CC BY
0PHARMACEUTICAL SCIENCES
THE EFFICIENCY EVALUATION OF THE PHARMACEUTICAL COMPNY MEDICAL REPRESENTATIVE PERFORMANCE IN UKRAINE
Olkhovska A.B.
ID: 0000-0002-0237-5 741 Candidate of Sciences in Pharmacy, Associate Professor of the Pharmaceutical Marketing and Management Department, National University of Pharmacy, Kharkiv, Ukraine
ABSTRACT
The article substantiates the importance of medical representatives in promoting medicinal products on the market and identifies the advantages of their visits to specialists in the health care industry. Drawing on literature sources, the author has identified the key channels of marketing communications and pharmaceutical companies according to the number of references as to the promotion of medicinal products by means of visits of medical representatives among the professional audience in the pharmaceutical market of Ukraine. The attitude of doctors to the information work of medical representatives in promoting medicinal products has been defined. The information needs of doctors for promotional medicinal products have been established. The efficiency of the medical representative performance has been evaluated on the basis of the Net Promoter Score indicator of the customer loyalty calculation and three segments of specialists have been allocated for whom a program for promotion of medicinal products through visits of medical representatives of pharmaceutical companies has been worked out.
Keywords: promotion, marketing communications, personal sale, medical representatives, information, medicinal products, doctors, pharmaceutical companies, efficiency.
Introduction
The strategically important vector in promoting medicinal products within the framework of the concept of relations is building up the loyalty of the target audience to pharmaceutical brands which is ensured by various components of marketing communications. The importance of marketing communications is constantly increasing, since their use can help pharmaceutical companies gain a competitive advantage in the market.
An important component of marketing communications in the system of the promotion of medicinal products, especially of the prescription ones, is personal sale.
Pharmaceutical companies consider this form of product promotion highly advantageous since it ensures direct communications of medical representatives with health care industry professionals [8].
During their visit to target audiences medical representatives perform a number of functions such as the information one, aimed at communicating the information about medicinal products, their features, possible administration, and competitive advantage; the commercial one, aimed at encouraging doctors to prescribe and pharmacists to recommend certain medicinal products; the image one, aimed at creating a positive attitude towards the brand of a pharmaceutical company [7,9,12].
The aim of this work is to determine the attitudes of doctors and assess the efficiency of the pharmaceutical company medical representative performance.
Materials and Methods research
The theoretical and methodological basis of the research was Ukrainian and foreign scientific literature on the practical application of the components of marketing communications in promoting pharmaceutical products, personal sale in particular; the organization, appropriateness and efficiency of the work of medical representatives of pharmaceutical companies undertaken with the target audience; the results of the survey of physicians according to the form proposed by the independent French pharmaceutical Bulletin "La Revue Prescrire" to assess the performance of medical representatives in the medicinal product promotion.
The methods of system analysis, content analysis, monitoring, logical generalization, sociological studies, etc. have been applied in the course of the research. The efficiency of medical representatives has been evaluated using the Net Promoter Score (NPS) indicator of the customer loyalty.
Results and Discussion
Among all the medicinal product promotion methods used in the global pharmaceutical market, the activities of medical representatives and personal sale are the most common and efficient ones [8].
Thus, following the results of 2016, the leading channel of promoting medicinal products among the professional audience in the pharmaceutical market of Ukraine was the visits of medical representatives (Fig. 1, 2) [5].
Source: the data of the market research analytical system «PharmXplorer» / «Pharmstandard» of the «Proxima Research»
■ Visits of medical representatives
■ Conferences, seminars
■ Press advertising
■ TV spots
■ Distance communication 70% ■ Postal mailing
■ Direct e-mailing
5,10%
3,90% 1,30%
6,90%
10,70%
13,40%
Fig. 1. The ratio of references of doctors to various means of the medicinal product promotion
5,90%
10,30%
1,70%
10,20%
14,00%
5,70%
Visits of medical representatives Press advertising Postal mailing Promotion events
Source: the data of the market ' research analytical system «PharmXplorer» /
«Pharmstandard» of the «Proxima Research» company
52,20%
Conferences, seminars TV spots i POS-materials
Fig. 2. The ratio of references ofpharmacists to various means of the medicinal product promotion
Medical representatives are a strategic resource for pharmaceutical companies and a link between pharmaceutical manufacturers and the health care industry professionals. The job content of medical representatives is to visit pharmacists and doctors in order to present the medicinal products of a pharmaceutical company and the main findings of the scientific research into the advantages of the above medicinal products as well as to form adherence to pharmaceutical brands, etc.
Based on our previous research findings, the majority of pharmaceutical (87%) and medical (91%) expert-respondents from different regions of Ukraine consider the involvement of medical representatives in promoting medicinal products on the market appropriate.
Following the results of 2016 in Ukraine, the TOP-5 of pharmaceutical companies based on the total number of references to the promotion of medicinal products by means of visits of medical representatives
among doctors and pharmacists included "BerlinChemie" (Germany), "Teva" (Israel), "Farmak" (Ukraine), "KRKA d.d. Novo Mesto" (Slovenia) and "Sandoz" (Switzerland) [5]. The ratio of promotional marketing activiies through visits of medical representatives in Ukraine is much higher in the foreign pharmaceutical companies (70%) than in the domestic ones (30%) which is primarily due to the high cost of this component of marketing communications.
To study the activities of medical representatives, their ability to convey the information about medicinal products to the target audience and the appropriateness of their personal influence on the behavior of professionals, an opinion survey of 897 doctors of various professions was conducted in September-December 2016 on the basis of city clinics and hospitals, Kharkiv medical centers, district hospitals and clinics in Kharkiv region. The segmentation of the doctors-respondents is represented in Fig. 3.
2 7 1,71,2 0,8 0,7
10,3
■ Physician
■ Obstetrician-gynecologist
■ Otolaryngologist
■ Neuropathologist
■ Gastroenterologist
■ Pediatrician
■ Cardiologist
■ Urologist ,9 Surgeon
■ Endocrinologist
■ Dermatovenereologi st
■ Infectiologist
Source: Own Research, 2016
9
Fig. 3. The segmentation of the doctors-respondents as to their qualification
The highest percentage of the doctor-respondents represented physicians (27.3%), obstetrician-gynecologists (11,9%), otolaryngologists (10,3%), neuropathologists (9.0%) and gastroenterologists (7.5%).
The majority of the doctors-respondents had a more than 20-year real-work experience (45%) (Fig. 4).
Source: Own Research, 2016
The doctors-respondents work experience
Fig. 4. The segmentation of the doctor-respondents as to their real-work experience
The degree of confidence in medical representatives and the information on medicinal products provided is an extremely important factor in promoting a pharmaceutical product on the market.
Almost 13 thousand medicinal products are currently registered in the pharmaceutical market of Ukraine with 70% of the market belonging to foreign medicines [6].
A fairly wide range of pharmaceuticals calls for time-sensitive information on medicinal products. The major task of a medical representative is to convey the above information directly to the doctor.
In an effort to study the attitude of specialists to the information work of medical representatives in promoting medicinal products the doctors were asked to give only a "Yes" or "No" answer to nine questions of the standard questionnaire of the independent French pharmaceutical Bulletin "La Revue Prescrire" [2] to survey professionals as to the visits of medical representatives. "La Revue Prescrire" has been monitoring the performance of medical representatives in promoting medicinal products to doctors since 1991 [1,2].
The results are presented in Fig. 5.
Source: Own research according to the standard questionnaire of the independent French pharmaceutical Bulletin «La Revue Prescrire»,
100 90 80 70
96,3
98,4
60
ti
o > 50
•S '"S
^£40
0 a
J 30
1 20 ö
J 10
0
1 Do the indications match those on the data sheet?
2 Does the dose regimen match that on the data sheet?
3 Did the representative spontaneously mention side effects?
4 Did the representative spontaneously mention contraindications?1
5 Did the representative spontaneously mention drug interactions?
6 Given the type of drug, do you think the representative should have mentioned the above information?
7 Was the representative willing to answer your questions?1
8 Did you find the representative convincing?
9 Were there strong inducements to prescribe the drug?2
1 Questions relating to side effects, contraindications and drug interactions 2 Arguments wed to pressure doctors to prescribe a particular drug, such as implying that refusal would increase patients" suffering or decrease their chances of survival
Fig. 5. The results of the doctor survey as to the informational work of medical representatives
The results obtained have allowed us to evaluate the quality and content of the communicative component of the medical representative visits to doctors. In general, the experts have positively evaluated the work of medical representatives, which confirms the appropriateness of their involvement in the promotion of medicinal products.
The majority of respondents believe that medical representatives provided them with complete information on the therapeutic indications (96,3%) and dosage (83,7%) of medicinal products. A significant percentage of the physicians surveyed (98.4 %) believe that a medical representative must provide information on side effects, contraindications and interaction with other medicinal products. However, the results of the author's survey reveal that quite often medical representatives hush up such information, although most physicians wish medical representatives to provide more information on side effects, contraindications and interaction of the medicinal products that are being promoted on the market by pharmaceutical companies. The above will facilitate a result-oriented prescription of medication to patients and their more rational administration. The doctors surveyed have also voiced the in-
formation needs regarding the price level of promotional medicinal products and their advantages in comparison with analogues.
The results obtained will be useful for pharmaceutical companies that promote medicinal products among the target audience through the visits of medical representatives.
The success of the strategy of the medicinal product promotion through the visits of medical representatives is based on the formation of the loyalty of the health care industry experts to pharmaceutical brands. Loyalty is currently considered a strategic tool of strengthening and expanding the customer base.
The next step was to evaluate the efficiency of the medical representative performance using the indicator of the doctor's loyalty. With this purpose the Net Promoter Score (NPS) method has been tested [3,4,11].
The visits of the medical representatives of one of the pharmaceutical companies in question to 93 physicians of 23 medical institutions of Kharkiv and Kharkiv region were being monitored during one month. A С09В B03 pharmacotherapeutic group prescription medicinal product was being marketed through the visits of medical representatives.
Following the visits of medical representatives, the doctors were asked to determine the probability of
1
2
3
4
5
6
7
8
9
prescribing the above medicinal product on a 0-to-10-point scale. The results are presented in Table 1.
Table 1
The rating scale of the responses of the doctors regarding the probability of prescribing the promotional _medicinal product_
The near-zero probability of prescribing the medicinal product Detractor Passive Promoter Extremely high probability of prescribing the medicinal product
0 1 2 3 4 5 6 7 8 9 10
Depending on the rated score, the respondents are divided into three groups: promoters (score 9-10), passives (score 7-8) and detractors (score 0-6). The more promoters a pharmaceutical company has, the higher the probability of attracting new customers, and therefore the higher potential for profit growth it has.
The next step was to calculate the Net Promoter Score indicator of the customer loyalty according to the formula:
NPS = % Promoter — % Detractor,
where NPS - the indicator of the customer loyalty,
%;
Promoter - the ratio of customers-promoters, %; Detractor - the ratio of customers-detractors, %.
The NPS indicator of the customer loyalty can take values from -100% (when every customer is a detractor) to +100% (when every customer is a promoter) [3,10].
The above technique has been applied to segment the doctors and identify three segments of professionals with "doctors-promoters" representing the largest percentage - 47% (Fig. 6).
The segmentation of physicians
Source: Own research, 2016
Fig. 6. The segmentation tree of physicians
Based on the results obtained, the indicator of the physician loyalty regarding the promotional medicinal product was:
NPS,
physicians
= 47% - 12% = 35%
An important aspect in the system of the evaluation of the loyalty of doctors is additional comments and explanations that reflect their behavioural characteristics during the survey regarding the likelihood of prescribing the promotional medicinal product to patients. Therefore, the doctors of the corresponding segment were further requested to justify the reasons for high or low probability of prescribing the medicinal
products. Based on the answers of the "doctors-promoters", the strengths of the promotional medicinal product and the appropriateness of certain components of marketing communications in its promotion on the market were identified. "Doctors-detractors" pointed out the weaknesses of the pharmaceutical brand that require adjustment.
A special program for the medicinal product promotion through the visits of medical representatives has been worked out for each segment of the doctors; the latter allows creating and (or) supporting the commitment of the target audience to the brand of the pharmaceutical company (tab.2).
Table 2
The program for the medicinal product promotion through the visits of medical representatives
_(excerpt)_
The segments of doctors The characteristics of the segment The main objectives of marketing communications The components of the promotion program
«Doctors-promoters» Loyal professionals who aim to prescribe the medicinal product to the patients and recommend it to their colleagues; they are ready to take on repu-tational risks of the pharmaceutical company and to voice a positive opinion about its brands; the most profitable part of the customer base. Encouraging and preserving the physicians' intentions regarding the prescription of the medicinal product. S A personalized model of communication with doctors. S Direct e-mailing. S Sponsoring scientific activities of doctors. S Webinars for doctors. S Dissemination of professional literature. S Printed materials, etc.
«Doctors-passives» Contented though passive professionals, who can change their attitude to the medicinal product and further give preference to its analogues; they are not ready to take on the reputational risks of the company. Creating positive attitude, improving the image of the pharmaceutical brand and the company on the whole. S Advertising the medicinal product in specialized editions for doctors. S Publishing the medicinal product case history. S Organizing the participation of doctors in seminars and workshops financed by the pharmaceutical company, etc.
«Doctors-detractors» Dissatisfied professionals who can harm the reputation of the pharmaceutical company brand with their negative reviews; might have had negative experience with the company. Providing doctors with extended information and transforming the negative attitude towards the medicinal product and (or) the pharmaceutical company into the positive one. S Increasing the number of the visits of medical representatives to doctors. S Direct information e-mail-ing about the findings of the clinical research and the new studies of the efficiency of the medicinal product administration. S PR activities through professional congresses, symposiums, conferences, round tables, etc.
Sources: Author's materials, 2016
The next stage was to substantiate the appropriateness of each component of the program for the medicinal product promotion through the visits of medical representatives for the pharmaceutical company in question with regard to the economic and communicative efficiency.
Pursuant to the promotion program, the pharmaceutical company in question is recommended to focus on those aspects of the marketing communication activities that are of real importance for doctors in deciding on prescribing the medicine to their patients.
Conclusions
The methodology of determining the NPS indicator of the customer loyalty can be applied by pharmaceutical companies to evaluate the efficiency and other components of marketing communications, since it has significant advantages of being simple, available, low-cost and convenient to use; it allows measuring the emotional component of the brand loyalty concept that will further influence the economic indicators of the company and comparing the results of the promotion of pharmaceuticals with their analogues. Based on the loyalty indicator, it becomes possible to determine the
main directions of the program for promotion of certain medicinal products, to work out marketing strategies for cooperation with various segments of customers and build with them constructive and long-term communications.
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