MAP of Motivation for Pharma Field Force

TM

MEDICINMAN
December 2013 | www.medicinman.net

Field Force Excellence

Editorial

Herzberg,
Motivation and
Indian Pharma
Field Force
Work-life balance is a major job
satisfier for Gen X and Gen Y.
Pharma needs to factor this in to
attract and retain talent.

W

hen I posted this
illustration (fig. 1) on
Facebook (FB) with the
caption – “Why a 5 Day Week May
Actually Increase Productivity”, it
touched a raw nerve and evoked
tremendous response from Indian
pharma field force people.
Theories on motivation have been
evolving over time. The most recent
work to have captured the attention
of academics and practitioners
alike is the well researched and well
articulated book by Daniel Pink
“Drive: the Surprising Truth about
What Motivates Us”.
Field sales people working in most
Indian companies have 24x7x365
schedule, leaving them with
hardly any quality time for family,
friends or just relaxing. This has an
adverse impact on motivation and
performance. Tired and stressedout Medical Reps are not the most
effective people and this is reflected
in the large number of less than
effective field sales calls. Concepts
like SFE will be far more effective
when combined with fundamental
aspects of job satisfaction that
leads to motivation and superior
performance.

“
(fig. 1)

“

Indian Pharma needs to look afresh at field force
motivation than simply using the outdated carrot
and stick method, which has only led to very high
attrition and steep drop in quality of people being
attracted to pursue a career in pharma field sales.

”

It was Frederick Herzberg, who first
developed the two-factor theory
that states that there are certain
factors in the workplace that cause
job satisfaction, while a separate
set of factors cause dissatisfaction.
Herzberg brought clarity by saying
that job satisfaction and job
dissatisfaction are separate factors
and act independently of each
other.

Anup Soans | Editorial: The MAP of Motivation

When we look at Indian pharma field force working
conditions job dis-satisfiers outnumber job satisfiers.
Indian Pharma needs to look afresh at field force
motivation than simply using the outdated carrot and
stick method, which has only led to very high attrition
and steep drop in quality of people being attracted to
pursue a career in pharma field sales. Even top MNC’s are
having a tough time attracting and retaining talent.
I have covered this topic in detail in the article –
“Understanding Significance of Mastery, Autonomy and
Purpose in Field Force Excellence”. (See page 18)
The MedicinMan Excellence Awards are an effort in the
direction of increasing job satisfiers and removing job
dis-satisfiers. To know more, be there at Brand Drift and
FFE 2014 on 7th and 8th Feb 2014.
Follow me on FB, LinkedIn and Twitter to get a pulse of
the Indian Pharma’s field force - and marketing news,
views, learning and development. I welcome your
thoughts and ideas on how pharma field force can be
made an attractive and satisfying career. This would
certainly have a positive business impact on the flagging
Indian Pharma growth prospects as indicated by a recent
IMS report, which I have also shared on FB.

Meet the Editor
Anup Soans is an Author, Facilitator and the
Editor of MedicinMan.
Write in to him: anupsoans@medicinman.net
Connect with Anup Soans on LinkedIn | Facebook | Twitter
Visit anupsoans.com.

MEDICINMAN Pharma Sales

& Marketing Conference 2014
FFE | BRAND DRIFT | AWARDS
7th - 8th February 2014
Courtyard Marriott, Mumbai
See page 7

CONTENTS (Click to navigate)
1. Sales vs. Marketing: the customer doesn’t
care! ..........................................................................4
In the war between sales and marketing, the
customer is hurt the most.
Salil Kallianpur
2. The Rural Healthcare Landscape in
India.......................................................................11
Serving the rural patient is an opportunity for and
the responsibility of healthcare companies in India.
Soumalya Chatterjee
3. Differentiating through on-the-job
coaching..............................................................14
Coaching is a day-to-day activity and not a one-off
event.
K. Hariram
4. Mastery, Autonomy and Purpose in Field
Force Excellence .................................................18
MAP enables field sales people to see the big picture
and use their abilities to implement strategies
systematically even in the absence of oversight.
Anup Soans
5. Free Medicines or Better Health? ..............23
The underlying assumption of Rahul Gandhi’s
manifesto is that merely providing medicines free
would help improve the health and the productivity
of the nation. In isolation that is simply not true.
Salil Kallianpur
6. Improving the Efficiency of MRs..................25
Pharmaceutical companies need to invest in better
ways of ensuring that their MRs get quality face to
face time with the doctor.
Dr. Aniruddha Malpani, MD
7. Oral Anti-Diabetic Agents-II.........................27
Dr. Amit Dang
8.Book Review: Bad Pharma: How Medicine Is
Broken and How We Can Fix It by Ben Goldacre
.............................................................................28
Prof. Vivek Hattangadi

MedicinMan Volume 3 Issue 12 | December 2013
Editor and Publisher

Anup Soans
CEO

Chhaya Sankath
COO

Arvind Nair
Chief Mentor

K. Hariram
Advisory Board

Prof. Vivek Hattangadi; Jolly Mathews
Editorial Board

Salil Kallianpur; Dr. Shalini Ratan; Shashin
Bodawala; Prabhakar Shetty; Vardarajan S;
Dr. Mandar Kubal; Dr. Surinder Kumar
International Editorial Board

Hanno Wolfram; Renie McClay
Executive Editor

Joshua Soans
MedicinMan Academy:

Prof. Vivek Hattangadi, Dean, Professional Skills
Development
Letters to the Editor: anupsoans@medicinman.net

E
E

SALES VS. MARKETING

THE CUSTOMER DOESN’T CARE!
In the war between sales and marketing, the customer is hurt the most.
Salil Kallianpur

A

few days ago, this picture put up by Anup Soans on his
Facebook (FB) page (see below) elicited 201 ‘likes’, 323
‘shares’ and 76 comments (as of Nov 2nd). The popularity of this post intrigued me not because it was something
that had never happened earlier - Anup is quite popular on
social media - but since it quickly assumed an accusatory tone
and one of grievance.
Although I have no way to ascertain it, I am sure the cartoonist meant the picture to be something else before another
creative person labeled the drummer as the ‘CEO’, the workers
on the train cart as ‘head office managers’ and the lone person
pulling the train cart with its heavy load of people as the ‘field
manager’.

Salil Kallianpur is
Commercial Head - Classic Brands
Center of Excellence, GSK. He is a
well-known pharma blogger and
social media enthusiast.
salilkallianpur.wordpress.com

4 | MedicinMan December 2013

Salil Kallianpur | Sales Vs. Marketing - the Customer Doesn’t Care!

“

The lone, redfaced ‘field
manager’ who
pulled the cart
didn’t seem to
convey to anyone
that while it was
his job to further
the organization
towards its
planned goal,
it could well
be a rotating
assignment

”

While the picture is a bit exaggerated, the way it was perceived
on the FB post seemed to turn the entire concept of teamwork
on its head. Despite a little prodding by the author, not one
person looked at this as representing teamwork. It did not
occur to anyone that the CEO might be seen to be making an
effort to keep the functions of the organization (if we assume
the train cart to be one) in a smooth rhythm so that efficiency
increases – a concept best demonstrated by the famous Kerala
boat races. No one thought it fantastic that all ‘head office
managers’ were working as one team towards furthering the
objectives of the organization without pushing an individual
agenda. The lone, red-faced ‘field manager’ who pulled the cart
didn’t seem to convey to anyone that while it was his job to
further the organization towards its planned goal, it could well
be a rotating assignment and when he pulled the cart up to a
certain point – or goal – he could then hop on board the cart
and begin to assist the other ‘head office managers’ with their
work while someone on board took up the task of pulling the
cart.
I found it very interesting that most people who commented
seemed to do so in a pattern. They all seemed to convey that
sales and marketing operated in different silos and not as two
arms of the organization; marketing personnel know little
about what sales personnel do and more often than not ‘force’
their ideas on them. A few gentlemen, who tried to support
the marketing function, either did so feebly or their arguments
were quickly drowned out. I was reminded of the ongoing
social media battle between supporters of two major political parties, which could be understood as that of opposing
ideologies and goals. In this case however, sales and marketing people seemed to worry more about which function was
better, more important or needed more effort and not on how
different functions within the organization work in tandem to
help it attain its goal.
The ‘war’ between sales and marketing goes back a long time
and spans across industries. However, it is also well documented that this lack of alignment ends up hurting organizational
performance. Time and again, both groups stumble (and the
organization suffers) because they don’t work together. There
is no doubt that when sales and marketing work well together,
companies see substantial improvement on important performance metrics: sales cycles are shorter, market-entry costs go
down, and the cost of sales is lower.

References:
1. ‘Ending the War between Sales and Marketing’:
Philip Kotler, Neil Rackham, Suj Krishnaswamy;
Harvard Business Review July-August 2006.


As the HBR says1 , the conflict between sales and marketing
apart from being economic, is cultural in nature. This is true
in part because the two functions attract different types of
people. Marketers are deemed to have more formal education
than salespeople. They are expected to be highly analytical,
data oriented, and project focused, always thinking about
building competitive advantage for the future. Sales teams do
not appreciate it as much as they should because they perceive
it to happen behind a desk in air-conditioned offices rather
than out in the field. Salespeople, in contrast, spend their time
talking to existing and potential customers. They’re skilled relationship builders; they’re expected to not only be savvy about
customers’ willingness to buy but also intuitively know which
products will fly and which will die. They want to keep moving.

Salil Kallianpur | Sales Vs. Marketing - the Customer Doesn’t Care!

“

The conflict
between sales
and marketing
apart from being
economic, is
cultural in nature.
This is true in part
because the two
functions attract
different types of
people.

”

They’re used to rejection, and it doesn’t depress them. They live
for closing a sale. It’s hardly surprising that these two groups
of people find it difficult to work well together. Yet there is not
a more opportune moment to harness the skills of both teams
than the current one.
The pharmaceutical industry in India just hiccupped. From the
customer facing side, new regulations such as the new pricing
policy has just made medicines more affordable. However,
a clamp-down on clinical trials has put the launch of new,
innovative medicines on the back-burner for the moment.
Also, there is no inflow of foreign capital into the sector putting
capital expansion plans of companies on hold. Additionally,
more and more Indian companies derive their real growth in
earnings from serving overseas markets.
In such a scenario, the last thing a customer would appreciate
is a chasm between internal departments in an organization
that hamper his ability to provide services to his patients. Corporate equity is at potential risk if information flow on products
is delayed because the marketing team does not respond to
requests from the sales team or if crucial travel information of a
KOL traveling to an international conference is withheld.
While I will not attempt to offer solutions or debate them here,
I want to leave you with some thoughts. Why is it so difficult
for colleagues within the same organization to work together?
Isn’t everyone trying to do the same thing i.e. attain market
leadership? How does it matter where you work or what you
do? Aren’t you proud of what you are doing? Are we getting
into the quicksand of wanting to do someone else’s role? At
the risk of sounding preachy, I’d like to invoke the Bhagvad
Gita here which extols us to merely do our duty and not worry
about someone else. Just excelling at what we do helps us
to create great value – tangible and otherwise. Cumulatively,
this ever-expanding pool of excellence is the fuel that propels
organizations from being good to becoming great. So instead
of worrying about why others fail, let us continue to focus on
our own success.
If the red-faced man in the picture didn’t pull the train cart,
how would it move forward? If the men on board didn’t tighten
the bolts on the track and pat down the stones of the ballast,
how would that section of the track become secure? If the CEO
didn’t beat the drum to a rhythm, how would the overall efficiency of the team increase and progress be achieved?
Now if the red-faced man was constantly badgered by the ones
on board, would he pull the cart? If he stopped pulling the cart,
would the whole team (organization) move? Would the CEO
then really matter?


As economic growth continues at its anemic pace, we’re all
looking for ways to make our operations more productive.
Bridging the sales-vs.-marketing divide is a way of achieving
this. Let us change our perspective. It will make a positive
impact on customers. We know well that customers these days
are too mobile, too connected, and too informed to tolerate
any gap between what one department says and another
does. So, if we allow sales and marketing to operate in silos, at
the end of the day, do you really think the customer cares? He
would just move on to the next company.

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NOMINATIONS INVITED

MedicinMan Excellence Awards
for Outstanding Indian Pharma Professionals 2014

Organized by Knowledge Media Venturz

MedicinMan invites nominations in the following award categories:
Sales Awards

Marketing Awards

Academic Awards

Special Category

Outstanding Medical Rep

Outstanding Product/Brand
Manager

Outstanding Pharma
Academician

Oustanding CEO/President/
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Outstanding HR Professional

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Outstanding Head of Sales
Processing Fee: INR 1,000/-




All nominations must be sent in the following format:
1.

Brief description about the nominated candidate/service provider with photograph/website details.

2.

Brief description about the nominated candidate/service provider’s achievements to be considered for the Award

3.

All nominations must be certified by two senior managers HR/Sales/Marketing of General Manager and above. In case of Service Providers the Nomination must be attested by two General Manager
level executives of the company to which the service was provided.

4.

Complete Contract details of Nominees as well as the nominating Managers with mobile, email, LinkedIn, Twitter and Facebook handles.

5.

All Nominees and nominating Managers must connect with Anup Soans, Editor of MedicinMan on LinkedIn, Twitter and Facebook for verification.

6.

All nominations must be from currently employed professionals working in companies with a turnover of Rs 50 crores and above with a minimum field force of 300 people.

7.

Incomplete Nominations will be rejected.

8.

The decision of the MedicinMan jury will be the final arbiter in short-listing and selecting candidates for the Awards.

All cheques/payments to be made in favor of “Knowledge Media Venturz” payable at Mumbai and sent along with nominations to: Anup Soans
Editor - MedicinMan
101 North Forte
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E

THE RURAL
HEALTHCARE
LANDSCAPE IN
INDIA
Serving the rural patient is an opportunity for and the
responsibility of healthcare companies in India.

Soumalya Chatterjee

A

few months back, I went for joint fieldwork in a remote
village of Madhya Pradesh. I was working in a Government hospital when a mother came with her 2-3 year old
baby to meet the Doctor. The baby was suffering from high fever
and weakness along with yellowness in nails, skin and eyes .It
appeared to be a case of Jaundice but unfortunately, the doctor
without any test or diagnosis, penned down ‘Typhoid’ in the prescription pad and prescribed Cefixime.
This incident motivated me to write this article and throw some
light on Healthcare in Rural India.

“

The causes of health inequalities lie
in the social, economic and political
mechanisms that lead to social
stratification according to income,
education, occupation, gender and
race or ethnicity.

”

Soumalya Chatterjee is Asst. Product
Manager at IPCA
- 67%


Soumalya Chatterjee | The Rural Healthcare Landscape in India

Biased Reality
1. Less than 20 % of Rural population have access to proper
healthcare facilities (PwC CII report-2010)
2. Low level of Government spending on Healthcare at 1 %
of GDP (Business Monitor International forecast-2011)
3. Doctor to Patient ratio in Rural areas is 1:20000 while in
Urban counterpart, the ratio is 1:250 (WHO report,2012)
4. 7 out of 10 medicines in Rural India is substandard/
counterfeit (WHO report, 2012)
5. 30 % of population travel more than 30 km seeking
healthcare in Rural India
6. Most of the Healthcare personnel in Rural settings is BHS,
BHMS or BAMS while in Urban India, most of them are
MBBS.
7. Healthcare is a low priority when it comes to income
allocation by a common villager (7-8%) while it is 16-17%
in a Urban household (PwC CII report-2010)
Root Causes
1. Not attractive enough for private sector

“

Less than 20 % of
Rural population
have access to
proper healthcare
facilities (PwC CII
report-2010)

”

ØØ Distributed population
ØØ Not enough money and so called ROI is minimal
(Corporate selfishness)
ØØ Incentive missing
ØØ Lack of proper infrastructure
2. People, who can afford, prefer private settings over Public
and those who can’t, prefer traditional or indigenous form
of medicine which is not much effective.
3. Inadequate financial resources for the health sector and
inefficient utilization result in inequalities in health.
4. Affordability is a major constraint as majority of rural
population earns less than 80 Rs/day.
5. Limited accessibility of Rural India to Healthcare facilities.
The causes of health inequalities lie in the social, economic
and political mechanisms that lead to social stratification
according to income, education, occupation, gender and race
or ethnicity.
Government Intervention
Health system strengthening
The Ministry of Health and Family Welfare (MOHFW) plays a
key role in guiding India’s public health system. The National
Rural Health Mission (NRHM) launched by the Government of
India is a leap forward in establishing effective integration and
convergence of health services.



“

Health information system

The Integrated
Disease
Surveillance
Project was set
up to establish a
dedicated highway
of information
relating to disease
occurrence
required for
prevention and
containment at the
community level,
but the slow pace
of implementation
is due to poor
efforts in
involving critical
actors outside the
public sector.

”


The Integrated Disease Surveillance Project was set up to
establish a dedicated highway of information relating to
disease occurrence required for prevention and containment
at the community level, but the slow pace of implementation
is due to poor efforts in involving critical actors outside the
public sector.
GRAM VAANI (developed by IIT-D)
It’s an innovative initiative by Government foreseeing the
technological advancements .It uses the mobile platform to
reach to remote places and guiding the villagers to treat and
prevent diseases. The success rate of this campaign is still
questionable.
Besides all this, as per the scenario, there has been launch of
Expanded Program of Immunization in 1974, Primary Health
Care enunciated at Alma Ata in 1978, eradication of Smallpox
in 1979, launch of polio eradication in 1988, FCTC ratification
in 2004 and COTPA Act of 2005
The Pharma Connection
Apart from NGOs like Deepalaya and SMILE foundation that
works exclusively for Rural Healthcare development, there are
Pharma companies that are not far behind when it comes to
CSR. Some of the useful initiatives by Pharma companies are
listed below:
1. Novartis -Arogya Parivar is Novartis’ rural marketing
initiative, wherein it markets a portfolio of drugs for
common ailments like diarrhea.
2. Pfizer- Pfizer runs project Sanjeevani so that it can reach
out to Tier II and below areas. The project is mainly for its
mature portfolio, to extend the PLC of the Brands.
3. Novo Nordisk - They have set up mobile clinics all over
Goa to diagnose people with diabetes.
4. Eli Lilly- Has a tie up with Self Employed Women’s
Association (SEWA) in Ahmedabad to educate, diagnose
and treat people for tuberculosis


“

The Way Forward

The ultimate goal
of a great nation
would be one
where the rural
and urban divide
has reduced to
a thin line, with
adequate access to
clean energy and
safe water, where
the best of health
care is available
to all, leading to
a healthy nation
that is one of the
best places to live
in.

”

1. Health education to the community should be a
prime function of the health workers and village level
functionaries
2. Health research system-need for strengthening research
infrastructure in the departments of community medicine
and foster partnership with state health services
3. Organizing and conducting nutrition education and food
hygiene concepts in the community and in schools
4. Survey and identify resources of safe water and to carry
out proper analysis of the water. Arrangements should
be made for regular purification of water through
chlorination.
5. Organize the people and resources for constructing
household and community latrines, and making
arrangements for collection and disposal of human and
animal wastes.
6. Progressively almost all deliveries should be conducted
under aseptic conditions by trained health personnel i.e.
the dais or female multi-purpose workers.
7. Intervention programs can be really helpful where
diseases like diarrhea, respiratory infections and other
serious infections can be prevented by immunization,
thereby reducing mortality.
8. More concentrated attention has to be given to younger
couples with low parity – a holistic focus toward family
planning.
In all the above mentioned endeavors, functionaries of
other sectors such as social and women’s welfare, education,
agriculture and animal husbandry, panchayats and voluntary
agencies like mahila mandals and youth clubs can contribute
very significantly.
The Healing Touch
The ultimate goal of a great nation would be one where
the rural and urban divide has reduced to a thin line, with
adequate access to clean energy and safe water, where the
best of health care is available to all, leading to a healthy
nation that is one of the best places to live in.
The ultimate yardstick for success would be if every Indian,
from a remote hamlet in Bihar to the city of Mumbai,
experiences the change.
At least if, we, or the person reading the article is being
proactive and contribute to eliminating the cause, there would
be a sea change in the existing scenario because tiny droplets
make a mighty ocean.


“The health of people is the foundation upon which all their
happiness and all their powers as a state depends”

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E

DIFFERENTIATING
THROUGH ON-THE-JOB
COACHING
Coaching is a day-to-day
activity and not a one-off event.

K. Hariram

I

n one of my recent interactions with a group of Pharma
Line (First and second line) Managers, a doubt with
regard to ON THE JOB COACHING was shared by them.

“I have 7 sales people in my team. I have to manage sales
and I am accountable and answerable for the results
month on month. So when I work with my team members,
I have to meet important Doctors, manage stockists,
handle administrative work, etc. So, where do i find time
for meaningful coaching, sustain the same including
timely feedback?”

K. Hariram is the former MD (retd.) at
Galderma India. He is Chief Mentor at
MedicinMan and a regular contributor.
khariram25@yahoo.com
16 | MedicinMan December

I realized that this concern was not something to be
brushed aside and was coming out as genuine concern
from many line managers. They probably did not have the
comfort of sharing with their own bosses.

K. Hariram | Differentiating through On-the-job Coaching

In most of the companies the oft repeated statement
from the Sales Head is “I do not care what or how you
do. Get me the numbers”. So when the leader of the
sales team gives very little or no importance to ‘on the
job ‘ coaching, how do we expect the line managers to
look at it as a means to sustained sales revenues!
Let us clearly understand one thing. If COACHING has to
be integrated into the day to day managerial function
and revenue generation has to be through the sales
people on a sustainable basis, then the selling process
has to be a well oiled mechanism. More importantly,

“

COACHING has to be an integral part of organizational
culture flowing from the top to the bottom.

Let us clearly
understand one thing.
If COACHING has to
be integrated into the
day to day managerial
function and revenue
generation has to
be through the
sales people on a
sustainable basis,
then the selling
process has to be a
well oiled mechanism.
More importantly,
COACHING has to
be an integral part of
organizational culture
flowing from the top
to the bottom.

”


I have always believed that COACHING impacts the
following:
1. Sales members’ alignment with the organizational
objectives.
2. Greater amount of self awareness self confidence.
3. Unwavering commitment to goals.
4. Behavioral changes that add momentum to
performance.
5. Fostering a performance culture.
Somewhere I read a saying, “In order to grow, you have
to let go”. In the crowded market place where the
differentiating factors are becoming narrow, how many
Sales Managers are willing to look at COACHING as an
opportunity to evolve and transform their sales team’s
culture as the biggest competitive edge ?
Often, to achieve or evolve, you do not have to do great
things. Simply challenging the ‘status quo’ and ‘changing
the limiting beliefs’ result in dramatic improvements.
This change or evolution starts with YOU...the Sales
Head.

E

MASTERY, AUTONOMY AND
PURPOSE IN FIELD FORCE
EXCELLENCE
Understanding Significance of Mastery, Autonomy and
Purpose in Field Force Excellence

MAP enables the field sales people to see the big picture and
use their abilities to implement strategies systematically
and consistently even in the absence of daily oversight.
Anup Soans

S

trategy Execution - The MAP of Motivation and
Performance
Getting the field force trained and deployed is a

challenge that constantly engages the time, efforts and
money of every organization and its managers. Field force
effectiveness is at the crux of implementing new product
strategies to enable the organization to meet its short and
long term goals without resorting to high-cost unethical
practices that eventually lead to unacceptable and
unsustainable outcomes as the Chinese experience clearly
demonstrate.
Getting the product strategy right, is the job of marketing
people and done properly, many do get it right. It is in the
implementation that most of them fail to get desirable
levels of success. In well managed companies, crafting
the product strategy is a robust process of analysing and
understanding various factors that influence customer

Anup Soans | Mastery, Autonomy and Purpose in Field Force Excellence

behavior, market dynamics and internal resources by a
select few people, but implementation of product strategy
is a task done by hundreds and often thousands of field
sales people every day. So, while the product strategy
remains robust and relatively stable, the implementation
is dynamic and has to factor in the abilities and motivation
of the field force.
The role, responsibility and contribution of field sales
managers in aligning their teams with the right product

“

strategy for each product/product category are critical.
Yet, often it is not recognized, much less addressed in

Balancing the tasks of
achieving sales targets
for existing products
and implementing the
strategy for new product
launches as well as
existing products is a
daunting task and very
quickly, the new product
is also merged into
the basket of existing
products and promoted
using the tactics
employed to promote the
existing products. An
effective field force is one
that is able to make the
distinction between the
need to promote existing
products without losing
sight of the strategy for
new products to ensure
future sales growth of the
organization.

”


a systematic manner. Given the multiple tasks that the
field force has to accomplish every day, their focus shifts
quickly from strategy orientation to executing tactics
that take them closer to their most important task of
achieving sales targets. Sales targets have to be achieved
within shorter timeframes of monthly, quarterly and
annual. Whereas implementing product strategy requires
longterm orientation and faithful adherence to execution
of strategy components, even when results are not
immediately seen or measurable.
Balancing the tasks of achieving sales targets for existing
products and implementing the strategy for new product
launches as well as existing products is a daunting
task and very quickly, the new product is also merged
into the basket of existing products and promoted
using the tactics employed to promote the existing
products. An effective field force is one that is able to
make the distinction between the need to promote
existing products without losing sight of the strategy
for new products to ensure future sales growth of the
organization. This requires a high degree of competence
and motivation, which the field force is not often
equipped with, leading to sub optimal results and loss of
strategic action that is needed to penetrate the market
and position new products as the future growth drivers.
This is one reason why the Indian Pharma has failed to
establish significant brands in the recent past. At the
Brand Drift 2011, two mega brands Januvia and Zerodol
were discussed by Sanjeev Navangul and Nandakumar
Shetty in a well moderated session by Vikas Dandekar
and the key to their success was clear strategy and solid
execution. What was remarkable was the diversity of
strategy and approach of the two companies.

Anup Soans | Mastery, Autonomy and Purpose in Field Force

Yet, significantly, both companies were successful in
their own way in adhering to implementing the strategy
faithfully with the field force people doing a splendid job
of complementing the work of marketing people. The
synergy between the strategy creators and executors
contributed to creating mega brands. MSD and IPCA
are as different as chalk and cheese, yet in their different
ways, they were successful in not only crafting a great
strategy but in executing them to create great value for
their companies, while making the work of field force
meaningful, interesting and rewarding.
Companies need to focus as much on the people who
execute the strategy as much as they do in creating
a strategy. What makes the field force an asset to the
company in executing strategies effectively? Good
companies begin by selecting the right people in terms of
Excerpts from Daniel Pink’s Book - Drive
Carrots sticks are so last century. For 21st
century work, we need to upgrade to autonomy,
mastery purpose, says, Daniel Pink in the Drive,
a new insight into what really works when it
comes to human motivation. When it comes to
motivation, there’s a gap between what science
knows and what business does. Our current
business operating system, which is built around
external, carrot-and-stick motivators doesn’t work
and often does harm. We need an upgrade. And
the science shows the way. This new approach
has three essential elements: 1. Autonomy – the
desire to direct our own lives. 2. Mastery — the
urge to get better and better at something that
matters. 3. Purpose — the yearning to do what
we do in the service of something larger than

their abilities. They also focus on matching the pedigree
of the people with the culture of the organization. For
example, a Mankind field sales person, who has done a
great job in executing the simple commitment focused
strategy of Mankind may not fit into the complex and
unbending work culture of an MNC.
Secondly, people should be selected not only for their
qualifications and skills, but more importantly, for their
mindset as it has the largest impact along with motivation
on their inclination to work without supervision. The
job of a field sales person is largely autonomous and
many good sales people love this aspect of their work.
Autonomy is also one of the key factors of intrinsic
motivation along with Purpose and Mastery described
by Daniel Pink in his book, “Drive: the Surprising Truth
about What Motivates Us”. I call it the MAP of intrinsic

ourselves.

motivation – all three are necessary to ensure a mindset

http://www.danpink.com/drive-the-summaries/

of performance in the face of challenges. MAP enables
the field sales people to see the big picture and use
their abilities to implement strategies systematically
and consistently even in the absence of daily oversight.
Systems like SFE are extremely useful in aligning the
work of the field force with the strategy of the company.
But SFE is an external regulator unlike MAP, which is an
internal driver. SFE alone is insufficient as the experience
of many companies show. SFE when combined with MAP
can be the driver of compliance and achievement as it
brings about synergy between what companies want field
force people to do and what people themselves value as


meaningful.

Anup Soans | Mastery, Autonomy and Purpose in Field Force Excellence
What then is MAP? As Stephen Covey says, “begin with the

mastery and use it to its fullest. But a sales person who can

end in mind”. The primary motivator of intrinsic motivation

see and appreciate the purpose of his daily tasks will take

according to Daniel Pink, is purpose. Without purpose,

time and efforts to gain the mastery needed to perform

it is impossible to engage people’s physical, intellectual

autonomously and effectively.

and emotional energies fully. Purpose brings meaning to

So, an effective field force is one, which can clearly

mundane work. Without purpose, work is repetitive and

understand and appreciate its purpose, is equipped with

quickly loses meaning, especially in the case of field sales

mastery needed to deliver this purpose and thus be

people - when they cannot see the big picture of product

empowered with autonomy to be motivated to perform

strategy in their seemingly disconnected work of meeting

not only when monitored by senior managers and systems

disinterested doctors.

but are motivated intrinsically to appreciate the purpose of

The second factor of intrinsic motivation is autonomy.

their work and thus make a meaningful contribution to the

Nobody likes to be watched over, all the time. But

execution of strategies consistently.

autonomy without mastery is not only ineffective but can

MAP is the internal compass that is always active and points

be dangerous as well and lead people to use unethical

the field force in the right direction intrinsically without too

means to achieve their targets. The third factor of intrinsic

much directives from others.

motivation is mastery. Good companies do focus on
equipping their field force with mastery of knowledge,
skills and systems like SFE. Emphasising mastery without
clarifying the purpose is like putting the cart before the
horse. Unless the field force people see purpose of their
daily tasks, they will not be empowered from within to gain

So make the purpose clear, train, coach and facilitate
mastery and then give field force the autonomy to transform
work into work-oh-frolic and performance into perforomance!

For More on Strategy Execution and Field Force Excellence,
attend Brand Drift and FFE 2014 at The Courtyard Marriott,
Mumbai on 7th and 8th February 2014.

Our Authors
Abdul Basit Khan
Dr. Shalini Ratan
Ajay Kumar Dua
Dr. Surinder Kumar
Amlesh Ranjan
Sharma
Amrutha Bhavthankar
Dr. Ulhas Ganu
Andris A. Zoltners
Geetha G H
Anthony Lobo
H. J. Badrinarayana
Aparna Sharma
Hakeem Adebiyi
Arvind Nair
Hanno Wolfram
Atish Mukherjee
Hitendra Kansal
B. Ramanathan
Iyer Gopalkrishna
Chayya Sankath
Jasvinder Singh
Craig Dixon
Banga
Devanand Chenuri
Javed Shaikh
Venkat
Jitendra Singh
Dinesh Chindarkar
John Gwillim
Dr. Amit Dang
Jolly Mathews
Dr. Aniruddha
Joshua Mensch
Malpani
K Hariram
Dr. Hemant Mittal
K. Satya Mahesh
Dr. Neelesh Bhandari
Ken Boyce
Dr. S. Srinivasan
Mahendra Rai

Mala Raj
Manoj Kumar
Mayank Saigal
Milan Sinha
Mohan Lal Gupta
Neelesh Bhandari
Neha Ansa
Nishkarsh Likhar
Noumaan Qureshi
Parveen Gandhi
Pinaki Ghosh
PK Sinha
Prabhakar Shetty
Vivek Hattangadi
Rachana Narayan
Rajesh Rangarajan
Ralph Boyce
Renie McClay
Richa Goyel
Richard Ilsley
RM Saravanan

Sagar S. Pawar
Salil Kallianpur
Salil Kallianpur
Sally E. Lorimer
Sandhya Pramanik
Sanjay Munshi
Shafaq Shaikh
Shalini Ratan
Sharad Virmani
Shiv Bhasin
Spring Sudhakar
Subba Rao Chaganti
Sudhakar Madhavan
Tony O’Connor
V. Srinivasan
Varadharajan K.
Vijaya Shetty
Vishal V. Bhaiyya
Vishal Verma
Vivek Hattangadi
William Fernandez

MEDICINMAN invites contributions from Pharma professionals on topics related to Field Force
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E

FREE MEDICINES OR BETTER
HEALTH? Salil Kallianpur

OPINION

A

“

While the availability
of free generics can be
a decision that could
change the lives of
hundreds of millions of
Indians, the proposal
runs the risk of being
overly simplistic and
potentially dangerous.
The underlying
assumption here is
that merely providing
medicines free
would help improve
the health and the
productivity of the
nation. In isolation
that is simply not true.

”


few days ago, the Vice President of the Indian National
Congress party, Mr. Rahul Gandhi tweeted that his party would implement the free medicines scheme for the
poor across India. Since the tweet coincided with Mr. Gandhi’s
visit to Rajasthan, it can only be assumed that he was touting a
relatively successful scheme that his party’s government runs in
the state.
Sometime last year, India announced a $5.4 billion policy to
provide free medicine to its people. This was the outcome of
the report of the High Level Expert Group appointed by the
Planning Commission in 2011 to look into the broader issue of
Universal Health Coverage (UHC), a key requirement to improve
social indices in India.
While the availability of free generics can be a decision that
could change the lives of hundreds of millions of Indians, the
proposal runs the risk of being overly simplistic and potentially
dangerous. The underlying assumption here is that merely providing medicines free would help improve the health and the
productivity of the nation. In isolation that is simply not true.
Health is a concept that far exceeds doctors, hospitals and
medicines. You need these only when you have to treat a
condition. The concept of keeping good health is to prevent
anything from affecting you mentally, physically or spiritually.
When the government decides that the first step towards UHC
is free medicines, it is a step forward gone horribly wrong. It
means that the government will do little to keep you in good
health and will come up with hare-brained schemes even after
you fall ill, leaving you to largely fend for yourself.
This is not to say that receiving free medicines is not a great
idea. To the sick and the infirm, it will provide succor to millions
who have to otherwise pay for it from their pockets. The problem is in its implementation. That Rajasthan did well with the
scheme – as did a few other states – is well studied. However
the fact that its nation-wide scale up was shelved demonstrates
the government’s sheer lack of confidence. Here’s why.
Currently, less than 35% of India’s population has access to
health care. This means approximately 2 out of 3 residents in
India do not have a medical facility (clinic or primary health
centre) to go to or a doctor to consult, much less be able to get
a prescription and buy medicines. Even the 1 out of 3 residents,
who have access to a medical facility, barely get to see a trained
medical professional.
This is because of an acute shortage of trained staff and chronic
absenteeism – doctors get their salaries from the government
anyway and prefer to spend more time at their private clinics
where they can charge for their services. And if the patient is
lucky to see a doctor and get a prescription, chances are that
the medical stores will be out of stock. The medicines are either
not purchased and delivered to the stores or sold into the private market for a hefty profit.

Salil Kallianpur: Free Medicines or Better Health?

“

Mr. Gandhi must
outline the measures
he would put into place
to prevent corruption
in the tenders floated
for the purchase of
high quality medicines,
create adequate
storage facilities, tackle
absenteeism of medical
professionals in public
hospitals and ensure
constant supplies.
These are just a few
issues. And going by
the way the Public
Distribution System
has shaped up over the
last few decades, there
is enough room for
skepticism.

”


If this is the state of affairs when only 420 million people are
anywhere close to accessing health care, imagine the sheer
grit, determination and resources needed to scale this up to
1.2 billion Indian citizens and a few million other residents1.
Is it any wonder then that today 80% of doctors, 26% of
nurses, 49% of beds, 78% of ambulatory services and 60%
of in-patient care are provided by the private sector?2
Providing free medicines is indeed a laudable idea but one
that is fraught with impracticality. Mr. Gandhi must outline
the measures he would put into place to prevent corruption
in the tenders floated for the purchase of high quality medicines, create adequate storage facilities, tackle absenteeism
of medical professionals in public hospitals and ensure
constant supplies. These are just a few issues. And going by
the way the Public Distribution System has shaped up over
the last few decades, there is enough room for skepticism.
So, what is the alternative? Given that India vies for the title
of “Pharmacy to the World”, it is safe to assume that there
is no domestic shortage of production of medicines. The
difficult part is to ensure that the medicines are of good
quality. If the FDA can tighten the noose on Indian suppliers
of generic medicines to the USA, there is no reason why the
Indian regulatory agency cannot do it for its own residents.
By ensuring the quality of medicines, the government can
rely on the open market mechanism that influences the
consumption of health care. The naysayers will do well to
merely check on the systematic rot and neglect that public
sector pharmaceutical companies have been put through
by the government to understand why manufacturing has
to be private-sector dependent.
The delivery system would also be efficient since it has
to be competitive and competent. The huge saving thus
accruing to the Government could be utilised to step up
public investments in rural and urban health infrastructure and services, thereby generating employment and
income opportunities -- both directly and indirectly. For
the genuinely needy, `medicine vouchers/stamps’ could be
supplied through the Panchayat Raj or local government
machinery that could be strengthened and empowered for
the purpose. But all this services the sick and is a drain on
the economy. Countries with the most efficient health care
systems are those that prevent illness through early detection combined with community-based primary care to limit
more costly upstream interventions.
India faces enormous challenges such as high disease
prevalence, unregulated and fragmented health-care
delivery system, non-availability of adequate skilled human
resource and inadequate finances to name a few. To address
these challenges there has to be a paradigm shift in health
policies. While the planners of his government have realized
that the central government is not ready to set up a scheme
of this scale in the face of such challenges, it seems Mr.
Gandhi is more optimistic about it.

E

IMPROVING THE EFFICIENCY OF MRs

P

harmaceutical companies spend crores in order to
market their brands, and medical representatives
(MRs) are the heart and soul of the sales department.
The sales force is the key link between the pharmaceutical company and their most important customer – the
doctor. This is why pharma companies employ an army of MRs
and invests a lot of money in helping them to nurture relationships with doctors, which they then hope will translate into
increased sales of their brands.
This is the age-old traditional model which companies have
employed for decades; and because it has been so successful
in the past, companies spend lot of money in training their
MRs on how to present themselves to doctor; and how to
position their brands, so they can compete successfully with
the hundreds of other brands in the market.
MRs are taught how to use collaterals; and how to educate
the doctor about the features and benefits of their brands.
Because so many of the brands are just me-too clones of each
other, MRs are also taught to flatter doctors and keep them
happy by gifting them with pens and other freebies; and they
routinely leave behind samples of their medicines, in the hope
that the doctor will prescribe these over the hundreds of alternatives he has available to him today.
While this model has worked well in the past, it has started to
lose its sheen. In the past, doctors would depend upon MRs
to educate them about the new molecules in the market and
help them keep abreast of the latest advances in the field of
medicine. MRs used to be respected because they were the
major source of scientific knowledge for many practicing doctors. However, doctors today have far more efficient ways of
learning about medical advances online. Also, a lot of doctors
are very suspicious about the information provided by the MR,
because they understand that this is contaminated by commercial influences and is not always trustworthy or reliable.

Dr. Aniruddha Malpani, MD
is the Medical Director at
Malpani Infertility Clinic in
Mumbai.


Most doctors treat MRs as salesmen who are good only for
providing free samples and other freebies. They make the
MRs wait for hours on end and will often demand incentives
to prescribe their brands. The Indian government is cracking
down on this unhealthy pharma-doctor nexus and the Medical Council of India is no longer willing to turn a blind eye to
this unethical behavior. This is why pharmaceutical companies
will need to discover better ways of influencing doctors.

Aniruddha Malpani: Improving the Efficiency of MRs

“

Pharmaceutical
companies need
to invest in better
ways of ensuring
that their MRs
get quality face to
face time with the
doctor. This is the
key to allowing
them to be able to
establish personal
relationships with
the doctor. They do
this by sponsoring
medical conferences
for example, but
this has become a
very competitive
space which can be
very expensive and
offers limited reach.

”

Pharmaceutical companies need to invest in better ways of
ensuring that their MRs get quality face to face time with
the doctor. This is the key to allowing them to be able to
establish personal relationships with the doctor. They do
this by sponsoring medical conferences for example, but
this has become a very competitive space which can be very
expensive and offers limited reach.
A better way of doing this is by creating tools for their MRs
which they can then provide to doctors to help them get
more patients. Doctors would be very favorably disposed
to any company which helped them increase their practice
and improve their income by keeping their patients satisfied!
Here’s a real life success story of how PEAS (www.peasonline.com), a company in which I am an angel investor has
done just that !
It’s a fact of life that patients are becoming more demanding today; and doctors need to invest in educating their
patients in order to keep them loyal. One of the key differences amongst doctors is the quality of their communication with patients, which is why doctors today are providing
patients with educational materials viz. handouts, books,
videos, DVDs and more. They find that not only is this a very
effective marketing tool, it also helps to increase patient
loyalty; differentiates themselves from competing doctors;
and helps mitigate the risk of malpractice as it shows that
they have educated the patient about possible risks and
complications.
A clever pharmaceutical company is now providing these
patient education DVDs free of cost to leading doctors.
These are high quality animations, rich in scientific content,
which are available in various Indian regional languages.
The magic sauce is that the pharmaceutical company is personalizing these DVDs with 2 minutes of introduction video
of the doctor about the condition and how it is his endeavor to provide best of medical care. The doctor now has a
corporate DVD which acts as a very effective marketing tool,
which he can provide free to all his patients!
The response from doctors has been mind-blowing. They
have been regularly asking the MR’s to replenish their stock
of DVD’s. On the other hand, MRs are very happy as well, as
they no longer need to wait for hours to see the doctor – he
is now inviting them to his clinic!
The common feedback from most of the Sales Representatives is: “Though it’s a tough task coordinating the video
shoot, it’s worth every penny. Thanks to this activity, we
got an opportunity to spend more time with the doctor on
this single day than we have had over the last few years put
together!


Not only does this create a lot of good will, it allows the MR
to form a close personal relationship with the doctor – and
this has to be music to the ears of any Marketing Head !

E

KNOWLEDGE FOR THE
FIELD FORCE SERIES
Oral Anti-Diabetic
Agents-II
Dr Amit Dang

C

ontinuing with the oral antidiabetic agents, in
this issue we will discuss the biguanides and
thiazolidinediones which are also known as
Insulin sensitizers. Both these agents lower blood sugar
by improving the response to insulin without increasing
the secretion of insulin.
Biguanides
Metformin is the only currently available biguanide.
It is the drug of first choice among newly diagnosed
patients of type 2 DM. Metformin can be used alone or
in combination with other oral antidiabetic agents or
insulin.
The main mechanism of action of metformin is decrease
in synthesis of glucose in the liver. The excess of glucose
produced in the liver is a major source of high blood
sugar levels in patients having type 2 DM. It also increases the glucose uptake and use by target tissues of the
body like muscle and liver; and thus corrects resistance
(decreased response) to the action of insulin in the
body. It is different from insulin secretagogues (sulfonlyureas) as it has no action on the secretion of insulin.
It also decreases the absorption of sugar from the intestines and increases the use of glucose by the different
organs of the body like muscle and liver. Metformin also
corrects the increased lipid levels in the body.
The patients may lose weight because of decrease in appetite. Hypoglycemia can occur when used with insulin,
so dose adjustment of insulin is required.

Dr. Amit Dang is Director at
Geronimo Healthcare Solutions
Private Limited.

Patients may have nausea with use of metformin. It
should not be given to patients having some disease
of kidney or liver, should be avoided in case of acute
myocardial infarction (heart attack); should be used
carefully among patients more than 80 years of age.
Rarely, it can lead to lactic acidosis and long term use
can interfere with absorption of vitamin B12. Metformin is also used among females having polycystic
ovarian disease.
Thiazolidinediones
The second group of insulin sensitizers is thiazolidinediones and Pioglitazone is the only drug available from
this group. Pioglitazone can be used alone or in combination with other oral antidiabetic agents or insulin.
Earlier, troglitazone and rosiglitazone were available in
the market, but now these are not available because of
hepatotoxicity due to troglitazone and cardiac effects
due to rosiglitazone. Pioglitazone was banned in India
earlier this year due to the increased risk of development of urinary bladder cancer, but the later the
decision was revoked.
Pioglitazone is the drug of second choice among
patients who fail to or have contraindications to use of
metformin therapy.
These drugs do not increase the release of insulin from
the pancreas. Pioglitazone has a different target from
metformin, and regulates the fat and glucose metabolism and increases the response of the body tissues
(like muscle, fat tissues and liver) to insulin.
Patients taking pioglitazone should be regularly monitored for liver enzyme levels. Patients may have weight
gain due to increase in body fat and retention of fluid.
This group is associated with an increased chance of
osteopenia (bones become less strong and dense) and
increased risk of fracture of bones. Pioglitazone is also
used among patients with polysyctic ovarian disease.
The rest of the oral antidiabetic agents will be covered
in the next issue.

E

BOOK REVIEW

BAD PHARMA:
HOW MEDICINE IS BROKEN
AND HOW WE CAN FIX IT
By Ben Goldacre; Publishers: Harper Collins, London

Vivek Hattangadi

B

ad Pharma acclaimed as the ‘Book of The Year’
(2012) by ‘The Times’ has ruffled the medical and
the pharma industry alike and prompted the
British Parliament to ask why all trial results aren’t made
public.
Bad Pharma opens with a very strong statement by the
author Ben Goldacre: “We like to imagine that doctors are
familiar with research literature when in reality, much of it
is hidden by the drug industry. We would like to imagine
that doctors are well educated when in reality much of
their education is funded by the industry. We like to imagine that regulators only let effective drugs in the market,
when in reality they approve hopeless drugs, with data on
side effects casually withheld from doctors and patients”.
Ben Goldacre takes readers through some significant
cases and shows how you do not need a pharmaceutical
degree to spot bad pharmaceutics.

Prof. Vivek Hattangadi is a Consultant in Pharma
Brand Management and Sales Training at The Enablers.
He is also visit-ing faculty at CIPM Calcutta (Vidyasagar
University) for their MBA course in Pharmaceutical
Management.
vivekhattangadi@theenablers.org


Doctors and patients need good scientific evidence to
make informed prescription decisions. Sadly, companies
conduct bad trials on their own drugs, which misrepresent and overstate the benefits by design. When trials
produce results which do not conform to the desired
results of the study, the data is simply buried. In fact, even
statutory bodies withhold vitally important data from
the doctors and patients who need it most. Doctors and
patient groups have stood by too, and failed to protect
the patients. Instead, they take money and favours, in a
world so fractured that medics are now educated by the
drugs industry.
Ben Goldacre says that the damage is pervasive and deep,
right to the roots of modern medicine. These problems
know no borders, and affect us all. For instance, in India
itself, prompted by pharma marketers, clinical trials on

Prof. Vivek Hattangadi | Book Review: Bad Pharma by Ben Goldacre

“

HR, Training, and
Line Managers
should combine
synergistically and
resolve the problem
of not getting good
people, attrition
rate is very high,
the available people
have very poor
communicating
ability, etc. and help
organizations to
march towards a
better and bright
future.

a product (dapoxetine) for PME (premature ejaculation)
were carried out on mentally ill patients. Goldacre comes
out very strongly on such trials when he says: “Risky
‘first-in-man’ trials are conducted on homeless people;
but more than that, full clinical trials are being globalised,
and a new development that has that has arisen suddenly in only the last couple of years. That raises serious
ethical problems because trial participants in developing
countries are often unlikely to benefit from expensive
new drugs; but it also raises interesting new problems for
trusting the data”.
The book has missed out one important issue which
perhaps is not relevant to the British and the western
world i.e. irrational fixed drug combinations (FDCs). This
is a problem related solely to the Indian pharma industry. Such irrational FDCs are even not available in the
‘so-called underdeveloped countries’ like neighbouring
Bangladesh and Nepal.
This book is a must read for all associated with the pharmaceutical industry and who wish to tread the path of
good marketing practices.

”


Marketing Conference 2014
7th - 8th February 2014
See page 7


MAP of Motivation for Pharma Field Force

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