The future of pharma's salesforce has been a hotly debated topic for years. Now we wave goodbye to one-size-fits-all and embrace a field force fusion

It has been a turbulent few years for pharma's salesforce as the industry has tried to find its feet amid a shifting healthcare landscape. For all intents and purposes, the sales rep should be dead, yet the role remains, and largely intact – albeit head count has reduced and other roles and job titles have sprung up. Indeed, the salesforce of the future is beginning to take shape. And there's even a place for the sales rep, experts say. That's because the new salesforce will be a blend of roles and capabilities.

"The salesforce is changing," says Alan Kidd, business development manager at CHASE. "It's becoming increasingly a mix – an educational and promotional mix, which includes digital and e-detailing, other roles and even health outcomes consultants."

This is echoed by Ryan Wooller, business development director at Star. He says the salesforce of the future will be made up of different role types, deployed in different geographies with messages tailored to reflect the requirements of the local health economies. "The days of the one-size-fits-all national sales team are numbered," he states.

Salesforce shake-up

For several years now, pharma's salesforce has been in a state of upheaval after austerity hit the NHS and prescribing decisions shifted from healthcare professionals to the managers holding the purse strings. As the sales rep's influence began to wane, the headcount reduced and pharma introduced a raft of new roles, from key account managers to NHS liaison managers.

Meanwhile, medical science liaisons emerged from nowhere and other roles have since popped up, with service re-design specialists, analytics experts and change management specialists, all thrown into the commercial mix. But despite this new landscape and these new roles, pharma is still looking for ways to work effectively in the marketplace, notes Kidd.

It hasn't been an easy transition – as the industry knows, the role of KAM has been highly debated, with initial teething problems around rebadging and upskilling. But there are now indications of what the future salesforce will look like and how this heterogeneous mix of roles and skills might work.

It comes amid a set of developing trends: the need to communicate a medicine's value proposition, especially in relation to pathway optimisation; the expanding availability of information via different channels; and the consumption of this information based on personal preference. These factors will determine how the salesforce will interact with those in the health system.

'If you don't have market access, there's no point having a salesforce'

Importantly, though, what hasn't fundamentally changed is what payers and healthcare professionals want – namely, robust evidence, engaged discussions with people who know what they're talking about, who know the brand, the competition, the disease area and the local issues, who will add value to the conversation and the healthcare system, and who they can trust. 

Take KAM, where there is now an onus on the role to step up. "Rebadging a hospital rep and giving them a new KAM, PRAM, RAM, TAM, LAM, SAM job title and an account plan template isn't enough anymore," explains Gary Killington, managing director at PI Partnership. "Now there is a real and justifiable customer expectation that our commercial teams need to be able to not just deliver key messages with a hint of a value proposition, they need to have a clear value-based discussion and do it with authority and presence."

But more than that, KAM has become "the gatekeeper", Kidd says; the role that "acts as a catalyst" to get the right people in front of each other, which might be a medical science liaison to communicate the science or a health outcomes consultant to discuss the health economics.

As such, the consensus is these KAM roles – based on the management of accounts with specific characteristics and needs – are fundamental and, as Wooller says, can make a significant commercial impact. The caveat, however, he says, is that KAM must be implemented in the right way and, adds Kidd, with the right person in the role.

Death of the sales rep?

Although many could argue that sales reps are becoming obsolete, the belief is that there will still be a role for them in the future as part of the salesforce mix. Kidd points out that doctors still need information on new medicines and many prefer a face-to-face interaction or Skype call rather than sourcing this information via an e-detail. He also mentions incidences where doctors have called pharma companies to organise a rep visit.

Likewise, Wooller believes sales reps still have a place, but he says the real question now is what are we asking them to do? "The impact these individuals can make is predicated on a pharma company's commercial strategy being sound and the value proposition of the medicine they are promoting aligning with healthcare stakeholders' needs," he says. "There are more nuanced ways to add value and achieve a commercial return than what we would describe as 'traditional selling'." For instance, value-added services around service re-design or educational programmes may end up the primary driver, he says, with 'traditional selling' becoming a by-product.

This is an important point, Kidd agrees, as the sales approach will depend on the disease area, the medicine and the health bods involved. "In some occasions an MSL will add value but in others the salesforce will be sufficient or even e-detailing may be the preference," he says.

Fundamentally though, regardless of job title, Kidd believes that providing information is still effectively a sales conversation. "Whether it's a rep or an emerging role it's still a sales conversation, uncovering needs and the doctors' issues and giving information about the drug and showing how the drug can meet their needs. Selling," he says, "will be at the core of these interactions and it will not necessarily be a rep on every occasion."

Killington puts it another way, saying the way selling will be done in the future is evolving to become customer engagement. "For me, it's not about the job title, it's more about do we have a cross-functional team that is able to communicate and work at all levels with a diverse healthcare system?"

A new approach

Of course, market access has to be thrown into the mix. Kidd warns against deploying a salesforce before market access has been granted. "If you don't have market access, there's no point having a salesforce – doctors won't want to talk to you." He says pharma needs to understand the timing of when to deploy a salesforce, which might require differential resourcing across the UK depending on where market access has been obtained. "That is a different approach to the past and that's a big challenge for the industry; figuring out what level of market access is market access. It really needs to be more than NICE approval – it needs to be on the local formulary."

Being flexible in your approach is key, adds Wooller. "The overlap of your medicine's value proposition with the market environment will define the strategy; the strategy defines the activities required, which in turn allows capability and capacity requirements to be locked."

The rules around the salesforce are being all shook up and expectations from healthcare are high. What is clear is that pharma needs a range of experts and a range of channels to provide information. The future salesforce won't be the one-size-fits-all model of old. Instead, content, channel and skills will be a mix based not on what pharma wants but on what healthcare needs.

Katrina Megget is a freelance journalist specialising in the pharmaceutical industry