E-detailing is the technological equivalent of the pharmaceutical representative’s traditional sales aid, used as part of their sales visits to healthcare providers. Either internet based or loaded onto a tablet PC, an e-detail is an interactive presentation which is backed up by robust CRM systems to allow for a tailored marketing approach for every single customer. Internet based e-detailing is seen by some as a method to overcome the challenge sales reps face to secure physician meeting, the e-detail effectively replacing the face-to-face contact.
Tablet based e-detailing will be presented in much the same way as paper detail aids and require contact time, however the electronic detail aid is capable of providing interaction, video content, sound, and animation which are believed to increase engagement and therefore the messages have higher salience and retention. An e-detail is stored electronically; CRM systems can be used to select appropriate content depending on the physician data and can be used to track results. The format also allows for electronic storage of clinical papers, articles and so forth, which are then easily accessible when required.
The electronic detail aid also means that updates are much easier as they involve uploading new content and there is no requirement to re-print another version. Because it is an interactive medium, the belief is that the physician will be more engaged in the messages that she or he is exposed to and thus the message will have higher salience and retention. There are a number of practitioners of e-detailing, in Europe, perhaps most prominently Creative Lynx a Manchester based creative agency who have won awards for their work in this field.
In the United States, The All scripts Physicians Interactive Group is a clear leader and purveyor of e-detailing services and physician relationship building. In Austria the Medizin Medlen Austria is the “golden standard” for pharmaceutical contents. Why add ‘e’ to traditional detailing? Whether the medical professionals like it or not, doctors often rely on pharmaceutical companies for drug information. However, having time to see sales representatives is a limiting factor for doctors.
Therefore e-Detailing provides the opportunity for pharmaceutical companies to provide this interaction on the doctors’ terms, reduce sales force expenses without losing sales and continue to develop meaningful and productive relationships with customers. Objectives of e-Detailing The first step in any strategy is to set business objectives. The types of objectives set for implementation of e-Detailing systems are: to increase the length of detail to increase the effectiveness of the detail to increase the number of prescriptions, and to decrease sales force costs without losing effectiveness. Increasing length of detail.
A Data Monitor report states that industry experts agree that the average length of a traditional detail call is around two minutes in length. However, reports from companies utilizing different technology styles of e-detailing have found that the average length of e-details in the US is lengthened dramatically. The Physicians Interactive system was reported, by Dr Gerber (General Manager of Physician Interactive), to increase the length of a detail to around ten minutes. Using a videoconferencing style format, one US pharmaceutical Company found that its average e-Detail calls lasted around 17.
4 minutes during the hours of 8am to 6pm and 28. 6 minutes between 6pm and 9pm. This shows that, at the Very least, any form of e-Detailing is showing increases of a minimum of 5 times the traditional detail. References: 1. Wang A, Jung, J, “Effective &detailing: Building trust and convenience into the physician relationship ” IBM Institute for Business Value study. LITERATURE REVIEW Literature review Electronic detailing is traditionally y used to refer to a wide range of on-line or electronic promotional activities.
Sometimes these are carried out with the rep and doctor in the same place, sometimes with the rep talking to the doctor by phone while the doctor looks at the e-detail and sometimes the doctor views the e-detail independently of the sales rep altogether The promise of e-detailing tends to be that it will be cheaper and more effective than using traditional field-based sales representatives. There is a greater potential for targeting particular segments of the doctor population and therefore companies can better design their fleet of detailing materials for maximum effect.
Moreover, it can provide a 2417, open-all-hours accessibility and convenience – allowing e-details to be viewed by doctors at home when their working day ends . ” that field-based reps cannot compete with. Andy Sarfas, Head of E-business Development at Crookes Healthcare, sees e. detailing as a tool with the potential to be very useful in getting at a specific subset of healthcare professionals. “A Jot of our products are aimed at a specific area, such as dermatology, and there are a limited number of experts in the field. So this is potentially a very good route to get high quality information to those people,” he says.
Different e-Detailing formats e-Detailing simply means using Internet-enabled electronic technology in the detailing process, therefore many formats are possible. The ‘e’ represents the use of electronic technology and involves using these technologies achieve the content of traditional non-e-Details, including educating the physician about products,” interacting with the physician to answer questions regarding their individual information needs. It can also be used to offer samples, encouraging product use and increase prescriptions written.
Some of the current e-Detailing activities being initiated by pharmaceutical companies utilize integrated video-conferencing capabilities, Internet access and high-speed telecommunications lines that allow doctors to interact with distant sales representatives at any time. However, there are a number of options that are available and are detailed overleaf. 1. Virtual live e-Detailing With the virtual live e-Detailing system, the doctor (chosen by the pharmaceutical company) is provided a pre-configured personal computer with all the necessary applications preloaded and web cam to see and speak with a sales representative.
The doctor is provided with incentives (monetary) and in return is contracted to telephone all the pharmaceutical company representatives enrolled in the system at a minimum set frequency per month in exchange for receiving the . hardware and software. The physician initiates the e-Detail session and has control over the timing of the call (both in terms of when to call and the length of call). A typical interactive session lasts around 10 to 15 minutes.
During the call the physician and sales representative (via a videoconferencing system) view and listen to a multimedia presentation about the promoted product and have the opportunity to discuss any points. During the e-Detailing session, the physician would be able to interact with the sales representative via video and audio in real time. This type of system is provided by iPhysician. Net. A variance on this approach is a system where only the sales representative is viewed or only audio and data slides are shown, depending on the wishes of the physician. These systems are provided by CRX Solutions. 2. Scripted e-Detailing.
The scripted e-Detailing enables the physician 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, including research evidence, clinical practice guidelines, prescribing information and patient advice. The doctor ‘walks through’ the screens, usually with an honorarium incentive. This system may be on the Internet or on a closed Intranet. The software used is usually a form of customized profiling software so that individual doctor preferences are taken into account during the session.
This system does not have a live interaction between the physician and the sales representative. Questions and requests from the doctors would be available via an email link with an option for telephone call/visit from a sales representative. The Physicians Interactive, Clinnix, and MyDrugRep systems all utilise this approach. 3. e-Detailing websites cDetailing Websites have usually been developed by dot-com portals. These systems vary depending on appropriate physician targets and physician prescribing behaviour segmentation and information supplied to physicians on the site implementing them.
4. Messaging to physicians’ hand held computers Messaging is not being used yet, but will be growth area of the future. Companies expected to launch products are ePhysician and pocketscript as well as the established players like Hewlett Packard. 5. Pharmaceutical company eDetaillng systems. Pharmaceutical company e-Detailing systems are provided by a pharmaceutical company with preloaded equipment to the chosen physicians. This does not involve a third-party e-Detailing vendor company. The sales train the physician on use of the system.
These systems can be a variant of any of the systems above. CRX Solutions creates individualised software solution system for customisation and use by a pharmaceutical company for their chosen physician targets. This system also allows integration with the existing IT platforms (Siebel, Autonomy, BroadVision etc. ) so that the data found can be easily integrated with other data sets (including territory management systems and IMS data for ROI analysis). Other variants of this system are pharmaceutical seles representative ‘Call me buttons’ installed on the physician computer or on a website.
These systems require either a call centre link or a link to a sales representative’s mobile phone. In these systems the physician (who is already pre· identified through a verification system) can click on the ‘call me’ button that immediately activates the specific sales representative responsible for the system to call the physician concerned. Source: bttp :lfwww. eularis. comlarticlesledetalling-roileDet:ailiDg-A-Strategic- Analysis-of-lmplementation-and-ROI. asp Why that flight path? The pressure on Pharma to change the direction of its marketing has been building up since the dawn of the new millennium.
The industry has been stung by a series of patent expiries and there are fewer new products coming to market to generate similar revenue levels. The number of new drugs submitted to the EMEA for approval last year fell to 31, down from 58 in 2001 and 54 in 2000. A similar drop was seen in the US where the FDA approved just 17 drugs in 2002, down from a record high of 53 in 1996. Sales of those products already on the market, while not necessarily falling, have failed to keep up with investment in field-based sales representatives.
For years there has been a strict correlation between field force size and product sales. It didn’t matter what the therapy area was, how it fitted into the overall product portfolio or where the reps were operating; the more reps you ran, the more sales you made. Now, the industry is seeing the cost-effectiveness of its existing reps fall and that adding new reps brings fewer returns than before. The top 40 pharma companies have doubled the size of their sales forces in the last five years but prescribing has only increased by 15%. (Source:http://www. pharmafoeus. comlcdalfoeusBfl;J. 109.
22-O-0-Ofocus_feature _ detaiJ-0-75968,OO. html) Added to this, doctors have less time to spend with reps. In the US, doctors have already reached the point of what Cap Gemini Ernst & Young call ‘time saturation’, with UK and European doctors predicted to soon follow suit. There are, after all, only so many hours in the day and only so many reps that doctors can possibly see let alone want to – and still get their work done. Dr Arnir Hannan, Information Management and Technology Lead for Tameside and Glossop peT and e-learning GP ‘expert’ for the North West, is in favour of the medium.
“It’s short but detailed,” he says, “as opposed to a rep who could talk a lot but not impart much information and I really like the idea of being able to look at information at my pace, and potentially be able to store it, review it and forward it to others as I see fit. ” As with most things of an IT nature, pharma lags behind other industries with regards to e-business in general and UK lind European pharma tends to lag behind the US. In an industry more used to 10 to l5 year timelines in product development, immediate change often seems as likely as carrying off a handbrake turn in an oil tanker.
The US lifts off So far, the US has been at the forefront of e-detailing. This has been due to greater uptake of technology among healthcare professionals, the very different regulatory environment and the fact that, as the worlds biggest single pharmaceutical market, it presents the prime location for any new marketing initiative. However, these ‘very factors mean that US successes with e-detailing don’t directly translate to this side of the pond. “The US merket is so different that it is very difficult to draw any meaningful comparisons, ,. says Andy Sarfas.
“1 know there is an awful lot of activity going off in the States on e-detailing but it doesn’t cut any weight over here I’m afraid. ” Nevertheless, the outcomes from the US are encouraging. Baxter Bioscience recently completed a number of small-scale pilot studies, which it found to be very positive. “We had a really good experience of e-detailing in the sense that in one of the pilots we had about 27% of the doctors that were reached and actually responded were doctors that would not have seen a sales rep,” says Brian Bertha, VP, Strategy and Ebusiness at Baxter Bioscience.
The method will likely need to be proved allover again in Europe, with all its different operating environments, before companies here are convinced. UK and European countdown Last year, most of the big pharma companies were trialling e-detailing initiatives in Europe and anecdotal evidence strongly suggests that the number of pilots is now rising across the board. The UK, along with Germany, is at the forefront of European e-detailing. This has come after about two years of people thinking that e-detailing sounded like a nice idea but not a pressing business need.
Now, within the last nine months to a year, more and more companies are approaching technology vendors seriously prepared to look at e-detailing, The important thing, according to Dr Amir Hannan, is whether the information being provided through an e-detail is relevant. “My feeling about e-detailing, or for that matter seeing a rep, is that they are able to highlight things that a busy clinician might not otherwise have time to sit and read through or come across,” he says. “There is a lot more opportunity, given the medium, to be creative and not just copy the details that reps already have.
If its stimulating and interesting from my perspective I’m more likely to open it up,” he adds. A number of companies, having conducted small pilots in Europe and the UK. , are now moving onto the next stage and rolling out initiatives over several different brands and geographical areas. But as to who is doing what – at the moment its all in the realm of confidentiality and non-disclosure agreements. However, companies such as Aventis, Novartis and Pfizerare understood to be among those to have invested heavily in e-detailing programmes. Down to Earth.
As a new marketing medium for the industry there may be some disquiet as to how it should fit within the ABPI’s Code of Practice. I joke that itisa good thing for complaints to be made, because it proves that e-detailing is being taken as seriously as other promotional means, but in reality no one wants to defend themselves from such complaints if it can be avoided. The underlying law on which the Code is based doesn’t actually refer to electronic advertising or the Internet as such, which plants a seed of confusion in some people’s minds.
However, the European directive and UK regulations that are the basis for the Code apply to advertising, whatever format it is in. Indeed, the Code of Practice was this year updated with a special clause to cover the Internet in pharmaceutical marketing. Essentially, the Code of Practice in its entirety applies to all advertising, whether in an electronic, verbal or hard copy format. It therefore doesn’t matter how information is presented – any claims made must be capable of being substantiated • so the fact that something is being e-detailed doesn’t drastically change anything.
The PMCP A, which has had a number of enquiries form pharma companies in this area, suggests going through an electronic detail and checking it as if it were a hard copy detail. Returns Where is the return on my investment? Its always a tricky issue in marketing, but calculating RoI in any e-business initiative is particularly difficult given the newness of the medium and the consequent scarcity of data.
A lot of the available measurements have been ‘soft’ ones· qualitative rather than quantitative data that don’t look at the bottom line of why pharma should use e-Detailing. : “People tend to look at increasing the length of the detail or increasing the effectiveness of the detail, which are well and good, but they also need to 10000k at increasing the number of prescriptions and potentially decreasing salesforce costs as well. ‘
Returns may also depend on where in its lifecycle 3 product is. “E-detailing seems to be better for products at launch and products that are very mature and at the end of their lifecycle,’ says Andre Bates. Given the range of variables, therefore, there seems to be no quick answer to e-detailing Rol. But as Brian Bertha points out: “There is always a lack of hard data with advertising. ” E-detailing in the marketing mix.
Whatever its future, no one, not even the technology vendors, expects e-detailing to take over from visits by traditional sales reps. The advantages of face-to-face selling are simply too great and doctors, like anyone else, tend to buy from people. They like the contact and interaction they get with visits by good reps and the chance to go over things as they occur to them that might not be on the detailing script. But given that things need to change in pharmaceutical marketing, e-detailing could be an important supplemental practice, adding something to the overall marketing mix and strengthening the hand of sales reps.
Dr Amir Hannan likens it to the contents page of a text book, with its summaries of the issues that can then be discussed as necessary with a sales rep. “It’ has advantages and there is a place for it,” he says, “which is different to that that reps give. But I wouldn’t go so far as saying its instead of reps – it supports what reps do. ” Andy Sarfas agrees: “E-detailing will never replace face-to-face but I think it can be an important supplementary. tool. Effectively it allows you to put your best representative in front of a much wider gro:up of people.
” The e-detailing space ahead E-detailing is predicted to emerge as a core component’ of the marketing mix by 2006. Early adopters can look forward to knowing what to do, what will work and how to use it when the time comes to roll out large-scale, country-wide schemes. The lack of publicly available hard evidence is prompting some companies to adopt a wait-and-see approach. Andy Sarfas says: “We looked at using e-detailing about six months ago and the main barrier was the lack of hard evidence of successful e-Detailing in the UK.
It’s very difficult to get a handle on how many healthcare professionals can actually access the system and how many would access the system. ” But he is optimistic for the future. “If doctors can access information on demand through a system that delivers then I think we’ll see an explosion [in e-Detailing use]. ” The industry is currently negotiating an impasse worthy of the chicken and the egg. Investments in e-detailing are held up until its efficacy can be proved, but efficacy can not be proved until the medium is tested, which requires investment.
Positive results are coming from the US, but they are no match for trialing in your own market and making it work on your terms, and that requires considerable thought on what you want to do with it. Perhaps it is still true that ‘no one ever got fired for choosing mM’, but in a changing business environment it will soon be more than just the innovators that need to stick their necks out and try something new. Code of Practice complaints 1II”e always 8 possibility for any marketing ·effort and you might instead be rewarded for your efforts.
Results of e-detailing survey indicate pharma see a future for it in the marketing mix The UK Pharma industry remains open-minded about using online detailing, but wants to see more evidence of its effectiveness, a new survey shows. In a poll carried out for Pharmafocus by online detailing company Medix, 64% of respondents said they were likely to use e-detailing in the future and 59% thought it provided a valuable support to rep activity. Although only 3% thought it had no place at all in the marketing mix, 38% of people polled felt that, as a relatively new concept, it had yet to be proven.
The research, the first of its kind to assess industry rather than doctor attitudes to e-Detailing, suggests that, given time, the medium is likely to become a significant-part of the Pharma marketing mix. Rino Cola Angelo, chief executive of Medix, commented: “Overall people who have used online detailing seem to have had a positive experience and see a future for it in their company:” The most popular advantages of online detailing identified by the survey were its cost effectiveness, its consistency of message and the convenience of its use for doctors.
With doctors facing increasing pressures on their time and workload, e-detailing has been suggested as a way for interested doctors to learn about new products at a time that suits them outside surgery hours. This trend will be added to as the UK, in common with much of the western world, seeks to treat an ageing population. Concerns about the medium’S lack of effectiveness were perceived to be one the biggest issues holding back greater use of e-detailing, with respondents noting the medium’s lack of the human interaction of a sales representative detailing a product to a doctor face-to-face.
Whilst there are video-conferencing models that could get around this, perceptions of the medium do not yet encompass the full range of e-Detailing methods available. The survey also rated traditional Pharma sales reps the most effective marketing channel available to the industry, ahead of journal advertising; sponsored seminars or conferences, mailings, giveaways and the Internet. But online detailing was viewed as an important supplementary promotional activity, with 41 % of respondents saying it provided value for money as a promotional activity.
More than half of those questioned thought e-detailing WlIS already an important clement of the marketing mix. A report last year by IBM Institute for Business Value agreed that a model where e-detailing and traditional sales representatives are both employed should be adopted. “In general, e-detailing can be used to fill in the ‘gaps’ where traditional detailing falls short,” the consultants said in their Effective E-detailing report. “E-detailing tactics should augment, rather than replace, the faceto-face approach. “
The Pharmafocus/Medix poll also suggested online detailing could also be particularly useful to products that are not currently being, or won’t be, detailed by reps. One Pharma brand manager said: “Its ability to get 10 doctors without a sales force would allow us to inform and influence GPs about om OTC launches without having to. buy in a GP sales force. ” A recent international survey by Cap Gemini Ernst & Young found that doctors were increasingly making a conscious decision to give up less of their time to see the industrys sales reps.
In the current climate, any additional routes of access to doctors are welcome,” another respondent commented. The Pharmafocus/Medix poll indicates that there are two groups of companies currently using e-detailing, Early adopters, who’ve used e-detailing on more than four products in the last year, have now being joined by a second wave of companies who c-detailed one product in the same period. The further adoption of e-detailing in the UK and Europe is currently constrained by the lack of hard evidence on the medium’s effectiveness.
However, two of the UK’s largest companies are among those understood to be working on e-detailing pilots at the moment and evidence from at least one of them is due to be released soon. Until then it looks like the industry is infuvour of e-detailing, but it’s going to take time before the medium is wholeheartedly embraced. Global Lessons Currently most e-Detailing initiatives are being run in the US and the reasons for this are clear; largest pharmaceutical market, more prescriptions, more physicians, and greater Internet penetration.
It is clearly the market to pilot first as the benefits found there are likely to be largest in ROI terms. IMS Health (2000) report that the breakdown of prescriptions by region is 39. 6% US 25. 1% EU 16. 4% Japan The Rest of the World (ROW) combined comes nowhere close to meeting these’ proportions of prescription sales. Also, the majority of case studies showing strong Raj are in US also. Some of the lessons learnt so far are: Physicians want to initiate the eDetail on their time terms Physicians value the relationship with their rep Physicians prefer interactivity.
E-detailing in Coming years: Today the impact of the internet and related technologies on every aspect of life is inescapable. So, we should not be surprised that this impact also extends to healthcare professional, patient and other stakeholder populations, in the context of disease and product research and information search and retrieval. Healthcare professionals now place the internet top of the list of sources of professional information, and pharmaceutical company executives are now realising that the traditional sales & marketing mix must evolve rapidly to include the online channel.
There are now certain companies (or even certain cells within certain companies) which are really beginning to understand e-detailing and the place of wider emarketing initiatives in their marketing strategy. ROI is now being proved more and more as e-detailing solutions begin to deliver campaigns that are ‘on message’ and’ hitting the right notes with the healthcare professional customer base.
These solutions are starting to win pharmaceutical company and industry awards (not just for innovation but also when pitched against traditional activities), and they are running iteratively over multiple campaign waves (i.e, learning from activity. refining the message and redeploying) …
The internet and related technologies have become a core. element oftoday’s digital age, an age that the pharmaceutical industry is slowly beginning to embrace, and an evolving e-detailing solution forms a significant part of the opportunity that this provides to the industry in thinking more smartly and getting greater ROI from their sales and marketing investment. Finally for those that still ask if e-detailing signals the death of the sales rep. my answer is categorically NO!
As e-detailing evolves it will only serve to improve the pharmaceutical sales force function and provide RULES AND REGULATOIONS FOR E-DETAILING EU Legal and Regulatory Issues Pertinent rules and regulations E-detailing has been pioneered in the US and as mentioned is already in use there. Whether it successfully drifts across the Atlantic will partially depend upon the ease with which eDetaii systems can be employed within existing legislation. It is important to be realistic about the European climate for the pharmaceutical industry which compared to the US’s is a lot less free.
The issue of direct-to-consumer of prescription medicines clearly highlights the difference in approach. In the US it has been perfectly legal for some time to advertise prescription-only drugs to the general public. Contrast this to Western Europe where it is still illegal and only very slowly are the regulatory barriers being eroded. Advertising and marketing of medicines is heavily regulated in Europe either by the European Council’s Directive 92/28/EEC or national legislation.
As e-Detailing uses recent technologies and new forms of communications there could be problems with existing legislation governing the advertising of prescription medicines. Another big difference between Europe and the US is the comparative freedom that US companies have to reward doctors. For example, doctors taking part in programmes run by Physicians Interactive must write a practice prescription before receiving a ‘reward’ and reinforcement package and iPhysicianNet provides doctors with computer hardware to take part in e-Detailing.
These methods to entice doctors to prescribe or take part in a .detail, would be frowned upon in Europe, probably would break codes of practice and even break legislation. We examined the some of the regulatory issues directly affecting any e-Detailing facility. The legislation of the 16 countries of the European Union falls directly under the EC’s, for those states outside the EU national legislation will apply, The regulation of medicines’ advertising in the United Kingdom provides a useful example of how cautious companies must be when designing an e-Detailing facility, We examined the various regulations and guidelines and contacted the relevant parties.
We posed questions about e-Detailing to which the answers were not already clear. The Medicines Control Agency (MCA) The Medicines Control Agency (UK) regulates and enforces the supply of medicines in the UK. The legal basis for the control of advertising of medicines is based on the Medicines (Advertising) Regulations 1994 and the Medicines (Monitoring of Advertising) Regulations 1994. These fall under the European Directive 92/2811EC on the advertising of medicinal products for human use.
This covers all methods of advertising, including electronic and therefore e-Detailing. The regulations concerning this topic are succinctly outlined in MeA Guidance Note No. 23 ‘Advertising and Promotion of Medicines in the UK’ 1. We wrote to the Medicines Control Agency to clarify a number of points surrounding e-Detailing. Q. Can the Internet be used to promote prescription products to medical professionals? The answer is yes, provided the site is ‘wholly or mainly’ directed at health professionals (regulation l3(I) Advertising Regulations).
This may involve confirming that the end-user is a health professional. In particular a site offering an e-Detailing facility must not linked to other websites that are mainly aimed at, or promoted to, members of the public. Q. What is the definition of a visit by a sales representative? This is an important question as the Guidance Notes states in Clause 4. 7(2): “[sales] Representatives should during each visit, give to all persons whom they visit, or have available for them, a copy of the SPC data sheet for each product which they promote at that visit.
” The MCA defines a visit as a ‘physical encounter’ which does not include virtual interaction. Q. Can SPC information be delivered electronically? Provided that the SPC information meets the requirement of Schedule 2 of the Advertising Regulations they can be delivered electronically. However, when a representative visits a prescribing professional (see above) the MCA considers that SPC information cannot be provided electronically and a physical document must be to hand. Q. Can companies involved in e-Detailing supply the necessary equipment (i.e. a computer) to doctors?
The MCA replies. “Regulation 21 of the Advertising Regulations which makes ‘provision for inducements and hospitality will also apply to e-Detailing. By regulation 21(1), a ‘gift. pecuniary advantage or benefit in kind’ may not be provided unless it is ‘inexpensive and relevant to the practice of medicine or pharmacy’. The MeA regards inexpensive as meaning a gift etc. which does not cost more than ?