How GSK shattered conflict of interest in ties with doctors
Lynn Baxter started as a medical representative in the United Kingdom, rising to local, regional and global positions handling different products and markets in various countries such as China and Belgium.
She is currently the president of GlaxoSmithKline (GSK) in the Philippines. GSK is a research-based, patient-focused global pharmaceutical firm.
She shares her insights on the sales innovation process happening in GSK.
Q1: GSK is operating in a highly regulated pharmaceutical industry, yet, it added another layer of internal process where the sales force is no longer rewarded based on the number of prescriptions generated. Why was this practice changed? What new metrics will you use? What are your options if this doesn’t work out?
A: It is a well-established practice in the pharmaceutical industry, globally, including the Philippines, to incentivize individual medical sales representatives and sales teams based on the number of prescriptions written by doctors. This commercial practice, which GSK Philippines also applied in the past, could open Filipino patients and the public to view a conflict of interest, real or perceived, in the interaction between pharmaceutical companies and doctors.
For patients, this could ultimately undermine trust and confidence in the treatment choices made for them.
We, in GSK, want to change this.
As a global healthcare company, we believe we can play an important role in making bold choices to innovate and lead the change.
As we aim to be one of the most innovative, best performing and trusted healthcare companies, we need to make “how” we do things just as important as “what” we do.
In 2015, we announced the implementation of significant new measures in the way we market and sell our medicines and vaccines to doctors. Transforming our business model to ensure patients are at the heart of every decision we make including changing how we incentivize our medical sales representatives.
Around the world, our medical sales representatives no longer have individual sales targets.
Instead, alongside group performance, they are now incentivized based on a broader set of business performance measures that helps ensure they deliver high-quality, balanced, and patient-centric discussions and activities to doctors.
I firmly believe that it is the right thing to do in fulfilling our role of helping doctors make informed decisions for their patients.
While bold and unprecedented, I see that there are many benefits to patients and doctors, and to business performance.
In my engagements with many doctors all over the Philippines, I have been very encouraged by how they are commending the change GSK is leading.
With the changes we are leading, we want Filipino patients to feel confident that whenever they are prescribed a GSK medicine or vaccine by their doctor, the decision was based on understanding and belief in available scientific evidence.
Q2:How do you reconcile the sales targets of upper management with the deliverables of the sales force? How do you assure attainment of sales target then?
A: As a global corporation, we have obligations to deliver sustainable returns to our investors and shareholders. Like any other local operating company, our business in the Philippines is expected to perform and contribute to these financial objectives.
Our strong 2016 global group performance has been achieved under this new model, which retains a focus on performance but simply decouples individual medical sales representative incentives and individual doctor prescribing.
More than two years under the new incentive model, we recently reported our global first quarter performance for 2017 and we continue to see positive growth and improved margins.
I believe that pharmaceutical industry performance and stakeholder trust will increasingly be inextricably linked.
Alongside trust, for our business to succeed, it is important that all of us in the company work together in an aligned way to do great business—everyone is accountable, everyone contributes.
In many of my engagements and conversations with our teams, wherever in the organization, I always emphasize the importance of the role of each individual and team to understand and deliver on their contribution to the company’s success.
Among our sales teams, they remain clear that they are the business owners in their area of operation, fully accountable to deliver business performance. So while there are changes in how we are incentivizing their performance, their primary role remains—to convince doctors to prescribe the right GSK products to patients, based on scientific evidence communicated in a balanced and ethical manner.
Q3: GSK stopped direct payments to doctors when they speak on your behalf during events. This means VIP doctors’ endorsement is no longer a key factor for success. What innovation replaced this and why?
A: We see that there is an opportunity for the industry to transform and modernize this established way of providing support to professional medical education, in a way that removes any perceived or real conflict of interest and builds trust. Involving doctors, patient groups, and a wide range of experts in the pharmaceutical industry, we engaged in global discussions on how we could work together to build a new approach.
This helped lead us to a decision to end the practice of paying doctors to speak on our behalf about our medicines and vaccines before their colleagues.
Instead, we took a bold investment decision to actively recruit more medical doctor experts and specialists to work within GSK so they could have access to the latest scientific and clinical information to support them to effectively speak and answer questions about our medicines and vaccines, without raising questions on conflict of interest.
In the Philippines, we have successfully recruited extremely credible and experienced doctors who are highly regarded both locally and globally, many of whom were attracted to join GSK due to our focus on innovation, performance and trust.
Q4: GSK is now heavy on digital media, educating doctors via webinars and online resources instead of inviting them to attend seminars in five-star hotels. What has been your experience on this so far? How is the invitation extended considering some hospitals have already disallowed visits from med reps?
A: I acknowledge that doctors are increasingly challenged by the demands of both their professional and personal lives. For them to make timely and appropriate treatment decisions for their patients, they need information and answers fast—tailored to their needs, whenever, wherever, in a way that is convenient to them. It’s also important to note that today’s rapidly changing world offers new opportunity through technology-aided platforms and alternative channels that allow sharing of information faster, broader, and in cost-effective and convenient ways.
To better respond to doctors’ needs and, at the same time, deliver an improved customer experience, we in GSK decided to significantly invest to scale-up and accelerate our multichannel interaction platforms through which doctors can access relevant information—whether through their smartphones on their way to work, their computers in the clinic or their tablet devices in the evening at home.
Q5: What were the challenges in the beginning? What challenges do you still need to overcome?
A: Internally, GSK employees in the Philippines, especially our medical representatives, initially sought to gain deeper understanding of the new business model’s rationale and clarity on how it would be successfully implemented in the local setting. Understandably, our sales teams had to take time adapting to changes in what were expected of them, as these required building new capabilities and revising the basis of their incentives.
Externally, we were faced with some challenges on re-aligning our ways of working and redefining the relationship between our medical representatives and doctors.
We needed to continually clarify the changes we were making and the positive benefits these would bring in helping doctors make informed treatment decisions for patients by providing information in different and convenient ways.
More recently in 2016, GSK Philippines took up the mandate to embrace and “industrialize” the delivery of GSK’s new business model at a faster pace—scaling up execution of doctor interaction activities through several different channels, aiming to deliver exceptional customer experience.
This ambition required stronger dedication, commitment and focus from the whole GSK Philippines organization.
It is critically important that we innovate with pace and agility to operate efficiently and effectively to realize our vision of a modernized operating model that delivers sustained business performance and builds trust.—CONTRIBUTED
