Even before the Covid 19 outbreak, the mood in many Japan pharma sales teams was turning dark. A palpable sense of unease and ambiguity — “moya moya kan” in the local vernacular — was steadily affecting motivation, commitment, and engagement levels in the ranks.

The list of why’s is long:
– ongoing criticism of pharma overspend on sales efforts vs. R&D
– newly aggressive MHLW drug re-pricing & cost controls
– increasing adoption of facility and regional formularies
– expansion of hospital restrictions on MR visits
– and from last autumn, newly restrictive MR compliance guidelines

Add to those rumblings the uncertainty around the current pandemic, and the outlook for “business as usual” is very poor indeed. My weather forecast anticipates that it will be wet, cold and miserable for MR’s through the summer, with in-person visits largely restricted through the o-bon holidays in August at a minimum. And as doctors begin to adjust to those new conditions, it will be increasingly difficult for pharma to revert to the sunny old model we once enjoyed.

Welcome to the new reality for the Japan pharmaceutical industry!

So for us the key question is — how can we reset our existing teams for confidence and success in this new environment? My answer is VR.

But not that VR

I’m not talking about virtual reality. I am talking about re-defining sales teams in Japan. The actual translation of “MR” in Japanese is “iyaku-joho tanto-sha” or “pharmaceutical information provider,” but this job description is clearly outdated. I suggest we move to a new nomenclature — the VR or “Value Representative”. VR’s concentrate their energy first and foremost on adding value to physicians, patients, and other healthcare system stakeholders. As a result of their efforts, better care decisions are made, drugs are used appropriately, and their companies make money that can be used to further develop innovative treatments.

These are things we talk about now. But how do we actually get there?

Spare me the details

For starters, let’s kill the word “detail”. Product characteristics are important, clinical evidence is important, of course, of course. But if a rep’s mindset is “to detail” a physician, he or she might as well not bother — most of these one-way calls simply waste the physician’s time, and in the end will do more harm than good.

But it’s not all the reps’ fault. If we want reps to sell like the blockbuster decade of the early 2000’s, we should continue to use the same KPI’s, the same targeting matrixes, and the same SOV-focused tools the current sales leadership grew up on when they were reps: X# calls per target per month, X% coverage, X# new scripts in Q3, #% market share… Oh look, that’s right where we are now!

Don’t worry that the products have changed, the value proposition has changed, the physician expectation has changed, the world has changed. Sure, it worked back then. And to a certain extent, it still works — at least it did until February 2020. But it decidedly won’t work for anyone in the same way moving forward.

The doctors don’t want it. The reps don’t want to do it. And you shouldn’t make them. Especially post-Covid 19. Bringing a rep into a clinical environment to spout product information is NOT putting patients first.

So how to mold a Value Representative team?

Japanese reps are exceedingly diligent, professional, and knowledgeable about clinical evidence, guidelines, and other technical matters. But let’s face it, the sunny and happy SOV environment they lived in until recently did not challenge them to truly focus on exploring needs and responding appropriately to their physicians.

The most obvious starting point is to have VR’s ask questions. But not just any questions. I mean great questions. Outstanding, provocative, insightful questions that reflect a deep desire to serve doctors and their patients. Questions that drive conversations forward, spark motivation and eventually enable behavior change.

How can they learn to do that? Sure it is a cliche, but the main thing is to stop selling. We need to encourage them to focus on desired clinical and behavioral outcomes, not Rx counts (that will come later). This mindset is hard to maintain while being inundated with activity-based KPI’s around call counts and message delivery (see above). It sounds corny, but let’s help reps reflect back on why they chose to join the pharma business, what is important to them, and how they can truly help — especially in this environment — by serving their physicians with true integrity in each and every interaction.

From a skill standpoint, VR’s should think in terms of “conversations” (again not “details”). Companies should provide reps a robust framework that guides them through the right steps needed to draw physicians out, fully understand the situation, identify a relevant, emergent need, and then eventually tie that back to their product or solution only when and if it makes sense. A sales culture built and coached around such a process will help every rep do better in every physician call they make. Whether in-person or virtual, no matter how hard the winds are blowing outside.

Does your team ask questions? Pretty much everyone does, of course. But are they good questions? Great questions? Outstanding, provocative, “now-that-you-ask-it-makes-me-reconsider-what-I-was-doing-up-until-now” kind of questions?

If not, your teams are still not true VR’s. And they are not going to do well in the rainy days to come.