8/6/2019 PCAM Presentation
1/33
Primary care account
management
November 2008
8/6/2019 PCAM Presentation
2/33
What is account management?
8/6/2019 PCAM Presentation
3/33
Definitions of account management
Account management is an attitude where many different skills and in-depth account
knowledge are utilised combined with tenacious behaviour
Key skills for successful account management
Planning Relationship Problem
building solving
Marketing Negotiating Opportunity
creating
Organisation Communicating Presenting
Selling
8/6/2019 PCAM Presentation
4/33
Key areas of knowledge for account management
The benefits of successful key account management include:
keeping out yourcompetitors
a focus on long-term planning
a mutually beneficial business relationship increased business growth
Focus Flexibility
Diplomacy
Tenacity
Independent
training Team
player
Opportunity
seeker
8/6/2019 PCAM Presentation
5/33
Becoming a partner of choice
Customer perception has a huge impact
A true partner ofchoice will focus upon the customer's agenda
Account managers should be customer-focused
How can I add
more value for mycustomers?
8/6/2019 PCAM Presentation
6/33
Customers have three maintypes of need:
organisational needs
personal needs
clinical needs
Becoming a partner of choice
Questions to consider:
How often do we take time to discover ourcustomer's perceptions of us and discover theiragenda?
How often do we find ourselves in win: win scenarios versus win: lose or lose: win?
What questions will help you to uncover the customer's agenda and therefore their real
needs?
Customer needs
Maslow's hierarchy of needs theory
Customers buy on their emotional/personal needs
Must identify the most important needs Often the focus is on customers clinical needs
without exploring the others
8/6/2019 PCAM Presentation
7/33
Becoming partner of choice
Level 1 Me too, is seen by customers as someone who is selling a product which
they perceive to be the same as everyone else, there seems to be no differentiation
so cost is their main decision criteria. There is no customer loyalty.
Level 2 The salesperson is seen as someone with a product with some benefits above
other suppliers. Cost is still a driving force and customer loyalty is low. The sales person hasmore of an emphasis on benefit selling.
Level 3 The sales consultant is seen as some one who will help the customer achieve their
objectives. Here, cost is no longer the driving force and customer loyalty increases. The sales
consultant sets their account objectives to mirror the customer's objectives. They understand the
customer's priorities, challenges and needs.
Level 4 The partner ofchoice is seen as part of the team, an insider. They offer strategic advice whilst still selling theirproduct. Price is no longer a huge threat as customer loyalty is at a high. They have a huge network within the account andknow when things are going to happen before they do. They constantly discover new opportunities in the account, understand
the decision making process, and win new business. They work at a higher level, understanding the organisational priorities,needs and challenges in addition to those of the individual key customers.
8/6/2019 PCAM Presentation
8/33
Differences between key account management, account
management and account selling
The pharmaceutical industry uses many different labels when defining an
account approach:
y account selling
- short-term goals- large accounts or business units
y account management
- long-term business relationship
- multi-levelcontra
ct
y key account management
- accounts are prioritised
8/6/2019 PCAM Presentation
9/33
Identifying key accounts
A key account offers long-term potential. If you are required to prioritise youraccounts, ask yourself the following questions:
Is this account a high revenueproducer?
Are they looking
for industry
partnership?
Are there
opportunities to
increase sales?
Is it a strategically important
account, ie, one with highnational or regional influence or are they key opinion leaders inyour disease area?
8/6/2019 PCAM Presentation
10/33
Why is account management important?
Proactively manage our future business
Identify customers that will help achieve objectives
Gain entry to new customers
Increase loyalty and allocate resources
The wider network may include customers not seen before, for example:
finance directors,
customers within the primary care trust
bed managers
8/6/2019 PCAM Presentation
11/33
Influence versus usage
It is important to understand the customer's level of influence versus theirusage of a product
Often time is spent with key customers who have high influence yet theirusage is low
High users with less wider influence would be the GPs and increasingly,
nurses and pharmacists Time management is important
Questions to consider:
In accounts where you have formulary inclusion in both primary and secondary care, what actions
are you taking?
Who are you seeing?
Are you relying on one or two customers to influence the level of prescribing in the account?
What else could you do to drive your business in this account?
Product on PCT formulary GPs/pharmacists/nurses High usage/ low influence
Product not on PCT formulary Secondary care referral High influence/ low usage
8/6/2019 PCAM Presentation
12/33
Discovering opportunities
Uncovering opportunities
Asking about the customer's long-term and short-term priorities andchallenges could uncover an area where you can work together inpartnership
Understanding who influences a
customer's de
cision-making opens up theinfluencing network
What are the PCT and trust long-term objectives?
What do they need to help achieve those objectives?
What is the customer's perception of you and yourcompany?
What are your strengths, weaknesses, opportunities and threats?
Sales figures, how are they tracking? What are yourcompetitors doing? Are
you responding appropriately? Past successes/ failures, what have you learned? What will you stop, start
and continue doing?
Who are the key decision-makers and who influences them?
8/6/2019 PCAM Presentation
13/33
SWOT analysis
Each of the four areas should be considered in terms of what is beinganalysed.
Strengths
Internal characteristics,
behaviours, aspects ofperformance etc. that
you consider to be
strong.
Weaknesses
Internal characteristics,
behaviours, aspects ofperformance etc. that you
consider to be weak.
OpportunitiesExternal events, changes,
happenings etc. which may
provide positive
opportunities for growth or
improvement.
Th
reatsExternal events, changes,
happenings etc. which
could be detrimental to any
aspect of the area being
analysed.
8/6/2019 PCAM Presentation
14/33
Planning and prioritisation
It is recommended that an account development plan is put into place for each
account.
The three steps to completing a successful account plan are:
Set account
objectives
what by when
Key strategies
and tactics
how to achieve
the objective,
by who and by
when
Write the key
account
development plan
in an easy to
follow format
8/6/2019 PCAM Presentation
15/33
Setting goals and objectives
Account objectives will differ for each account
Objectives are SMART
Use the following outcome planner to check whether the objective you have
written will enable you to achieve your ultimate goal:
1. Outcome
2. Run it like a video
3. Can you own it?
4. Is it appropriate?
5. Positive by-products6. What is the cost?
7. Time frames
8. Ecology
9. How will you achieve it?
Questions to consider:
Consider your most important
account. What is your account
objective? Now run through the
well formed outcome planner.
Is your outcome the same or
do you need to change it?
8/6/2019 PCAM Presentation
16/33
Planning and prioritisation Information gathering
When working in a primary care arena we need to know who is who, whichcustomers are important to our business and where to find them.
Need to know how to:
- access our target customers
- find out if they are prescribers
- if they are, what they prescribe in theirarea of medicine together with who the
other key influencers and decision-
makers are
Examples of information required:
the decision-makers
the influencers; positive and negative who is involved in decision-making
within the local health economy?
customers perception of you, your
company and the account SWOT
analysis
the customer's needs; organisational,
personal and clinical
the customer's priorities andchallenges in the short, medium to
long-term
the customer's perceptions of
competitors
8/6/2019 PCAM Presentation
17/33
Tactical plans: the how
In order to grow market share orcash growth many different actions can betaken based upon the opportunities uncovered or already available in theaccount.
These could include:
formulary/guideline inclusion or review
departmental protocols
secondary care guidelines
shared care guidelines
speaker meetings
departmental meetings
selling one on one
8/6/2019 PCAM Presentation
18/33
Resource required
Account management is not about working harder it is about working
smarter
Often there are internal resources available that could be utilised more
thoroughly and consistently
Internal resources may include:
Marketing
Medical
Medical information
Colleagues
Managers
Representatives
NHS liaison
Budget
Questions to consider:
What are the internal
resources that you could
utilise in your most
important account?
8/6/2019 PCAM Presentation
19/33
The big picture
PEC board
PEC chairman
Chief executive
Director of finance
Social services representative Director of public health
Executive nurse
Clinical governance lead
Prescribing lead
Pharmacy advisers
PCT board
Lay chair
The lay members
The chief executive
Director of finance
Director of public health
8/6/2019 PCAM Presentation
20/33
PCTs
Within a primary care organisation are many sub-committees such asprescribing, cardiovascular disease, diabetes and clinical governance.
When putting an account togetherconsider the important questions eg:
Who is on what committee?
What level of influence does each of these committees have on the rest of thePCT?
What is the level of influence each of these committees has beyond theconfines of the PCT?
Who within the PCT does it have most influence with?
What relevance does this information have to helping me achieving myobjective?
What must I be doing?
8/6/2019 PCAM Presentation
21/33
PCT funding
PCTs
81 per cent of NHS funding
100 per cent of the expendable budget
Four distinct areas must be funded:
1. commissioning of hospital, mental health and learning
disability services2. primary care infrastructure
3. providing community services
4. running and management costs
8/6/2019 PCAM Presentation
22/33
Drugs and therapeutics committees
Role of drugs and therapeutics committees (DTCs) - spanning both
secondary and primary care:
develop and/or approve hospital, clinical directorate and nursing
medicine policies
monitor drug budget develop and/or approve cost containment measures
advise the trust of the impact of new drugs
seek funding for new drugs
advise pur chaser of impact of new drugs
seek funding from purchaser for new drugs
develop and/or approve joint/shared care prescribing protocolswith primary care
develop and/or approve patient information
develop and/or approve prescribing documents (primary and
secondary care)
monitor medication errors
8/6/2019 PCAM Presentation
23/33
Working together
Although different stakeholders within accounts have individual agendas,
drivers and targets, there is also significant overlap in their agendas.
8/6/2019 PCAM Presentation
24/33
Formularies
What are formularies and guidelines for?
1) Administrative reasons: this leads to rationalised purchasing and simplifiesdispensing
2) Clinical reasons: the fewer the number of products, the more familiar ea
chone will be to doctors, nurses and pharmacists, which lessens the likelihood
of mistakes in prescribing, dispensing and administering the drugs
3) Medical reasons: for example, restricting the use of antibiotics so as tominimise the development of resistance. This tends to be an area whereformulary/guideline recommendations are quite strictly applied
4) Cost containment: formularies/guidelines may ensure that it is more difficultfor newer, more expensive products to be used in accounts. The keyinfluencers can limit cost within a given therapy area.
8/6/2019 PCAM Presentation
25/33
Advantages to formulary/guideline inclusion
In some therapy areas the formulary is used more as a guideline.
The simple guide to gaining PCT formulary inclusion:
1. Obtain a copy of the formulary
2. Find out how often the area prescribing and medicines management committee/ DTC sit
3. Project plan
4. Find out what the procedure is for getting a product considered for discussion at APC and
DTC level
5. Who is on these committees?
6. Plan your campaign
7. Uncover what criteria the committee will use to make a decision
8. Before the meeting, provide your supporters with written evidence to help them back your
product
9. If you are successful, find out why and if you're not find out what needs to be done next time
8/6/2019 PCAM Presentation
26/33
What if your product is not on formulary?
Guidelines help achieve standardised care and promote evidence-basedmedicine
Guidelines are often produced by the members of the primary caremedicine management group or area prescribing committee using the bestavailable evidence at the time
Shared care guidelines are aimed at both primary and secondary careprescribers
80 per cent of prescribing will fall within the guidelines
Questions to consider:
In which of your accounts do you need to gain formulary status? Have you a written project plan with milestones and timelines
on how you will do this?
In those accounts where you have formulary status do you
know when it is up for review?
What are the obstacles to you achieving your goal?
When guidelines are issued does the PCT name your product?
8/6/2019 PCAM Presentation
27/33
Shared care guidelines
The NHS Management Executive issued its guidance on prescribing at the
hospital/GP interface through an executive letter EL (91) 127: responsibility
for prescribing between hospitals and GPs.
The NHS Executive has asked for:
'Responsibility for prescribing between
hospitals and GPs so that where a
consultant considers a patient's
condition is stable, he may seek the
agreement of the GP to share the care'.
EL (94) 72: purchasing and prescribingfurther stated that where GPs accept
prescribing responsibility, they should
have all the information and support
that they need to prescribe and monitor
their patients.
Shared care guidelines willnormally include:
indication
general guidance
background
secondary care responsibilities primary care responsibilities
contact details
8/6/2019 PCAM Presentation
28/33
Patient pathways
'The patient pathway is the route that a patient will take from their
first contact with an NHS member of staff (usually their GP),
through referral, to the completion of their treatment. It also covers
the period from entry into a hospital or a treatment centre, until the
patient leaves. You can think of it as a timeline, on which every event
relating to treatment can be entered. Events such as consultations,
diagnosis, treatment, medication, diet, assessment, teaching and
preparing for discharge from the hospital can all be mapped on this
timeline.
The pathway gives an outline of what is likely to happen on the
patient's journey and can be used both for patient information and for
planning services as a template pathway can be created for common
services and operations.'
What is a patient pathway?
The Department of Health website definition is:
8/6/2019 PCAM Presentation
29/33
8/6/2019 PCAM Presentation
30/33
Politics
Local delivery plans
Local delivery plans are three-year programmes to improve the healthstatus and healthcare of a local population. They have to reflect nationalpriorities.
Local delivery plans cover:
1. the most important health needs of the
population
2. the main healthcare requirements of local people
3. the range and location of services and the
investment required
Hospitals and primary care
There is much talk these days of the primary-secondary care
interface; this encompasses what types of specialty can be
performed, and which types ofclinician can work in each setting.
8/6/2019 PCAM Presentation
31/33
Influencing
Roles within the decision
There are generally six types ofcustomer in an account:
1. Decision-makers make the final commitment to the outcome you areseeking
2. Influencers (+)can positively influen
ce the de
cision3. Influencers (-) can negatively influence the decision. They may use
competitor products
4. User prescribes the products and will work with the decision
5. Specialist will be engaged by the decision-maker to advise orcover themore technical area's in the decision
6. Ally with someone who you have a great relationship with, who helps you
discover new opportunities and will give a heads up on the account. Theymay have no influence on the decision you seek
Questions to consider:
Consider your key account:
what decisions do you need to be made
who is involved in that decision?
what are their roles and what is your strategy with each of these people?
8/6/2019 PCAM Presentation
32/33
Influencing tactics
There are many techniques we can use to influence. We can use more thanone in any given situation:
build rapport with yourcustomer by matching and mirroring body
language, voice tone, speed and volume
create empathy
logical structured argument
asking a favour; done well, people find it hard to say no
create a compelling futureimagine if
using others who have a greater relationship with the customer
negotiate if I do x will you do y?
appealing to ego or need for recognition
using third party references to appeal to their sense of affiliation, eg, Dr X
at the PCT was saying it has saved him lots of time
8/6/2019 PCAM Presentation
33/33
Questions?
?