedismotechcompharma-selling-what-doctors-want-from-medical-sales-repsh1048597 pblogmedismotechcompharma-sfe-sales-force-effec1048597 veness

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 52: Key challenges and priorities in sales transformation  indonesia prespective

THE WINDOW IS EVER SHORTER

Today only 7 of sales calls are longer than 2 minutes

Your opportunity will end in

Based on Canadian Study ArcusBC Medical Association 2011

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 53: Key challenges and priorities in sales transformation  indonesia prespective

THE TEAM IS GETTING SMALLER(BUT THE SALES GOALS ARENrsquoT)

102000 REPS IN 2007

75000 REPS IN 2012

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 54: Key challenges and priorities in sales transformation  indonesia prespective

What level of face-to-face calls from field based specialists do you expect in order to develop and grow

regional-level thought leader relationships (per year)

N=28

1-8 calls per year32

8-10 calls per year25

10-12 calls per year11

13-14 calls per year14

15-18 calls per year3

19-26 calls per year11

More than 26 calls per year

4

68 call no more than1 time per month

DEVELOPING RELATIONSHIPS

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 55: Key challenges and priorities in sales transformation  indonesia prespective

PERSISTENCE

Over 30 of leads are never contacted at all

By just making a few more call attempts sales reps can experience up to a

70 increase in contact rates

Source Insidesalescom

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 56: Key challenges and priorities in sales transformation  indonesia prespective

FIRST THINGS FIRST

Rumors of the death of the sales force have been vastly over exaggerated

50-75 of physicians prefer to have some contact with reps

Thatrsquos right They want to be detailed

Knowledge Networks and Physicians Consulting Network 2011

Business Insights LTD 2009

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 57: Key challenges and priorities in sales transformation  indonesia prespective

THE SPECTRUM OF COMMUNICATION OPTIONS IS WIDE

copy Copyright 2001 by ZS Associates All Rights Reserved

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 58: Key challenges and priorities in sales transformation  indonesia prespective

MARKETING OBJECTIVES AND THE MOTIVATORS FOR THE PHYSICIANSrsquo PRESCRIBING DECISIONS CHANGE OVER THE COURSE OF THE PRODUCT LIFE CYCLE

copy Copyright 2001 by ZS Associates All Rights Reserved

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 59: Key challenges and priorities in sales transformation  indonesia prespective

MOST PHYSICIANS SAY INFORMATION FROM PHARMACEUTICAL COMPANY REPS IS UP-TO-DATE USEFUL AND RELIABLE

Source KRC Research Survey of Physicians about Pharmaceutical and Biotech Research Activities and Information Commissioned by PhRMA March 2008

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 60: Key challenges and priorities in sales transformation  indonesia prespective

WHAT PHYSICIANS WANT AND NEED FROM PHARMA

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 61: Key challenges and priorities in sales transformation  indonesia prespective

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 62: Key challenges and priorities in sales transformation  indonesia prespective

WHAT PHYSICIANS WANT AND NEED FROM PHARMA CONTrsquo

httpwwwworldofdtcmarketingcomwhat-physicians-want-and-need-from-pharma-2013

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 63: Key challenges and priorities in sales transformation  indonesia prespective

BUYER BEHAVIOR MODEL

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 64: Key challenges and priorities in sales transformation  indonesia prespective

KOL STRUCTURE SHOULD EVOLVE WITH THE COMPANY

In younger smaller organizations with few products KOL management should be very hands-on as an

organization grows and the number of therapeutic areas increases clinical and commercial leaders

employ more strategic approaches

KOL Function Maturity

KO

L M

anagem

ent

Sophis

tication

New Bio-Pharma

Medical amp clinical leaders collaborate with commercial to develop KOL strategy

Identify Key Opinion Leaders for Therapy

Develop excellent relationships with National KOLs

Develop regional KOLs

Leverage relationships to educate providers on disease and therapy

Maintain and improve KOL relationships for existing and developing therapies

Mid-Cap Bio-Pharma

Medical clinical amp commercial leaders collaborate to develop stratified KOL strategy across therapies

Leverage existing KOL relationships and experiences to develop KOLs in new therapeutic areas

Develop and improve systems for tracking all company interactions with KOLs

Shift NationalGlobal KOL contact to dedicated functional personnel for each therapeutic area

Conduct periodic reviews to identify and approach new KOLs

Large Bio-Pharma

Continue cross-functional collaboration to ensure KOL strategies remain current

Periodic refinements to KOL management structures based on experience and changing therapeutic needs

Focus on continuous improvement in KOL relationship management and tracking to optimize systems and processes for maximum impact

Continue periodic reviews to identify and approach new KOLs

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 65: Key challenges and priorities in sales transformation  indonesia prespective

Intangibles

WHAT KOLS VALUE MOSTThe open-ended responses were spread roughly evenly across three broad categories contribution and involvement rewards

and benefits and intangibles Percentages of multiple responses are shown below with representative verbatim values

Q What do KOLs seem to value most in their relationship with your company (please list top three and describe as necessary)

44 46 48 50 52 54 56 58 60

Being on the cutting edge Involvement in changing science Clinical studies participation

Innovative products Engaging Peers Chance to Give Advice Ability to contribute

Rewards and

Benefits

Contribution and

Involvement

0

Integrity Ethics Patient Focus Honesty

Transparency Service orientation Brand value

Support for research

Sponsorship Honoraria Ability

to publish CV building business

perks

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 66: Key challenges and priorities in sales transformation  indonesia prespective

INNOVATION DIFFUSION CURVE AMONG PHYSICIANS

D

C

A

Cautious Majority

Laggards

Late Adopters

Innovators

B

E

Early Adopters

Target First Movers With Tailored CME

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 67: Key challenges and priorities in sales transformation  indonesia prespective

VALUE INNOVATION

Product

benefits

Brand

benefits

Service

benefits

Acquisition

costs

Customer Value-surplus

Costs of

- buying

-production

- handling

- services

- etc

Margin

Creation of Customer Value (W Reijnders 2005)

Price

Eg

Information search

Travel expenses

Wait time

Consult or guidance

Annoyances of

Building

Personnel

Others

et cetera

Eg

- accessibility

- consult service

- attitude

problem solving

client directed

friendly

et cetera

Brand characteristics

Confidence

Function

Emotion

Et cetera

Customer desired

product range

breadth length depth

of assortment

Complementarities

Cohesion

Services

Guarantee

Et cetera

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 68: Key challenges and priorities in sales transformation  indonesia prespective

ABOUT THE 3 RULES Better before cheaper Donrsquot compete on price compete on value

Revenue before cost Drive profitability with higher volume and price not lower cost

There are no other rules Do whatever you have to in order to remain aligned with the first two rules

Invigorating biopharma How the three rules can drive superior performance DUPresscom

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 69: Key challenges and priorities in sales transformation  indonesia prespective

STRATEGIES FOR FOLLOWING THE THREE RULES INPHARMACEUTICAL

Invigorating biopharma How the three rules can drive superior performance DUPresscom

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 70: Key challenges and priorities in sales transformation  indonesia prespective

THE EVOLVING STAKEHOLDER LANDSCAPE

Source Jeff Wordham and Sheryl L Jacobson Transforming commercial models to address new health care realities July 12 2013 httpdupresscomarticlestransforming commercial models to address new health care realities

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 71: Key challenges and priorities in sales transformation  indonesia prespective

TRANSFORMING COMMERCIAL MODELS TO ADDRESS NEW HEALTH CARE REALITIES

Transforming commercial models to address new health care realities

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 72: Key challenges and priorities in sales transformation  indonesia prespective

NEW COMMERCIAL MODEL PILOTS

Multifaceted patient-support

programs

New partnerships and collaborations

Disease education and patient screening

Online communities to support peer-

to-peer education and information

exchange

Programs to diversify the sales

toolkit

Transforming commercial models to address new health care realities

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 73: Key challenges and priorities in sales transformation  indonesia prespective

CLASSIC BEHAVIORAL SEGMENTS IN A SALES FORCE

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 74: Key challenges and priorities in sales transformation  indonesia prespective

PART OF A DOSSIER FOR AN AREA MANAGER

Manipulating sales to maximize incentives by alternating between excellent and poor performance in successive quarters

Using behavioral segmentation to boost salesforce effectiveness Copyright copy McKinsey amp Company

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 75: Key challenges and priorities in sales transformation  indonesia prespective

RESEARCHING THE INFLUENCERS ON PRESCRIBING A PHARMACEUTICAL PRODUCT

2012 Update from the Learning amp Development Committee The EphMRA Learning amp Development Committee

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 76: Key challenges and priorities in sales transformation  indonesia prespective

SAMPLE GROUPS USED IN A PHARMACEUTICAL MARKET

The EphMRA Learning amp Development Committee

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 77: Key challenges and priorities in sales transformation  indonesia prespective

ARE SALES REPS NECESSARY

Although the pharmaceutical sales force has doubled between 1995 and 2000 the number of audited calls has only increased by 10

Reps average only 2 quality details per day (quality details includes discussion of features benefits and data)

Only 43 of pharma reps ever get past the receptionist

Only 7 of pharma rep visits last more than 2 minutes

Only 6 of physicians think representatives are very fair balanced

Only 8 of calls are remembered by the physician

56 of physicians think representatives are more aggressive today than in the past

Less experienced younger sales forces (average age of a US rep is 26)

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 78: Key challenges and priorities in sales transformation  indonesia prespective

WHAT ARE SALES REPS ABSOLUTELY NECESSARY FOR

Increase Scripts Written

Deliver Samples

Source of Practical Information for Docs

Cater Lunches for Docs

Compensate for Lack of Trained HospitalOffice Staff

Manage Patient Assistance Programs

All of the Above

None of the Above

19

13

24

9

7

6

8

14

copy 2007 VirSci Corporation (wwwvirscicom) All rights reserved

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 79: Key challenges and priorities in sales transformation  indonesia prespective

Top Performers

Sales Rep A

Sales Development Plan Sales Rep A

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 80: Key challenges and priorities in sales transformation  indonesia prespective

BUT THEIR EXPECTATIONS HAVE DRAMATICALLY CHANGED

Customized to their practice

Responsive to the conversation

Delivered how and when itrsquos convenient

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 81: Key challenges and priorities in sales transformation  indonesia prespective

WHY COACH SALES REPS

Sales people who receive fewer

than two hours of coaching

per month achieve 90 of quota

Sales people who receive at least

three hours of coaching per

month achieve 107 of quota

Sales people who receive 2-3

hours of coaching per

month achieve 92 of quota

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 82: Key challenges and priorities in sales transformation  indonesia prespective

A NEW PARADIGM THE REP RELIANT BLOCKBUSTER

Marketing was the major driver behind the last generation of mass-market mass-scale blockbusters But the new generation of highly specialized highly expensive drugs requires more individualized selling and learning The conventional wisdom about the selling mix is about to change

Biologics are taking

the lead

Designed for very

targeted patient

populations with few

treatment alternatives

Biosimilars changed

the conversation

New choices in old

categories will require

reps to deliver subtle

value props

New incentives will

shift focus

Incentives will be

weighted to these life-

long higher-cost

drugs

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 83: Key challenges and priorities in sales transformation  indonesia prespective

IT WAS SUPPOSED TO IMPROVE EVERY CALL

more personal

more flexible

more effective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 84: Key challenges and priorities in sales transformation  indonesia prespective

MAKING THE PACKAGE SALESA number of converging trendsmdashfrom more personalized medicine to more commoditized

categoriesmdashwill prompt a more packaged selling system one that combines a diagnostic tool

with a proven support system to both identify a patient and help him or her succeed on a given

Rx

Diagnostic + Product + Support[more personalized medicines] [more successful patients]

More medical knowledge for reps

ability to give live demonstrations

and do hands-on training with staff

New kinds of research and data

that prove the outcomes-based

value of patient support programs

Page 85: Key challenges and priorities in sales transformation  indonesia prespective