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Piggy in the Middle
PharmaTimes article by Katrina Megget - September 2011

There will always be a need for first-line managers, but what role will the traditional RBM play in the changing pharma marketplace?

The past few years have provided much soul searching for pharma. Where is innovation coming from? How should the industry communicate via social media?

Is the role of sales representative dead?

But perhaps surprisingly there has been little talk about how some of these changes will affect other intrinsic roles, such as the regional business manager.

“There has been a lot of discussion around the role of the representative, the key account manager, the market access manager, etc, but very, very little on the changing role of the regional business manager,” says David Round, general manager, UK, at Cegedim Relationship Management. “Their role is almost getting lost amid the other noise.”

While it is inevitable that the pharma industry shake-up will impact first-line managers, but how companies are approaching this is very much up in the air. What does seem to be emerging, however, is a general consensus that the traditional RBM role is in decline.

Understandably this reflects the industry-wide sales force cull — less representatives require less RBMs — but another trend is also starting to develop.

“Clearly there is still a place for the ‘traditional’ RBM,” says Darren Mercer, commercial director at Nycomed UK.

“But as pharma looks at the structure and type of sales personnel it requires, this is having an impact, both in the overall numbers of RBMs required and the type of role an RBM undertakes.”

And this is something that companies are struggling with: just looking at the variety of emerging job titles highlights this — regional manager, regional account manager, regional account director, healthcare manager, integrated healthcare manager, senior business manager...

“I could quote the alphabet to give you a list of the different names companies call their sales managers,” says Jennine Clark, from Otsuka and winner of the recent PharmaTimes New RBM of the Year Award. The different titles, she says, are indicative of the seismic shift occurring within the healthcare sector. “Nowadays we need to be more strategic rather than just implementers and have well-rounded sales, communication and performance management skills. Certainly the hottest topic at the moment is ‘change management’.”

A business management role

Not surprisingly, the evolving RBM role is becoming far more wide reaching.

As Jean-Francois Delas, vice president at Kinapse says: “The role of the RBM is evolving from one almost solely focused on team management to one centred on regional business management.”

In other words, the role is becoming more strategic and customer focused, says Mercer. “Companies are seeing the importance and value of having their best people in front of customers where they can interact and engage at a high level and also have autonomy to make immediate decisions.”

Chris Wilkinson, national sales manager at Galderma, suggests the traditional RBM is being forced to up-skill both themselves and their teams. “Gone are the days when an RBM could simply spend four days a week in the field and one day on admin without a further purpose in mind,” he says. Now it’s about field visits in relation to key account management, market access strategies and disease management — instead of simple product sales.

Simon Brander, managing director of CSL, agrees. In the past, representative coaching, development and direction was probably all that was required of an RBM, he says. “But now the RBM will be expected to have more of a business management function; coordinating activity in accounts and generally ensuring that coherent business plans are being developed and followed through.”

For example, in Germany, the role of district manager is shifting from “pure people management” of up to 20 sales representatives, to a more differentiated role as market access and key account management tasks become increasingly important, notes Arnim Jost, general manager, Germany, at Cegedim Relationship Management.

“We see department managers managing local and regional market access tasks, visiting local and regional health authorities or health fund representatives, in parallel to managing their direct reports. Meanwhile, in several companies’ department managers cover local and regional KAM and key opinion leader activities as well.”

Retrain or bring on new talent

“And where there is a change in service strategy and business model, companies have to question whether they have the right people and skills”, adds Dan Goldsmith, general manager Europe at Veeva Systems. The RBM role itself is being “redefined” — and this redefinition is something that varies between companies. For instance, he continues, comparing the RBM role with that of KAM and deciding which is a better fit in the new healthcare environment is what “many companies are trying to figure out right now. The big question is whether pharma can retool individuals in these roles or whether they should bring in new talent”. However, Erik Jan Scholten, director of Your Insight, is concerned about the variety being explored in this area and the internal focus of the role, despite it being cited as “customer focused”. As he notes: “Have you ever heard of a doctor or a hospital talking about themselves as an ‘account’?”

Of course, with uncertainty and change, there is no clear path that companies should take. As Kavita Oberoi, founder and managing director at Oberoi Consulting, notes, the role has been muddied as others carrying some of the same responsibility pop up in parallel, including healthcare development managers. And the RBM title could go completely, she adds, especially if more specialist roles are preferred. Wilkinson too is concerned that if pharma loses the sales representative as the link between company and customer, “the RBM job will no longer exist in its current form and they will move from managers to senior account sales people” — but the likelihood of this happening in the foreseeable future, he says, is doubtful when managers are clearly still needed.

Likewise, Amanda Flanagan, sales director UK and Ireland at Almirall, believes the RBM role is still an important one within the industry.

“They may have different titles,” she says, “but fundamentally we still need managers managing teams.”

At the same time this role of people manager also now includes health outcomes management. As Flanagan asserts: “The RBM role now combines people and business management that is ultimately associated with driving outcomes — both in terms of business results for the company, and value and better patient management for the customer. The role has had to evolve — outcomes and improved patient management is our customers’ objective and our roles need to align with that.”

Delas echoes this, saying the emerging RBMs will ultimately be accountable for outcomes — “but in order to be successful, they will have to deliver through people and their team”.

Indeed, it is likely to be a hybrid role in the future as RBMs seek to understand their local health economies and market access boundaries, while providing a service that may not in fact be solved by that company’s medicine.

According to Goldsmith, RBMs are in a unique position to be the voice of customers and to deliver the value that is increasingly demanded. “Individual sales representatives do not have the influence they used to over the customer and their buying behaviour, and this increasingly integrated ecosystem for decision making means there is a real role that RBMs can play,” he says. “It’s something the representative can’t do because there is no visibility or incentive; neither do they have the bandwidth to understand marketing at that level.”

As quality, outcomes and value become the new catchphrases of the global healthcare environment, Clark says it is essential for pharma to speak the customers’ language and understand their priorities so that industry can work in partnership with them. Indeed, she believes RBMs are closer to the business than ever before. Moving forward, the path pharma will take in redefining its RBM role is still unclear.

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