Monday, March 17, 2014

Doctor Glaxo is here to teach you

GlaxoSmithKline Plc (GSK) plans to hire doctors to educate their peers about its drugs instead of paying external speakers, a further change to its marketing practices following a record fraud settlement in the U.S.
The drugmaker is also investing in improving its multichannel marketing strategy through media such as online streaming of educational content, Deirdre Connelly, head of Glaxo’s U.S. pharmaceuticals business, said in an interview in Philadelphia. The changes come at a time when London-based Glaxo is introducing products recently approved to treat skin cancer, HIV and respiratory diseases.
Glaxo has been reforming marketing practices to improve its reputation. In 2012, the company agreed to pay $3 billion to settle allegations that it illegally promoted its Paxil and Wellbutrin anti-depressants and failed to report safety data on the Avandia diabetes drug. Hiring doctors and medical experts to speak as in-house representatives of Glaxo will provide more transparency, Connelly said.
“We’ll continue to disseminate this very important information on drug benefits and risks, but we’re just not going to do that by hiring external speakers,” she said. “We want to ensure that no one even perceives us to be doing anything wrong.”

Customer Evaluations

Glaxo plans to hire a range of people with medical backgrounds, including doctors and scientists with expertise in specific disease areas, though how many is still unclear, according to the company. It will be fewer than the number of external speakers the company has employed, Connelly said. In December, Glaxo said that it will stop paying doctors for giving speeches and attending medical meetings by early 2016.
Connelly started her career as a sales representative at Eli Lilly & Co. (LLY) and rose to lead that company’s U.S. operations. She joined Glaxo in 2009 and was responsible for devising the company’s new compensation model that got rid of the link between sales targets and bonuses. Bonuses are now based on selling competency, customer evaluations and overall performance of the representative’s business unit.
Dubbed “Patient First,” that measure was implemented in the U.S. in 2011. A similar program will be extended to all markets by 2015, Glaxo said in December. The announcement also came amid an ongoing bribery investigation of Glaxo in China.
Hiring internal speakers isn’t a widespread practice in the industry and has pros and cons, saidPratap Khedkar, who runs consulting company ZS Associates’ global pharmaceuticals practice in Philadelphia.

Credibility Question

Because they will be employees of Glaxo, the company won’t have to report payments to doctors under the so-called Sunshine Act in the U.S. that requires such disclosures. On the other hand, their credibility may be questioned, and they won’t be able to answer questions such as how they would treat a patient with specific symptoms or problems, given that they aren’t practicing physicians, Khedkar said.
The Glaxo representatives may be perceived in the same way as so-called medical science liaisons, who typically have pharmacy or nursing degrees and play an educational role in speaking to doctors, such as explaining clinical trial results, Khedkar said.

Opinion Leaders

The corporate ties and a lack of reputation among practicing colleagues may hamper the Glaxo representatives’ sway with physicians, said Erik Gordon, professor at the University of Michigan’s School of Law and Ross School of Business.
“Doctors aren’t influenced by just any other doctor,” Gordon said by e-mail. “They are influenced by doctors who are sufficiently well known, respected, and seen as key opinion leaders -- real experts with lots of experience with patients.”
The shift in strategy comes as Glaxo introduces several key new products, including Breo and Anoro for respiratory disease. Breo’s uptake in the U.S. has trailed that of Merck & Co.’s Dulera, which is in the same class of drugs, and were little changed in the week ended March 7, Bloomberg Industries analyst Sam Fazeli said today, citing data from Symphony Health Solutions.
“The real test will be how Anoro gets on,” Fazeli said. Anoro, which will be introduced in the U.S. by the end of April, has higher sales potential than Breo, potentially reaching $1.55 billion in 2017, according to the average of five analyst estimates compiled by Bloomberg.

Instant Replies

Connelly said the experts at Glaxo will be expected to use a growing range of digital tools designed to help market products.
In addition to targeted e-mails and Web seminars, drugmakers are increasingly using mobile platforms including instant replies to questions sent by text message that doctors can use while seeing patients, ZS Associates’ Khedkar said.
Companies are investing to add more multichannel tools as doctors are increasingly pushing back on visits by sales representatives, he said. Still, that spending totals about $1 billion industrywide, compared with about $10 billion for sales-force channels, Khedkar said. The industry’s expenditure on sales-force channels has halved since 2006, he said.
Glaxo has reduced its sales force by more than 30 percent since 2009, while adding new educational roles and jobs targeting pharmacies, among others, Connelly said.
“In addition to how we operate, in terms of values and Patient First, we have a different business model today from what we had before,” she said. Those changes have helped shield Glaxo’s U.S. sales from the investigation in China, she said. The company’s U.S. pharmaceutical and vaccine sales rose 5 percent in the fourth quarter, compared with a 29 percent drop in China.
“We had done a lot before that happened,” she said. “We were fortunate that we were ready for an event like that.”
To contact the reporter on this story: Makiko Kitamura in London at
To contact the editors responsible for this story: Phil Serafino at Kim McLaughlin, Thomas Mulier

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