Selling the e-remedy

Faced with spiralling marketing costs, reduced product lifecycles and an increasing reliance on ‘blockbuster’ drug launches, many pharmaceutical companies are turning to internet technologies to help them more effectively market and sell their products and develop new channels to an increasingly complex customer base.

The challenge faced by sales professionals in the pharmaceutical sector is to identify how new communications technologies can provide their companies with a crucial competitive edge and keep tabs on their rivals’ initiatives. One of the biggest buzzwords currently being used in the pharmaceutical industry is ‘e-detailing’, viewed by many pharmaceutical companies as a way to maximise time, cut costs and increase GP prescribing.

After a lot of dipping of toes into the e-detailing water by the industry it is only now that models are beginning to emerge that look set to fulfil the initial hope and promise.

What is e-detailing?

Put very simply, e-detailing is the digital equivalent of a pharmaceutical salesperson’s visit, using internet-enabled technology in the sales detailing process to supplement and reinforce other offline investments. Solutions vary in interactivity from those providing relatively static online product information to others allowing doctors to use online interaction. Still others involve the doctor in a ‘face-to-face’ video detail via the computer.

E-detailing is not a single entity, but can take many different forms – from remote live discussions with salespeople to a purely scripted interaction with a website or an ‘Interactive Voice Response’ (IVR) phone line. Most e-detailing models have been tried in the but only some – such as forms of ‘scripted’ e-detailing – have been shown by independent studies to increase prescribing compared to traditional detailing methods. Certain e-detail models are now available in where there are tighter regulations concerning doctor promotions that make it harder to incentivise doctors to participate.

Each e-detail model differs in its popularity and applicability to specific doctors. For example, GPs are more easily accessed than specialists in ‘scripted’ e-details, which we will examine later. Therefore, pharmaceutical companies need to consider their e-detailing options carefully to choose a model that will be right for their particular product, target doctor group and country. Many pharmaceutical companies are simply starting a pilot with one or two models.

Why so prominent?

Today’s healthcare professionals are busier than ever. Not only do they have more patients than ever before, they also have more issues to deal with, such as financial management, staffing and empowered patients. Their need for medical information – particularly of pharmaceutical products and services – is greater than ever, yet they have less time available to see salespeople from pharmaceutical companies who they often rely on for this information.

The pharmaceutical industry is also becoming a far more competitive place, with an increasing number of companies trying to promote more products to a customer base that has less time to deal with them. Even when they do meet their customers, research has shown that sales professionals are faced with an average session of three minutes and an attention span that is even shorter. 

Aside from overall development of the internet in everyday life, there are three direct drivers behind the growth of e-detailing:

•  Increasing costs and decreasing effectiveness

•  Busy doctors with little time to see salespeople

•  High connectivity and acceptance of the internet.

In the , the industry is reckoned to spend $15billion a year advertising its products to the medical profession. Detailing – that is, using sales professionals to call on doctors to promote products – accounts for around 45 per cent of this spend. The last decade has seen substantial growth in the use of salespeople as the marketplace becomes increasingly crowded with similar products.

The top 40 pharmaceuticals companies in the now employ an estimated 80,000 salespeople – a doubling since 1996, although the increase in prescribing in this period has risen by only 15 per cent. Some studies from the States suggest that 40 per cent of salespeople’s calls are cancelled or rescheduled and over 80 per cent of conversations between salespeople and doctors last not much more than two minutes. In the , studies suggest that 30 per cent of GPs no longer see salespeople from pharmaceutical companies. Doctors, both in and the , are acknowledged to be highly time-pressured and encouraged to see as many patients as possible. Consequently, pharmaceutical companies’ very significant expenditure in traditional detailing is not yielding the desired returns. With a constantly increasing number of drugs to sell, the sales force’s efficiency is dramatically decreasing.

There is no doubt that detailing directly to the doctor serves an important purpose. Doctors want and need information from sales professionals, but on their own time terms. E-detailing can potentially provide doctors with a more convenient means of getting the information they want at a time that suits them. E-detailing offers pharmaceutical companies the potential to revolutionise medical promotion by increasing both the reach and quality of their messages to a wider audience of doctors and potentially to other healthcare influencers. At the same time, it is not a replacement of the sales force. Instead, it allows sales professionals to be more effective and concentrate on those doctors for whom face-to-face calls are essential.

Information overload

The ubiquitous nature of the internet – in theory – provides access anytime, any place and anywhere. This means that busy healthcare professionals can receive information in the evening or in the morning before work in the comfort of their own homes when, naturally, they are far more likely to be receptive to it. Indeed, research shows that on average a customer will stay with an online detail for eight minutes – compared to the previously mentioned three minutes for traditional sales calls – and the potential of e-detailing starts to become clear.

The problem is in the sheer amount of information that is thrown at today’s healthcare professionals, whether from the spoken word, print media or the internet. The internet is especially problematic in that the information can leave them unsure of where to turn next.

This has been the problem to date. Healthcare professionals hate having to remember multiple passwords and they have understandable reservations concerning security, quality and accuracy of information, the benefit they will receive and the motivation behind the site.

Types of e-detailing

To date, the majority of online medical information offered to doctors by pharmaceutical companies has been largely static product information websites. This may be useful for a one-time visit, but it does not engage the doctor, nor encourage him to return to the site and develop a long-term relationship with the pharmaceutical company. This is verified by a Forrester study where doctors ranked pharmaceutical product websites last with respect to perceived value and frequency of use; indeed more than 50 per cent of the doctors surveyed had not visited a pharmaceutical company website in the past six months.

E-detailing simply means using digital technology in the detailing process. Therefore, many formats are possible, including use of technologies such as the internet, video-conferencing and Interactive Voice Response to enable interaction with the doctor. It is important to remember that the ‘e’ does not simply equal use of the internet. Any technology allowing interaction with the doctor is eligible.

1  Virtual live e-detailing

The doctor is provided with a pre-configured PC containing preloaded applications, and a webcam to liaise with a sales professional. Incentives are provided with and, in return, the doctor is contracted to telephone all the pharmaceutical company’s salespeople enrolled in the system at a minimum set frequency per month. The doctor initiates the e-detail session and has control over the timing of the call. A typical interactive session lasts around 10 to 15 minutes and the doctor and salesperson view and a multi-media presentation about the promoted product and discuss any queries in real time. This type of model is unlikely to be acceptable in where there are much more restrictive limits on the value of goods that can be given to doctors during marketing.

2  Scripted e-detailing

Scripted e-detailing enables the doctor to use a personal computer to launch a sponsored learning application, often consisting of a series of interactive screens with multi-media information about the promoted product. This can include research evidence, clinical practice guidelines, prescribing information and patient advice; the doctor ‘walking through’ the screens. The system may be on the internet or on a closed intranet or via IVR telephone line. This system does not have a live interaction between the doctor and the sales representative, thus questions and requests from the doctors would be available via an e-mail link with an option for telephone call or visit from a salesperson.

3  Doctor portal e-detail

Online communities via doctor portals offer an opportunity to deliver pharmaceutical company messages to a specific audience of doctors. This model has been used in the and is emerging in . This model is most often used for delivering ‘soft’ general marketing messages, via sponsorship of a disease area forum or an online CME module. Potentially, it can be used to provide ‘hard’ product specific messages – like traditional detailing – via alliances with scripted e-detailing players.

Why doctors like e-detailing

Potentially, doctor portals can provide access to hard-to-reach physicians, such as specialists, although for most portals the number of doctors who actively use it is usually significantly less than the official membership list. Portals can usually provide online statistics that give insight into where doctors spend their time and, hence, provide an insight into their web habits and interests. However, these are not necessarily straightforward to interpret. For instance, there is no easy way to know whether the reason a doctor spent ten minutes looking at a web page was because he was interested or because he was bored and took a break to something else whilst the web page was open! There is little evidence of the actual impact of portal-based e-detailing on number of prescriptions issued.

Differences across the water

Regulations governing pharmaceutical promotion are more restrictive in than in the . In the , companies can supply higher value goods to doctors during promotion than in , for example:

•  One doctor portal provides free-of-charge PC hardware required for video conferencing to doctors in return for the doctor agreeing to place, receive or return videoconference calls pharmaceutical clients

•  A pharmaceutical company gave palm Personal Digital Assistants (PDA) together with portal software to a selected group of doctors

•  Some e-detailing vendors give doctors a popular medical book or a certificate redeemable for a medical education product in exchange for a completed e-detail

•  A ‘pay per e-detail’ model is being considered by a doctor group that is offering pharmaceutical salespeople guaranteed detailing time for a fee. Debate on the legality of this approach has meant that no-one has yet taken up this offer.

In , however, the value of goods that can be given during a promotion is much less than in the . For example, the Association of British Pharmaceutical Industry’s Code of Practice governing promotion of pharmaceutical products limits the value of any gift or benefit given to a doctor to be no more than £6 plus VAT. Hence, the extent to which the success of e-detailing in the can be replicated or even improved in depends on finding appropriate ways to incentivise doctors without breaching current regulations. It is unlikely therefore that models such as live video detailing can be replicated in under the current regulations.

On the other hand, is potentially ahead of the in technologies that can be used to provide convenient, continuous access to doctors. In addition to the internet, some technologies that are potentially relevant in future for e-detailing in are mobile phone and PDAs, and Interactive Digital Television (iDTV).

Benefits for pharmaceutical companies

An e-detailing system offers both the pharmaceutical company and the doctor a number of advantages. E-detailing, however, should not be seen in isolation, but as a compliment to an existing sale force. A good e-detailing strategy can potentially improve a salesperson’s effectiveness by allowing him to focus on priority products and key doctors who respond well to face-to-face calls. In this way, e-detailing can be used for reaching remote and hard-to-reach doctors.

With e-detailing, the pharmaceutical industry gains a greater understanding of their customers via an additional channel. This provides new sales opportunities and the ability to provide a better service, while healthcare professionals are able to receive the information they want, when they want it and can receive a better service based on their own preferences.

Is e-detailing the way forward for pharmaceutical companies? We certainly believe so and are now managing some large projects with the leading corporates, but time will tell if suppliers here overcome the legal limits and ‘go with the flow’.

Colin Williams is Head of Marketing at PharmiWeb Solutions. He has considerable experience in developing and marketing e-business solutions for the healthcare market and has over seven years of pharmaceutical marketing and market research expertise from prestigious companies such as Boehringer Ingelheim, Taylor Nelson Sofres and IMS Health.

Tel 01344 667430 

colin@pharmiweb.com