SALES FORCE EFFECTIVENESS SUPPLEMENT

Call Planning that Delivers on

Brand Strategy
New Information Sources Determine Prescriber Value
BY MATTHEW LINKEWICH AND JAY MARGOLIS, IMS HEALTH

The challenge of optimally reaching physicians with resonating

messages is an involved process. Each stage along the way is
dependent on the precision of the one before. Creating a call
plan may be a rather mechanical last step, but its impact hinges
upon the thinking that has gone into the overall strategy most
particularly in the segmentation and brand strategy phases much
further back in the overall process.
THE CASE FOR CHANGE
About 75 percent of pharmaceutical companies are
still determining which physicians theyll call on
and how often just as they did ten years ago
when the name of the game was reach and
frequency. Even in a time of increasing financial
pressures, thinner profit margins, a migration to
specialty products and physician backlash against a
waiting room full of pharmaceutical reps, companies
still continue to allocate their sales resources on the
basis of physicians prescribing volume and market

share alone.With leadership focusing on improving

field force productivity, it only makes sense to
rethink the way sales efforts are directed.
For a product to have the best opportunity to
win in the marketplace, there must be a seamless
progression from market intelligence and analytics
to brand strategy and finally to sales execution.
When a call plan is developed narrowly on the
basis of physicians prescription volume and brand
market share exclusively, the resultant plan is not

only a divergence from the brand strategy, but

also can be widely inefficient given unseen or
unaccounted market pressures such as managed
care. As such, representatives will find themselves
executing an errant plan that does not maximize
their full potential.
When properly conceived and configured, the call
plan directs reps to those physicians whose practice
characteristics, constellation of prescribing behaviors
and attitudes are conducive to supporting the brand
goals. Even without involving primary research to
uncover physician attitudes, segmentations based
on secondary data sources can identify and
subsequently the call plan can direct reps to
physicians who:
Support the brand, and in the case of a new brand
are early adopters of new treatment alternatives
Respond positively to promotion
Generate true new business (as opposed to
repeat prescriptions)
Frequently switch patients to/from the brand
Treat patients fitting the products profile
Have a greater patient compliance and persistency
than the market average
Are in a position to prescribe the product from a
managed care perspective
Follow the products dosing guidelines
Stand to become more valuable to the brand
over time
Support the right mix of products for the
companys portfolio goals
Fortunately, there are solutions available to help
companies capitalize on these additional insights in
their call plans. In many cases, use of these additional
insights has aided representative inputs to the overall

process, in many cases raising their satisfaction with

the insights delivered by the home office.
WHEN TO REFRESH CALL PLANS
In general, pharmaceutical companies should be
refreshing their call plans about twice a year. One
sure sign that its time to overhaul the call plan, not
simply update it, is if sales efforts are not gaining any
traction in the marketplace. Other triggers include a
major market event (loss of exclusivity), change in
the companys product portfolio and a change in a
competitors product mix.The bottom line is that as
products advance through their lifecycle and market
dynamics shift, brand strategy should be continually
reevaluated and therefore the call plan should be
revised to reflect the new marketing approach.
Call planning, being downstream from segmenting
and identification of prospects, is totally dependent
on the thoroughness and accuracy of these earlier
steps. It only stands to reason that reps success in
the field hinges on how well companies identify the
physicians that hold the most potential for a brand
however that potential is defined. Companies that are
in the habit of viewing physician potential through
the rather restrictive lens of prescription volume and
share can also benefit from developing new call
plans derived from more sophisticated market
segmentations.
For that reason, lets review the information
components currently available from secondary data
sources for segmenting and selecting physicians before
we cover the call planning process itself.
IDENTIFYING THE RIGHT PHYSICIANS
The secret to a good call plan is a highly refined
prospect list. And the secret to a good prospect list
is choosing the right variables upon which to
segment the physician universe in the first place.

Reps success in the field hinges on how well companies

identify the physicians that hold the most potential for a
brand however that potential is defined.

Deciling prescribers only on prescriptions that are in play can lead to

different physician selection decisions when compared to deciling prescribers
on market TRx volume

TRX Decile

New to Brand (NBRx) Decile

1
2
3
4
5
6
7
8
9
10

148,649
11,445
3,785
1,663
771
363
150
25
1

55,156
13,173
6,027
2,874
1,357
601
166
28

7,924
7,249
5,391
3,746
2,197
1,203
365
49
1

1,692
2,927
3,566
3,175
2,462
1,546
600
85
2

395
957
1,683
2,162
2,231
1,828
970
161
7

166,852

79,382

28,125 16,055

10,394

98
279
541
939
1,419
1,683
1,464
346
28
4
6,801

14
60
111
192
429
762
1,336
972
141
11
4,028

3
3
17
65
109
450
1,042
515
62
2,266

More than half of all TRx deciled

prescribers did NOT initiate or
switch therapy; 1,310 were TRx
decile 5 or higher

While the industry is not yet broadly using many of

the behavioral information components on the
following list, all are readily available and provide
insight into the brand potential that resides within
each physicians office:
STANDARD PRESCRIBING VOLUME AND MARKET
SHARE METRICS

Measures of what physicians currently prescribe are

decidedly important in determining a physicians
value to a brand. But they should not be the only
metric used to evaluate physicians (as they are for
the vast majority of companies).This will become
clear as we move through the other information
components.
PROMOTIONAL RESPONSIVENESS

Similar to consumer buying behaviors, physicians

do not respond uniformly to marketing promotion.
Therefore, it is important to delineate those
physicians that value representative detailing
activities by longitudinally tracking call activity
and physician prescribing behavior.While this

2
1
5
15
97
483
705
196
1,504

1
1
5
15
161
505
376
1,064

10

1
30
117
477
625

213,928
36,093
21,109
14,770
10,937
8,115
5,614
3,382
2,022
1,126
317,096

NBRx results in more focused

physician selections with 3,193
docs in top 3 deciles, compared
to 6,530 based on TRx deciles

analysis is frequently conducted by many larger

brands, it is rarely infused into the resource
allocation and call planning process.
PHYSICIAN PRACTICE AND PATIENT CHARACTERISTICS
FROM APLD

To date, only a few progressive companies have

ventured to use anonymized patient-level data
(APLD) in segmenting physicians.This rich
information source can be leveraged to hone in on
physicians whose prescribing behaviors and practice
profile are compatible with brand strategy.
New to Brand Prescriptions
Longitudinal analyses of physician prescribing can
filter out new prescriptions that continue or
restart therapy, leaving only the volume of
prescriptions generated for patients who have
been prescribed a brand for the first time.The
resulting measure of New to Brand prescriptions
(NBRxs) serves as an important indication of
which physicians are generating the most true
new business for a brand an especially

Bringing further segmentation variables to bear produces six segments and

identifies 32,086 high potential prescribers

Segmentation Variables
Prescribing Universe:
317,096 Physicians

Market Volume &

Product Share

High Potential Segments

S1

S2

S3

S4

S5

S6

Portfolio Value
Included

Managed Care Favorability

70,862 Physicians
in NTB Decile 2-10

Responsiveness
% New to Brand
Adoption Behaviors

Excluded

246,234 Physicians
in NTB Decile 0-1

Dosing, Compliance
and Persistency

32,086 Physicians
in 6 Segments

Physician Lifetime Value

important piece of information for products

treating a chronic condition in a market where
brand loyalty is high.
When deciles are created based on the number of
prescriptions truly in play compared to using
total prescribing volume, the call plan can look
dramatically different.
Product Switching
It may be valuable for companies to look beneath
new prescription volumes to understand what
percentage of a physicians prescriptions that
initiate therapy actually represent switches to or
from a given product.This is particularly beneficial
if brand strategy is built on the premise of
competitive detailing.
Patient Compliance and Persistence
Patient compliance and persistence varies
dramatically from one physician to another.
Companies with a product for a chronic
condition in a market in which persistence is
generally low would want to identify those
physicians whose patient base is above average in

this area. Additionally, brand managers can actively

target those areas with higher persistency rates to
understand prescribing dynamics which ultimately
can be used for the development of promotional
messaging in other areas of the country.
Patient Age and Gender
Depending on the therapeutic area and the
products attributes, such characteristics of a
physicians patient base may be important in
determining the best physicians to reach. For
instance, a company marketing a therapy delivered
via a transdermal patch may want to concentrate
its sales efforts on physicians treating patients who
are predominantly over age 65.
Dosing
Particularly for products with dose-dependent
pricing, it could be valuable to identify those
physicians who are dosing appropriately. In
certain drug classes, atypical anti-psychotics for
example; the price difference associated with
various doses can be hundreds of dollars per
patient per month/prescription.

MANAGED CARE AFFILIATIONS

Few would dispute the importance of

understanding the role that managed care policies
and affiliations play on a physicians prescribing.
When a physician is not in a position to prescribe a
companys product because of formulary
restrictions, calls made to that physician will not be
effective from an ROI perspective.
Although many companies have the ability to push
managed care information out to sales reps, doing
so is impractical. Reps can become overwhelmed
trying to access, retain and make use of information
about formulary status in relation to individual
physician practices. However, when managed care
level of control is factored into the physician
segmentation, it is taken into consideration
automatically in creating call lists, without reps
having to worry about it.
LIFETIME VALUE OF PHYSICIANS

It may be worthwhile to calculate and consider the

anticipated lifetime value that a physician represents
to a brand. Some physicians who have a low portfolio
value today may be on a trajectory to become a
valuable portfolio prescriber in a matter of a few
years. Depending upon where a product is in its
lifecycle and the companys pipeline, it may make
sense to identify these physicians and cultivate
relationships with them today.
Another option would be to consider the profitability
characteristics of physicians in the marketplace.
Depending on brand strategy, physician profitability
based on their method of payment dynamic (cash,
Medicaid, commercial insurance, Medicare Part D),
could be considered so sales representatives spend
time in physician segments where the pharmaceutical
companys bottom line is maximized.
PORTFOLIO VALUE

A physician can easily be a valued prescriber for one

brand in a companys portfolio and not for another.
Knowing this is important when trade-offs have to
be made between finite resources.
AFFILIATIONS AND INFLUENCE

A physicians membership in a group practice or

degree of influence over other practitioners may

When a call plan is

developed narrowly on the
basis of physicians new
prescription volume and
brand market share
exclusively, the sales force
cannot hope to support the
brand strategy with any
degree of precision.
also be valid criteria for segmentation.While a
physician may not generate many prescriptions
directly, he or she may indirectly influence many
high prescribers.
CALL PLANNING MADE EASY
Following the segmentation exercise (which ideally
was conducted on an array of variables), all
physicians in the universe are assigned a score
based on their estimated value to the brand.They are
then segmented based upon their overall portfolio
valuation. Now, its a matter of determining which
segments to include, which to exclude, how many
calls should be directed at each individual and in
what order products should be discussed.
The first step is to plot the physical location of all
prospects to see how they are distributed among
existing territories.The next is to perform a work
load build-up to determine the capacity needed to
reach the most valuable physicians and understand
how that compares to the current sales force
constraints in place.
A computer program then tests various scenarios,
territory by territory, to determine the optimum
number of calls for each physician and the best
order of the product details. It is important at this
stage to look across the portfolio and to make
trade-offs according to what will be most beneficial

to the company overall.To find the best approach

for the company, the analysis must take a holistic
approach to evaluating the portfolio mix and
promotional allocation.
For each scenario, the computer model will
estimate the expected impact on sales associated
with each level of effort, product by product.
A BLUEPRINT FOR FIELD SUCCESS
The resulting call plan provides each rep with a
road map that specifies which physicians to call on,
how often and in what order to detail products.
Depending upon how much information the
company wants to share with reps and on the
capabilities of its sales force automation system,
individual call plans can also indicate the reasons
behind the instructions for each physician. For
instance, the plan might indicate that a physician is
particularly responsive to promotion and that is why
he or she is to receive a higher volume of calls. Or, it
might explain that one physician who is a high
volume prescriber is nevertheless to receive few calls
because of his or her managed care status. Or, it
could specify that a given physician frequently
switches patients from the companys brand.
While not all companies want to share this level of
detail with reps, it is potentially important because
the reasons for channeling effort to two physicians in
the same decile might be completely different. It can
also help reps adjust to the changes sometimes
dramatic that they see in their call plans when
factors other than prescribing volume and share are
taken into consideration.The new plan may ask
them to forego calling on physicians theyve always
regarded as their top priority and suddenly begin
calling on relatively unknown physicians.
The more reps understand about why decisions
were made, the more confidence they will have in
their new direction. Ultimately, this will lead to a
greater ability to effectively implement brand
strategy and drive portfolio performance.
A PRIME EXAMPLE
One company operating in a chronic therapy
market with a relatively small sales force needed

STEPS TO CREATING AN EFFECTIVE CALL PLAN

Start by segmenting physicians along
variables that relate to your brand strategy
Create a workable prospect list from the
segmentation
Generate a call plan from the prospect list
that makes the best trade-offs from a
resource and portfolio standpoint
Determine how much information you want
to share with reps about the reasons each
physician is on the call list
Educate reps on the strategy behind your
new call plan
Give reps an opportunity to make
adjustments based on their field experience
(for instance, physician access)
Refresh the data every six months and make
ongoing refinements to the plan as market
dynamics change

help in creating a call plan that would allow it to

compete effectively against much larger companies.
Sales for the companys product were relatively flat;
only 11 percent of its market growth was coming
from new patients and persistence was low across
the class.
Given its market situation, the company realized
that its success depended upon capturing market
share within physicians offices that may not be on
the radar screen of its larger competitors.
The companys initial volumetric deciling exercise
reduced the number of prospective physicians for
their product from more than 300,000 in the
universe to approximately 71,000 still too many
for the company to reach given the size of its sales
force. However, once a new initial filtering process
and segmentation parameters were applied to the
universe of physicians the prospect list dropped
to a much more manageable 32,000 physicians.

The reasons for channeling

effort to two physicians in
the same decile might be
completely different.
Physicians were selected for in-person promotion
based on their new to brand volume, product
share, promotional response level and managed
care influence.
MONEY ON THE TABLE
Traditional volume-based call planning has been
utilized for years due to its simplicity and ease of
implementation. However, this has come at the
expense of brands ability to capitalize on their
strategy and positioning. Companies that fail to
take advantage of the new information resources
available are ultimately sacrificing brand success by
not properly equipping their largest promotional
investment, the sales force.
The real issue is the money on the table.Whether it
is sourced via potential expense reductions, better
overall use of promotional resources or through
sales increases, the use of these new information
resources can provide a more precise, informed and
focused call plan.

Matt Linkewich
Engagement Manager,
Sales & Account Management
Consulting
IMS

Jay Margolis
Engagement Manager,
Sales & Account Management
Consulting
IMS

Matt Linkewich and Jay Margolis are Engagement

Managers in the Sales & Account Management
Consulting practice at IMS, helping pharmaceutical
and biotech clients of all sizes develop and execute
sales strategies designed to maximize brand and
market performance. Matt and Jay have developed
and delivered mission-critical solutions to clients
in the areas of customer segmentation, resource
optimization, incentive compensation and call
planning. Their collective background includes
nearly 25 years of pharmaceutical industry and
consulting experience. They can be reached at
mlinkewich@us.imshealth.com and
jmargolis@us.imshealth.com respectively.

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