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Is ‘account management’ the way forward? Pharmafocus 2007

The days of the ‘pure GP’ rep are over. Today’s reps must manage he new prescribing customers in a totally different way, says Magda Lowthion.


GPs with special interests (GpwSI), supplementary prescribers, practice-based commissioning (PBC), quality and outcomes frameworks (QOF), the merging of PCTs, the development of cancer and CHD networks – you’ve heard the terms, but does it really matter how you sell and to whom? The NHS is awash with new prescribers, influencers and initiatives that can have an effect on which products a clinician prescribes. But is the industry changing with the NHS?

Ask any salesforce effectiveness manager what they are doing to identify and target these new customers and which of them will offer them the greatest ROI, and you’ll get a different answer every time.  Some will say they are happy to carry on selling to the customers who have served them well for years, whereas others will go into great detail about how they are already looking to re-align their sales forces and change their targeting strategy.

It is clear that if it is to succeed, the industry will need to change – and to change at the same rate as its customers – which is fast.

Farewell to the ‘pure GP’ rep
So, when is a GP rep not a GP rep? The answer, of course, is when they work with the current NHS. The days of a ‘pure GP rep’ have been numbered since the demise of ‘pure GPs’. It’s no longer enough for a rep to think “I just need to see a GP this morning and any GP will do”.

Relevant, precise and consistent GP targeting has been the foundation of many successful primary care product launches, but the industry again needs to change the customer groups they consider in their targeting strategy.

The introduction of more than 7,000 GPwSI and 14,900 nurse prescribers, supplementary prescribers and independent prescribers means it’s not just the GP that a primary care rep needs to see. Specialised GPs, practice nurses, district nurses, health visitors, clinic leads, commissioning GPs and retail pharmacists all need to be part of every primary care targeting campaign, and this becomes even more complex when you enter the specialist care arena

Just who and where are all these new customers is the question all forward-thinking SFE managers should now be asking themselves. As well as when and how often, the SFE manager also needs to consider the extent to which the marketing messages are tailored. The environmental pressures at play within the local health economy may also affect message development and delivery, so, ideally, these also need to be considered.

Just what is an account?
And just how are these extra 22,000 (and growing) new customers going to be seen the required number of times a year? The simplest approach is to add them into the current targeting list without consideration of a change to territory alignments- but this approach alone risks alienating or undermining the commitment of your salesforce.

An increasing number of pharmaceutical companies are moving towards a fundamental change in how the industry sees the primary care reps working. They are also adopting a well-used working practice from other industries; the age of ‘account management’ is well and truly with us.

Not so many years ago, when employed as a primary care sales rep, it was instilled in me that I had a targeting list and it needed to be followed strictly, even if this meant turning down the offer by a kind receptionist to see a ‘non-target’ GP in place of an unavailable ‘target’ GP.

There was certainly no time in my day to see a practice nurse or think about stepping into a retail pharmacy, and what was even more certain was the fact that my regional manager would view my seeing these people as a total waste of time. This is no longer the case.

Reps now spend less time driving around to see just one or two GPs in a practice and more time seeing GPs, nurses and retail pharmacist in an account. But just what is an account? A GP practice? A practice-based commissioning cluster?A GP practice and its neighbouring acute trust? A GP practice cluster and its PCT? Does this vary by brand, therapy area, product life-cycle? The permutations go on and there is no ‘right’ answer, beyond the fact that that call to the single target GP will not be enough to meet your target sales.

What is certain is that once you have decided on a definition of what your ‘account’ includes, you will then need to feed all the relevant customers, locations (both primary and secondary), roles and responsibilities into your CRM to create a meaningful (and measurable) targeting list.
The advantage of the move towards an account management approach is it often negates the need to realign the territory structure or, in some cases, downsize to facilitate successful account management. It is also possible to run account management alongside the ‘classic’ sales model prior to re-aligning the entire sales force.

A moving target
Deciding which ‘accounts’ need to be targeted is no easy task, particularly when new prescribers and GPwSIs are constantly ‘qualifying’ and appearing as new customers. PBC is seen as a major initiative within the NHS; as with all NHS reforms, what this actually means in practice to those involved and those whose job it is to interact with them remains to be resolved.  However, what is clear is that PBC, alongside the QOF initiative, will have an effect on the priorities our primary care customers are focused on.

Knowing who and where these new customers are and what their priorities, influencers and influences are, is fundamental to effective account-based selling, and will need to be matched by a detailed understanding of the clinical, patient and policy networks that they influence and contribute towards.

If you are in the fortunate position of having products that sit in a therapy area that is directly covered by QOF, you will have a (relatively) clear picture of how your customer accounts are acting. But, there is more to health need than that and in disease areas such as osteoporosis, where do you start in the identification of these new accounts and customer groups?

Do you ask your representatives to keep their ear to the ground or take guidance from the NHS information partners who can inform you of who, what and where your key account-based targets are based on your specifications? Food for thought and debate.


Magda Lowthion is a Business Development Manager at Binley’s. For more information, call 01268 495600 or visit

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