Pharma Field Force Excellence

FFE 2013 - the annual flagship event of MedicinMan - is
less than 7 days away. Two important issues are being called
up for discussion this FFE - Business Intelligence and
Employee Engagement and their contribution to Field Force
Productivity.
Engagement of the Field Force lies at the heart of our work
at MedicinMan (See MedicinMan May 2013). When
employees are fully engaged, they are happier with their
jobs and contribute more to the organization. Which is why
we have a full panel discussion on the relationship between
Employee Engagement and Field Force Productivity at FFE
2013. On the panel are industry thought leaders and long-
time patrons of MedicinMan.
At MedicinMan, we think we have a good understanding
of what Employee Engagement looks like. Over the 20-odd
issues released, we have read stories of individuals rising to
great heights in their lives and careers because they were
meaningfully engaged in their work as Medical Reps and
Front-line Managers.
Not in the least, our own work in delivering high-quality
content and constantly improving the magazine since
inception - all at zero cost to the reader - is testimony
to what belief in one's vision and mission can produce.
Participation by Pharma Professionals at the highest levels
of industry in FFE 2013, is an affirmation of our beliefs and
work.
If you haven't booked your spot at FFE, don't panic, we still
have a limited number of seats available. Please go to the
registration on page 28. -MM
MEDICINMANField Force Excellence
TM
June 2013 | www.medicinman.net
FFE 2013.
Saturday, 8th June 2013 | Courtyard Marriott, Mumbai

Opportunities
& Challenges
Field Force
Productivity:
The #1 Learning Opportunity for Senior
Managers to Enhance Field Force Productivity.
FFE 20135
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10 15 20 25 30 35 40 45 50 55 60
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Date: Saturday, 8th June 2013
Theme:FieldForceProductivity
Place: Courtyard Marriott, Mumbai
INside
> Faculty
> Agenda
> Objectives
> registration on Pg. 28
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MEDICINMANField Force Excellence
Saturday, 8th June 2013 | Courtyard Marriott, Mumbai

1. What the Doctor Wants from the MR..............4
Doctors want MRs who are knowledge workers,
willing and able to partner with him to better serve
his patients.
Dr. Aniruddha Malpani, MD
2. The Marks of a True Professional.....................8
A True Professional is one who has achieved a
high standard of “Personal Quality” in everything
from dressing sense to professional knowledge and
inter-personal relationships.
Rachana Narayan
3. Paradigm Shift..................................................11
How Pharma companies can survive and thrive in
the New DPCO era.
Sharad Virmani
4. The Single-Minded Success of Sachin
Tendulkar..............................................................15
What Gen-Y can learn from the cricket-or-nothing
attitude of the Little Master.
RM Saravanan
5. Catch People Doing Things Right ..................18
FLMs must proactively engage their team in doing
the right things and doing things right.
K. Hariram
6. Building Sales Teams from Scratch................21
Every team goes through the stages of Forming,
Storming and Norming before they can start
Performing
Anup Soans
7. Observational Research in Healthcare..........25
Javed Shaikh & Shafaq Shaikh
8. Patient Reported Outcome Measures in
Pharmacoeconomics...........................................29
Mahendra Rai & Nishkarsh Likhar
Contents (click to navigate)
MedicinMan Volume 3 Issue 6 | June 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 Hattangaadi, Dean, Professional
Skills Development
MedicinMan ChangeMakers
Saurabh Kumar
Make a difference in Pharma. Join MedicinMan
ChangeMakers. Write in to our editor to find out
more:
anupsoans@medicinman.net
Letters to the Editor: anupsoans@medicinman.net
4

E
4 | MedicinMan June 2013
What the Doctor
wants from the
Medical REp
Dr. Aniruddha Malpani, MD is the Medical
Director at Malpani Infertility Clinic in Mumbai.
“
”
Sneaky underhand sales techniques just
do not work. Just like you don’t like
pushy salespeople, neither do doctors!
If you want the doctor to listen to you,
you need to earn his trust and respect.
How can you do this? Remember that
doctors are experts. They take pride in
their scientific knowledge base. They
are impressed by representatives who
are knowledgeable and well-informed.
Many doctors will be happy to use
representatives as a valuable source of
continuing medical education, but you
need to earn his respect in order to do so.
O
ne of the most challenging tasks
for you as a healthcare field force
executive is to engage with doc-
tors. Physicians are perhaps the most im-
portant component in pharmaceutical sales
because they write the prescriptions that
determine which medicines will be used by
patients. Influencing the physician is the key
to pharmaceutical sales and traditionally
this was done by encouraging sales repre-
sentatives to create a personal relationship
with the doctor. Medical representatives
call upon physicians regularly, and hope
to influence his prescribing by providing
drug information, free drug samples, and
freebies such as pens and pads. You hope to
build a relationship with the doctor, which
you can leverage to influence him to write
your brand. This is still the prevalent model
today; but is broken for many reasons.

What the Doctor Wants from the Medical Rep | Aniruddha Malpani, MD
The good news is that
there are now excellent
resources available
online, which you can
use to ensure you are
well-informed about
medical advances . Many
are free – for example,
MedlinePlus and Google
Scholar.
If you keep yourself
updated, you can offer to
act as a research assistant
for your doctor. Doctors
are busy people and may
not have time to search
the medical literature
themselves. If you can do
this for them, they will see
you as a valuable ally!
For one, many doctors do not see
representatives anymore. They
feel that they simply eat into their
precious time without adding any
value to their practice. Thus, I
will only see representatives once
– and will request them to email
me if there is information they
want to share with me. If I find
it of interest, I will give them an
appointment to make a presenta-
tion. This allows me to maximise
my productivity- and ensures that
I don’t waste the representative’s
time either!
Sneaky underhand sales tech-
niques just do not work. Just like
you don’t like pushy salespeople,
neither do doctors! Don’t insult
their intelligence by trying to
flatter them or manipulate them –
doctors are not stupid! Sales ploys
such as “closing the physician”, “
challenging them”, and “getting
them to commit” can turn them
off and this is one of the reasons
many doctors refuse to see pharma
representatives. Don’t damage
your relationship with the doctor!
Sadly, most reps have become
cynical. They feel doctors respond
only to flattery , freebies and in-
ducements. This is why they focus
on polishing their social skills, in
order to try to make the doctor a
friend. While this works, this is a
very short-term strategy, which
is likely to fail over time. Doctors
do not consider representatives to
be their peers – they will often just
treat them as a source of freebies.
How successful a representative
you are will depend upon how well
you can talk to the doctor. If you
want the doctor to listen to you,
you need to earn his trust and
respect.
How can you do this ? Remember
that doctors are experts. They take
pride in their scientific knowledge
base. They are impressed by repre-
sentatives who are knowledgeable
and well-informed. Many doctors
will be happy to use representa-
tives as a valuable source of con-
tinuing medical education, but you
need to earn his respect in order
to do so.
This is why you need to update
your personal medical and scien-
tific knowledge base if you want to
command the doctor’s respect and
attention. How can you do so? It’s
important that you take the initia-
tive –don’t wait for your company
to teach you. If you do so, this is a
great opportunity for you to stand
out from your peers!
The good news is that there are
now excellent resources avail-
able online, which you can use
to ensure you are well-informed
about medical advances . Many are
free – for example, MedlinePlus
and Google Scholar. If you keep
yourself updated, you can offer to
act as a research assistant for your
doctor. Doctors are busy people
and may not have time to search
the medical literature themselves.
If you can do this for them, they
will see you as a valuable ally!
Can you help them to prepare a
presentation for a conference? Or
help them to publish an article in a
medical journal ?
Can you do a PubMed search ?
Why not ? Teach yourself – don’t
expect to be spoon fed . You can
always ask your company’s Med-
ical Services Dept for help if you
are stuck! You can offer to email
your doctors with the latest infor-
mation. If you become the “go-to
expert” in a particular niche, your
doctors will turn to you if they
want more information!
The doctor should not just see you
as a salesman, but as a well-wisher
and ally! What value can you add
to his life? Can you show him how
to use medical productivity apps
for his mobile? Can you help him
to create his own website? Can
you help him to use Facebook and
LinkedIn?
“

What the Doctor Wants from the Medical Rep | Aniruddha Malpani, MD
If you invest in educating
yourself, the satisfaction
you will get from doing
your job well will increase
enormously! This will
boost your self-esteem –
and as you start to respect
yourself, your doctors
will respect you as well.
The good news is that as
specialists become busier,
representatives are going
to be able to find more
opportunities to be of
service to them.
Times are changing – and you
need to change with them! Med-
ical representative compensation
has historically been sales-based:
sell more drugs, make more mon-
ey. Doctors know a rep is incen-
tivized to sell more to make more.
However, global leaders such as
GSK are aiming to remove finan-
cial incentives from the equation.
Pharma reps still receive a mix
of salary and bonus, but GSK has
replaced individual sales targets
with new targets measuring the
overall performance of the sales
team and feedback from custom-
ers. This new system also evaluates
a rep’s scientific knowledge as well
as the ability to communicate that
information.
Other pharmaceutical companies
will soon follow GSK’s lead. How-
ever, why wait for your company
to do so? You should take the
initiative and do this of your own
accord – for purely selfish reasons!
Remember that there is much
more to life than just counting the
number of boxes of medicines you
have sold! You need to be engaged
and in order to enjoy your job, you
need to add value and believe that
you are doing something con-
structive with your life.
If you invest in educating yourself,
the satisfaction you will get from
doing your job well will increase
enormously! This will boost your
self-esteem – and as you start to
respect yourself, your doctors will
respect you as well. The good news
is that as specialists become busier,
representatives are going to be able
to find more opportunities to be of
service to them.
Start to think of how you can
contribute to making the world
a healthier place, by helping the
doctor to do a better job! -AM
“
Missing something important?
You can access all past issues of MedicinMan at: http://medicinman.net/archives.
Be sure to Subscribe on our website (top-right corner: www.medicinman.net)
to stay up-to-date with us.

The most exciting part of the conference: FFE 2013 begins with the CEO Roundtable. Pharma Leaders have the
opportunity to interact freely and set the tone of the event. Participants have the opportunity to interact directly
with the CEOs during Q & A.
Sujay Shetty,
Partner & Lead,
Pharma & Life
Sciences, PwC.
Shakti
Chakraborty,
Group President,
Lupin.
Ganesh Nayak,
COO & Executive
Director,
Zydus Cadila.
Bhaskar Iyer,
Divisional VP,
India Commercial
Operations, Abbott
Hosted by www.MedicinMan.net. Organized by Knowledge Media Venturz.
www.kmv.co.in
High-Engagement CME for Brand Building
Presented by:
Faculty
Less than 7
DAys to Go.
Register
Now!
Saturday,June8,2013|CourtyardMarriott,Mumbai
 8
CEO Roundtable:
Field Force Productivity: Opportunities & Challenges
AweSum
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E
The Marks
of a true
Professional.A True Professional is one who has achieved a high standard of “Personal
Quality” in everything from dressing sense to professional knowledge and
inter-personal relationships.
Rachana Narayan is a Trainer at A Menarini India Pvt. Ltd.
She has previously worked in Medico-Marketing Dept. at
Torrent Pharmaceuticals.
L
et me confess that I am not writing
this as an expert in grooming
nor do I possess some technical
qualification for the same. Yet, very often
I have been suggested to pen down my
thoughts on grooming and presentation
and making that first impression the best
one. Grooming is actually the result of the
ethics, habits and discipline that people
acquire over the course of many years from
their parents, family, friends and learning,
that makes them different from others.
The degree to which a person varies in
their inter-personal and presentation skills
depends not only on their educational
background but also on the trans-regional
exposure a person has received during her/
his lifetime.
To me grooming is a very narrow term,
that in isolation cannot trigger the desired
result. It may lead to grabbing attention but
attention without respect may be dangerous
at times. So, I prefer to call it ACHIEVING
PERSONAL QUALITY, which is a
broader term and always leaves room for
improvement.
Achieving quality in self, just like in
any other product, does not come
spontaneously. In fact it needs a lot of
understanding, rehearsals, learning from
past experiences and eliminating harmful
personality aspects. To me, some of those
aspects of personality, which will render
satisfactory Personal Quality for self as well
as others, come from following:

E
“
The Marks of a True Professional | Rachana Narayan
1
Dressing Sense: Appropriate
dressing as per body type and oc-
casion is a must to grab apprecia-
tive attention. In professional business
settings, it needs to be more orthodox.
The more you are covered, the better
for you. Dressing should make you feel
comfortable and confident. Selection
of colours as per skin type is an art and
comes with trial. In case of doubt, plain
light colours are always best and white
and black always tops the list for any
skin type. In sales especially, dress-
ing has a direct correlation with sales
results.
Ornaments and jewelery should be
minimal and delicate. Pearl necklaces
or gold chains with small diamond
pendants give authentic professional
look to ladies. One could also go for
lightweight imitation jewelery match-
ing with dress colour.
2
Gestures: A confident gesture
with pleasant smile and good
eye contact is the first aspect of
grabbing attention. Openness to other’s
thoughts makes a person reliable and
trustworthy. It’s always the innermost
desire of every human being to be
heard and that one quality makes the
person Mr./Mrs. Dependable.
As per a study, smiling, as a positive
gesture of acceptance, has been shown
to increase sales success rate by 20%.
3
Personal Hygiene: This is one
aspect without which even the
highest standards of etiquettes
fail to leave a mark. Cleanliness and
good body odor, even though they may
not provide any added advantage, will
be a big turn-off if neglected.
4
Tone of voice: Tone of voice
is always neglected but voice
modulation helps in creating an
impression that lasts even after the per-
son has gone. This is one of the aspects
which may help salesmen to create a
lasting impression. All good speakers
have mastery in this.
5
Communication Skills: As per
the research done by Adler R.,
it has been estimated that 70%
of our time is spent communicating –
writing, speaking or listening. Hence,
spending that time judiciously is very
important. In order to communicate
effectively, Harvard Business Review
recommends communication to have
three elements: credibility, emotional
connection and logic. Communication
which instills trust, provides emotional
need satisfaction and is backed by logic
always stands out and creates a positive
image of the person. This also leads to a
higher closing ratio in sales.
6
Knowledge: A good image
is built on the foundation of
sound knowledge. Knowledge
here is not restricted to the product
and processes alone. It also includes
having command over the language,
information about the environment
and the customer. Knowledge enhances
competency, boosts the confidence and
provides the intellect to handle queries
efficiently.
7
Personal and inter-personal
relationships: It is now a proven
fact that it is not only knowledge
but also people skills that take a person
to the top.
A survey from the Menlo Park done in
2011 found that 48 % of workers be-
lieved that being courteous to co-work-
ers can greatly affect a person’s career
and accelerate advancement. Another
research from Harvard University, the
Carnegie Foundation and the Stanford
Research Institute linked 85% of job
success to people skills. Thus, a person
without good relationship skills with
colleagues cannot achieve success in
the long run.
In today’s era of social networking,
people skills have come to acquire a
much more important role. We are
nothing but the impression we leave
on others. Whether we want or not, we
are always in the process of creating an
impression about ourselves. There are
people judging us and spreading the
message that ultimately decides our
success with them and in life.
Hence, concentrating on the small
aspects of PERSONAL QUALITY can
create a big impact on life. Joyce Broth-
ers, rightly said, “A strong, positive
self-image is the best possible prepara-
tion for success”. -RN
We are nothing but the
impression we leave on
others. Whether we want
or not, we are always in
the process of creating
an impression about
ourselves. There are
people judging us and
spreading the message
that ultimately decides
our success with them
and in life.

Key Questions for Discussion:
1. What is the role of Business Intelligence in enhancing Field Force Productivity?
2. Can accurate Business Intelligence lead to an optimized Field Force structure?
3. Can Business Intelligence help Field Force optimize physician targeting?
Faculty
Business Intelligence for
Field Force Productivity
Vikas Dandekar,
India Bureau Chief,
Elsevier Business
Intelligence
Salil Kallianpur
Commercial Head -
Classic Brands Center
of Excellence, GSK
Dr. Viraj Suvarna
Medical Director,
Boehringer Ingelheim
Ameesh Masurekar
Founder Director - AIOCD
Pharmasofttech AWACS
 8
Presented by:
www.aiocdawacs.com
PANEL DISCUSSION
FFE 20135
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F
inally the tiger has come out of cage.
The New Drug Policy came into force on 15 May,
2013.
The Government of India, on May 16, announced the New
Drug Policy, which brings 348 drugs and 652 formulations
in the Essential Drugs List thus reducing their cost by about
25-30%.
What this means for MNC’s & Pharma Majors is:
ØØ Volume Erosion
ØØ Shrinking Profits
ØØ Increased Operating Cost to Sales Ratio
The impact of this price reduction could be around 40-60%
for many products promoted by MNC’s and pharma majors
in India.
Incidentally all MNC’s and pharma majors have high MRP’s
and sizeable volumes for most of their products which fall
in these 27 therapeutic segments and therefore they are
expected to take a severe hit in turnover and profits.
By conservative estimates, the expected erosion in turnover
of MNC’s and pharma majors could be 12% to 20% and the
expected erosion in profits around 20% - 25%.
To top this off will be the additional pressure from the
pharma retailers where the margins have been reduced
from 20% to 16%. This powerful lobby would be pressur-
izing Pharma Companies for more freebies to compensate
their margin loss.
In recent years, most of the MNC’s and pharma majors
have expanded their field force to capitalize by maximizing
their volume share of these key brands from rural markets
The Rural Markets mainly support these Key Brands.
Now with reduced prices and profits it will become difficult
for them to sustain many of these markets.
Sharad Virmani is Vice President, Marketing and
Sales at Comed Chemicals and Pharmaceuticals.
virmanis@gmail.com
How to survive in the New-DPCO era.
P R D G
A A
M
i
S H F TI
E

Paradigm Shift: How to Survive in the New DPCO Era | Sharad Virmani
The pressure will also mount on urban markets to compensate
these volumes through other products.
Race will now begin to build new big brands which fall outside
this list of essential drugs.
Rising operating costs to sales / profits would be the key con-
cern.
Outsourced Field Force - The New
Paradigm.
It’s time to change business tactics.
To cut down the rising costs and optimize profits, the best
available alternative for MNC’s and pharma majors is to use
outsourced field force.
The Advantages of using Outsourced Field Force:
1Cut Operating Costs: improving market access and pene-
tration at lower cost.
ØØ Manpower can be employed at 30-40% less salaries com-
pared to internal employees.
ØØ 20-30% lesser daily allowances compared to internal em-
ployees.
ØØ Decrease internal headcount.
ØØ Reduced overheads.
ØØ Reduced fixed costs.
2Grow Share of Voice - Increase Revenue:
ØØ Promote brands which are in essential drugs list.
ØØ Parallel promotion of key brands with different brand
names to optimize market share.
ØØ Target niche segments.
ØØ Promote matured brands – leaving the company field force
to focus on new products.
ØØ Target new customer degments – no customer overlap.
ØØ Promotion at retail counters to maximize gains from brand
equity – capitalizing on the OTC appeal of the product.
3Flexibility for upsizing or downsizing quickly as needed –
a Commercialization risk mitigation strategy against future
unexpected events, such as pipeline disappointments, negative
FDA action and competitive threats.
4 Eliminate fixed payroll and benefits costs.
5Reduce legal expense and exposure due to the Outsourced
firm covering Human Resources issues.
This is the right time for MNC’s and big pharma companies to
explore CSO (Contract Sales Force) in India.
The big question is which out-sourced business model to use:
1. Regional Franchisees or
2. MNC-managed Contract Sales Organizations (CSOs)
To cut down the rising costs
and optimize profits, the
best available alternative
for MNC’s and pharma ma-
jors is to use out-sourced
Field Force.

Paradigm Shift: How to Survive in the New DPCO Era | Sharad Virmani
Regional Franchisees
Regional Franchisee’s are State operators – mainly well-to-do
C&F’s.
Shortcomings of regional franchisees are:
ØØ Infrastructure issues.
ØØ Cash mobility.
ØØ Manpower not willing to work under franchisee as they do
not have credibility and national presence.
ØØ High Attrition rates.
ØØ Lack of a professional culture and environment.
ØØ Short-term commitment.
Shortcomings for Companies working with Local Franchi-
sees:
ØØ Cumbersome multiple window operation with state-wise
contracts.
ØØ Monitoring from multiple windows is a problem.
ØØ Resource sharing through multiple points – increased over-
heads costs.
ØØ Dilution of message.
The Best bet is:
MNC-Managed CSO (Contract Sales
Force)
Benefits:
ØØ Professionalism – accountability and commitment.
ØØ Single contract.
ØØ Prior experience of managing CSO operations in multiple
countries
ØØ Single window operation / single command.
ØØ Confidence and job security of employees.
ØØ Uniform message.
ØØ Established infrastructure.
ØØ Credibility and national presence.
ØØ Single point resource sharing – reduced overheads for
parent company.
ØØ Cost economy.
ØØ Cash inflow and financial security.
ØØ Long term commitment.
ØØ Lower attrition rates.
Time has come for MNC’s and big pharma companies to change
their paradigms, shift gears and explore the emerging opportu-
nity of contract sales force business to leverage business advan-
tage and optimize profits. -SV

Employee Engagement:
A New Paradigm in Field Force Productivity.
Faculty
K. Hariram,
Former MD (retd.),
Galderma India.
Amlesh Ranjan
Associate Director,
Sanofi
Deep Bhandari
Director, Marketing and
Sales Excellence, UCB
Moderator:
Anup Soans
Editor, MedicinMan
S. Mohan
GM & Head, Training &
Development, Ranbaxy
 8
Pharma’s Premier Branding Event
“Pharmodeling for Healthcare: KAM & Market Access”
Session Lead: Amlesh Ranjan, Assoc. Director, Sanofi
“Role Clarity for Field Sales Managers to Enhance Field Force Productivity”
Session Lead: K. Hariram, Former MD (retd.), Galderma India
Presented by:
PANEL DISCUSSION
Power Session 1
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I
’m sure, there are many talented cricketers but
in terms of longevity, records and adaptability
to changing needs of the game, Sachin Ten-
dulkar scores over everyone.
How is Sachin Tendulkar able to play for 23 long
years with the same intensity? How is Sachin able
to have all the world records? How is this master
blaster able to adapt to the changing needs of the
game? These are questions I keep asking myself. I
had received many answers earlier. But today, I had
a realization, which transformed me much.
I realized that many cricketers, when they were try-
ing to make it to the Indian Cricket Team, probably
had a back-up option in their mind. There is a pos-
sibility that their sub-conscious mind would have
told them – “Play cricket. Do your best to get into
the Indian Cricket Team. In case, you miss a career
“If there is no cricket, then there is
no life for me.” Sachin Tendulkar’s
cricket-or-nothing attitude is what has
set him apart from other cricketers.
Here’s what Gen-Y can learn from the
Little Master.
The Single-
Minded
Success
of Sachin
Tendulkar.
RM. Saravanan is a corporate trainer and author of the books -
‘Reveal Your Genius’ and ‘The Winning Edge. He was formerly
Manager - Training at Chiron Panacea Vaccines.
rmsaravanan1000@gmail.com | revealyourgenius.co.in
E

The Single-Minded Success of Sachin Tendulkar | RM Saravanan
in cricket, don’t worry, as you can take
up a corporate job, since you are well
educated or you have an option to take
care of your family business.”
Whereas for Sachin Tendulkar, there was
no option and his dominant thought
would have been – ‘I will play cricket. If
there is no cricket, then there is no life
for me’.
Since there was no back-up option for
Sachin, he could bring an insatiable
passion and hunger to his game and that
made him one of the most complete
batsmen of the century.
Success flows like a waterfall to all gifted
players, but the same success will flow
like tsunami to a man, who doesn’t have
an option of failure in his mind. I realize
today that having an option is the first
step towards under-utilizing oneself.
It is a fact. Let us see few examples to
understand this:
A sales professional, who thinks of only
‘one target’, will invariably achieve, as
well as surpass the target compared to
the sales professional, who thinks ‘2
targets’ - option 1 and option 2.
A working professional, who thinks ‘I’ll
grow in this organization’, will invariably
grow in the organization compared to
the professional, who thinks ‘I’ll grow
here or there or elsewhere’.
An employee, who wants to be an entre-
preneur, will be successful in his venture
sooner or later if he resigns from his job
and demonstrates single-minded focus
in his business, compared to a person
who continues to be an employee but
parallely starts a business and thinks that
if he gets success in business, then he’ll
quit his job.
An organization, that thinks that it can
groom its employees as they are the
future, will continue to develop strong
professionals and in the process, retain
their employees as compared to an
organization, which keeps back-up can-
didates ready if someone resigns. They
will never be able to develop people, as
they are already thinking that people
may leave.
Do you feel not having options is
stressful? It may be stressful but that is
a positive stress. The moment one has
more than one option, he is sending a
clear signal to the Universe that he is not
confident of achieving the first one.
Having options is like tying a bicycle to
your bike and thinking that if the bike
breaks down, then you’ll take the cycle.
It is not possible to travel at full speed
in such a manner. If you tie a bicycle to
your bike it will actually make you travel
more cautiously.
There is one more reason why having
one option or one goal will help im-
mensely. When you have only one focus,
you send a message to the Universe that
you have faith in this goal, in this ven-
ture, in this organization etc. And it is a
fact of life that faith never fails.
Let’s throw the options away. It is enough
that we played safe so far. When we have
one goal and one focus, we will entually
achieve it. Even if we fall short, what is
the worst that can happen to us? Anoth-
er solution will automatically come in
search of us when we needed it. Let us
trust and step forward in the direction of
our dreams confidently.
I would like to end this article with the
quote of Swami Vivekananda:
“Take up one idea. Make that one idea
your life; dream of it; think of it; live on
that idea. Let the brain, the body, muscles,
nerves, every part of your body be full
of that idea, and just leave every other
idea alone. This is the way to success, and
this is the way great spiritual giants are
produced.” -RMS
When you have only
one focus, you send
a message to the
Universe that you
have faith in this
goal, in this venture,
in this organization.
And it is a fact of
life that faith never
fails.
“
”

Agenda
 8
08.30 - 09.20 Networking Breakfast
09.30 Keynote Address: Shakti Chakraborty, Group President, Lupin
10.00 CEO Roundtable
Moderator: Sujay Shetty, Partner & Lead, Pharma & Life Sciences, PwC
Panel Members: Shakti Chakraborty - Group President, Lupin
Ganesh Nayak - COO & Executive Director, Zydus Cadila
Bhaskar Iyer - Divisional VP, India Commercial Operations, Abbott
11.30 Panel Discussion: ‘Business Intelligence for Field Force Productivity’
Moderator: Vikas Dandekar - India Bureau Chief, Elsevier Business Intelligence
Panel Members: Ameesh Masurekar - Founder Director, AIOCD Pharmasofttech AWACS
Salil Kallianpur - Classical Brands Centre of Excellence, GSK
Dr. Viraj Suvarna - Medical Director, Boehringer Ingelheim
13.00 - 14.00 Lunch
14.00 Panel Discussion: ‘Employee Engagement: The New Paradigm in Field Force Productivity’
Moderator: Anup Soans, Editor, MedicinMan
Panel Members: Deep Bhandari - Director, Marketing and Sales Excellence, UCB
K. Hariram - Former MD (retd.), Galderma
Amlesh Ranjan - Assoc. Director, Sanofi
Mohan Sheshadri - GM & Head, Training & Development, Ranbaxy
16.00 Power Session 1: ‘PharModeling for Healthcare: KAM & Market Access’
Amlesh Ranjan - Assoc. Director, Sanofi
16.30 Power Session 2: ‘Role Clarity for Field Sales Managers to Enhance Field Force Productivity’
K. Hariram - Former MD (retd.), Galderma
17.00 Closing Remarks
FFE 20135
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Less than 7
DAys to Go.
Register
Now!

L
et us look at a very familiar scenario. In the
quarterly cycle meeting there is an analysis
of number of calls, visit frequency and call
averages. The concerned sales person whose call
average is low is put down in front of everybody and
virtually ripped apart. Most often the concerned
FLM is also included in this exercise in front of his
own team members or the FLM is in for a surprise
with regard to this revelation. The Sales Manager,
feels that he has done his job and his ego is satisfied.
The ritual continues quarter after quarter with
minimal impact on sales.
Do the managers concerned realize the purpose
behind such an activity? Have they achieved their
purpose? Do they know that this has an impact on
the day to day revenue generation for which they are
responsible? By doing this have they changed the
behaviors of those concerned? Is there any coaching
done with regard to this? Million dollar questions, I
suppose.
Among the most important role of line managers is
the willingness and ability to inspect performance
according to expected standards, and the
commitment to reinforce what is learned through
feedback, consistent messages and coaching.
If you don’t inspect what you expect, you no longer
Catch People
DoingThings
Right*
.
K. Hariram is the former MD (retd.) at Galderma
India. He is Chief Mentor at MedicinMan and a
regular contributor.
khariram25@yahoo.com
*Title borrowed from Ken Blanchard.
E

Catch People Doing Things Right | K. Hariram
have the right to expect it. Inspecting what you expect is simply
holding people accountable for those behaviors, actions, attitudes
and decisions that contribute to results. Every line manager has
access to data of those where expectations have been set.
So monitoring and giving periodic feedback for course correction
and the immediacy of action helps in avoiding ritualizing such
things. The results will follow. Also, the sales team member
gets projected in proper light in front of middle and senior
management team. A sense of pride, self esteem and sense of
accomplishment gets reinforced. This also provides opportunity
to CATCH PEOPLE DOING THINGS RIGHT (Kenneth
Blanchard).
Here are four ways to ensure consistency in expecting and
inspecting:
1. Set clear expectations (not vague ones like ‘improve call
average, meet more frequently’ etc)
2. Teach, train and educate them.
3. Reinforce the training in meetings, assignments, coaching etc.
4. Inspect (monitor) regularly whatever you expect and redirect
immediately. -KH
“The Sales Manager
who berates his team,
feels that he has done
his job and his ego is
satisfied. The ritual
continues quarter after
quarter with minimal
impact on sales.
Abdul Basit Khan
Ajay Kumar Dua
Amlesh Ranjan
Amrutha Bhavthankar
Andris A. Zoltners
Anthony Lobo
Aparna Sharma
Arvind Nair
Atish Mukherjee
B. Ramanathan
Chayya Sankath
Craig Dixon
Devanand Chenuri
Venkat
Dinesh Chindarkar
Dr. Amit Dang
Dr. Aniruddha
Malpani
Dr. Hemant Mittal
Dr. Neelesh Bhandari
Dr. S. Srinivasan
Dr. Shalini Ratan
Dr. Surinder Kumar
Sharma
Dr. Ulhas Ganu
Geetha G H
H. J. Badrinarayana
Hakeem Adebiyi
Hanno Wolfram
Hitendra Kansal
Iyer Gopalkrishna
Jasvinder Singh
Banga
Javed Shaikh
Jitendra Singh
John Gwillim
Jolly Mathews
Joshua Mensch
K Hariram
K. Satya Mahesh
Ken Boyce
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
Our Authors
MedicinMan invites contributions from Pharma professionals on topics related to Field Force
Excellence. See: www.medicinman.net/author-guidelines for more information.

FFE 2013 is India’s premier event for Field
Force Excellence by MedicinMan.
The old methods of increasing field force num-
bers will only mean increasing inefficiencies.
Moreover, arbitrary targets and unachievable
incentives has made the field force wary and
weary and attrition is at an all time high.
The Challenges faced by Pharma in India is
manifold:
• Patent expiration and fewer blockbusters
• Stringent regulatory compliance
• Intense competition and
• Heightened cost pressures
This, coupled with social activism, decreased
face-time with Doctors, and commoditization
of the market, make questions of Field Force
Productivity all the more important.
In these circumstances, the urgent questions
for senior pharma managers are:
1. What are Pharma CEOs thinking about the
role of Field Force in the changed market sce-
nario?
2. What is the role of Business Intelligence in
enhancing Field Force Productivity?
3. How to attract and retain Gen-Y talent? What
is Employee Engagement?
4. What is PharModeling? How can KAM (Key
Account Management) lead to increased Field
Force Productivity?
5. How can Role Clarity of Field Sales Manag-
ers lead to increased Field Force Productivity?
Every year at FFE, MedicinMan brings togeth-
er industry thought-leaders to deliberate on the
most pressing issues facing the Pharma Field
Force in India.
Join us at FFE 2013 to learn, share and set the
agenda on Field Force Excellence for the year
ahead.
Who Should Attend: Senior Managers in
Sales and Marketing, Training, HR, SFE, SFA
and other Field Force related functions.
Why Attend: Do not miss out on this oppor-
tunity to learn about the best practices in Field
Force Excellence from industry thought leaders,
network with industry peers and pharma deci-
sion-makers and take home an action-plan for
Field Force Excellence in 2013.
Registerwww.medicinman.net/ffe13-registration
' U } z
 8
FFE 20135
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Objectives

Building
Sales
Teams
From
Scratch
O
ne of the key functions of a Front-line
Manager is to act as the glue that holds
MRs together as a team for a common
purpose and objective. The FM must understand
the process and dynamics of transforming a group
of strangers into a single, cohesive unit. FMs must
understand the personality traits of MRs and be able
to harness the strength of each personality
Understanding the four distinct stages of Forming,
Storming, Norming and Performing will enable
new FMs to be effective team-builders. In addition,
Rapport-building, Communication skills,
Empathetic leadership and Coaching skills are
needed to build sales teams.
Among the most important role of line managers is
the willingness and ability to inspect performance
according to expected standards, and the
commitment to reinforce what is learned through
feedback, consistent messages and coaching.
Understanding the process of team-formation can avert much distress for the FLM.
Each team goes through stages of FORMING, STORMING, and NORMING before they
can start PERFORMING. This knowledge is of vital importance to the team manager.
E

Building Sales Teams from Scratch | Anup Soans
FORMING: A sales team may be
formed to launch a new division or to
achieve a specific marketing/strategic
objective. The first stage for any team
is to come together. At this stage, the
team can perform only routine tasks.
It is possible to function for years at
this level, doing the same things in
the same ways and remaining as a
group of individuals, like the Indian
tennis duo Leander Paes and Mahesh
Bhupathi. FMs must foster FORMING
by being empathetic, asking probing
questions, active listening, discovering
the personalities of his MRs, and doing
things together. FMs must take the lead
in FORMING the purpose, goals and
directions for the team.
STORMING: At this stage, conflicts
erupt, as MRs seem to become
uncooperative, raise objections, and
become frustrated and hostile. MRs
become angry at each other as well as
at the whole idea of working together
as a team. While this may make the
FM feel like a failure, it is actually a
major step forward. If the team is to
survive, workable solutions must be
found by accommodating differences.
Useful skills at this stage are patience,
consensus-building, flexibility, and
an ability to see past the STORMING
clouds to the goal.
NORMING: Eventually, the storm
blows over and the team enters a period
of calm. Solutions to problems and
conflict seem possible. A unique set of
NORMS for teamwork appears. These
NORMS may be outside the official
rules, but the team members accept
them. The danger at this stage is for
good ideas to be withheld because
people do not want to stir things up.
After all, things have barely settled
down after the storm. Useful skills at
this stage are trust, a willingness to
take risks, innovation and the ability to
recognise and measure progress.
PERFORMING: At this stage,
disagreements are resolved amicably
in a win-win manner. MRs become
confident and trust their FM and
feel safe to take risks. New ideas and
ways of solving problems are pursued.
Activities that will help the team
remain productive without getting
stuck include taking calculated risks,
disagreeing constructively, and seeking
out challenges.
Teams do not remain permanently
at the Performing stage. A Storm can
erupt at any time. The pressure of the
need to perform or an unexpected loss
of a major business account such as
a large institutional deal can trigger
a storm. Losing or gaining a new MR
always returns the team to the Forming
stage. Changing FMs can also have the
same effect. Successful teams usually
recover from setbacks and get back to
Performing quickly. However, when
a team drops into a previous stage, it
must work its way back through all
the intermediate stages again, without
skipping any of them.
To produce PERFORMING teams,
FMs must focus on three critical areas:
1
Clear purpose and measurable
goals: Teams need a unifying
purpose. Develop a common
purpose for your team that unites you
and your MRs. Make each MR write
down the team’s goal and compare the
results. It may surprise you to discover
that there are as many versions of the
goal as there are MRs. Instead of forcing
your version on the MRs, make each
MR re-define his statement to reflect
the goals clearly.
2
Interdependence and Pride in
belonging: All team members
must recognise and accept their
interdependence. Teams must have an
interdependent working relationship
in order to exist. Otherwise, all you
Eventually, the storm
blows over and the
team enters a period
of calm. Solutions
to problems and
conflict seem
possible. A unique
set of NORMS for
teamwork appears.
These NORMS may
be outside the
official rules, but
the team members
accept them.
“

Building Sales Teams from Scratch | Anup Soans
Anup Soans is the author
of“HardKnocks for the
GreenHorn”, SuperVision for
the SuperWiser Front-line
Manager”and“Repeat Rx”.
He is a facilitator of
Learning and Development
Programs for Managers and
Medical Reps at India’s top
Pharma Companies
Contact:
anupsoans@gmail.com
+91-93422-32949
This article has been
extracted from the book
“SuperVision for the
SuperWiser Front-line
Manager” by Anup Soans.
The book is widely used as a
Learning and Development
resource by India’s top
pharma companies.
There is a special 1+1 FREE
offer currently available on
the book. See page 24 for
details.
will have is a group of individual
performers, like the Indian cricket team
a great team of individuals on paper,
but poor in collective performance.
Interdependency happens when
team members depend on each
other to produce a combined output
that is superior to their individual
performance. FMs must build pride in
the team. How does a small country
such as Sri Lanka or South Africa
produce such a fine cricket team?
Taking pride means being committed to
winning and not taking loss as a matter
of Karma. When the team wins, every
member must feel joyful about it, as this
is essential to winning the next time
too. MRs who contribute to the success
of other members must be recognised
and rewarded suitably.
3
Commitment and
Accountability: MRs must be
committed to mutual goals.
Without commitment, the team’s
performance suffers. Individual MRs
must be given specific assignments for
which they must be held accountable.
A lack of commitment to team effort
negatively affects enthusiasm and
reduces effectiveness. Ask MRs to
describe what frustrates them in trying
to be committed to the team, without
accusing them of not being committed.
Remove barriers that prevent them
from acting on their commitment. Hold
MRs accountable for the tasks entrusted
to them. Goals and plans must clearly
reflect organisational objectives to
ensure the support of senior managers
for your team’s success.
Ultimately, the team’s success is
dependent on the talents, abilities and
attitudes of its members. FMs must
actively seek out MRs who have the
right combination of talent, intelligence,
abilities and attitude, to give them a
competitive advantage on the field.
Talented MRs are intelligent people
with abilities and the attitude to achieve
pre-determined sales objectives.
While recruiting, FMs must take
stock of a candidate’s talents in terms
of performance potential, the ability
to handle a variety of customers and
other factors. MRs must be assessed not
only on intellectual skills, but also soft
skills such as emotional intelligence,
creativity, the ability to work in a team,
and the willingness to learn and share.
Conclusion
Companies generally look for talent
only at higher levels of management.
Today, pharmaceutical companies
require talented FMs and MRs who
have the ability to look at problems
from different perspectives and a high
degree of creative and non-linear
thinking to achieve business results.
Intense competition and the consequent
need for speed make the top-down
management approach ineffective.
Decisions need to be made at the field
level. As pharmaceutical field sales get
more and more challenging, FMs along
with their senior managers have to
identify, incubate and develop teams of
talented MRs who can make better and
faster decisions that address the needs
of the doctor/customer effectively.
While it may be easier to manage
average performers through mediocre
management skills, the imperative
for modern-day FMs is to upgrade
their abilities constantly and be able to
attract and retain talented MRs whose
breakthrough performances can be
models for other MRs. -AS

Buy 1 get 1 free !
MRP Rs. 799/- MRP Rs. 599/-
For Individuals*
Buy SuperVision for the SuperWiser Front-line Manager and Get HardKnocks for the
GreenHorn FREE.
For Corporates*
INR 500/- for a set of SuperVision for the SuperWiser Front-line Manager (1 copy)
and HardKnocks for the GreenHorn (1 copy) for purchase of 50 sets and above.
*Inclusive of Shipping to One Location.
Please pay through bank transfer to SB account no. *07141000006761* of “Anup Soans” HDFC Bank, Mosque Road, Frazer
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Field Force Excellence Tools for Individuals and Corporates

I
n an observational study investigators observe
subjects and measure variables of interest without
assigning treatments to the subjects. The treatment
that each subject receives is determined beyond the con-
trol of the investigator1
.
Observational research methods are employed within
a number of different scientific disciplines used in the
pharmaceutical industry, for example, epidemiology,
pharmacoepidemiology, statistics, health economics
and outcomes research, and survey research. However,
methodologies and terminology differences exist across
those disciplines. The terms epidemiology, pharmacoep-
idemiology, observational, outcomes, noninterventional,
nonexperimental, real-world, and registry are used inter-
changeably in association with observational research2
.
Applications of Observational Research.
Observational research is an integral part of clinical
development, life cycle management, and drug safety
surveillance evaluations. Observational research is not a
scientific discipline in itself, but a methodology central to
a number of scientific disciplines. On the drug develop-
ment and life cycle management continuum, companies
frequently use observational research studies to:
ØØ Define patient populations suitable for clinical trials.
ØØ Define the natural history of a disease and patients’
responses to treatment.
ØØ Standardize outcome measurements.
ØØ Provide help in the design of long-term clinical out-
Knowledge for the Field Force Series
- EMERGING AREAS IN HEALTHCARE -




OBSERVATIONAL RESEARCH IN HEALTHCARE
UUUUUUUUUUUU



Javed Shaikh is a Consultant (HEOR,
Pricing, Reimbursement and Market
Access) at Capita India, Mumbai.
cpnjaved@gmail.com
Shafaq Shaikh is an Associate
(HEOR, Pricing, Reimbursement
and Market Access) at Capita India,
Mumbai.
shafaq07@gmail.com
E

Observational Research in Healthcare | Shafaq Shaikh & Javed Shaikh
come trials, to increase oppor-
tunities for patient follow-up.
ØØ Improve patient-reported
outcome measures for clinical
trials.
ØØ Contribute to drug safety
evaluations, including risk
management strategies and
effectiveness evaluations of risk
minimization activities.
ØØ Evaluate the comparative
effectiveness between approved
products under conditions of
usual care.
ØØ Identify health care resourc-
es and costs associated with
treatment.
ØØ Identify drug utilization pat-
terns for approved treatments.
Observational Research Methods.
The three key, and most com-
mon, epidemiologic observational
research study designs, found in
virtually all epidemiology and phar-
macoepidemiology reference text
books are3
:
1. Cohort study
2. Case-control study
3. Cross-sectional study
1. Cohort Studies
These are the best method for de-
termining the incidence and natural
history of a condition. The studies
may be prospective or retrospective
and sometimes two cohorts are
compared.
Prospective cohort studies: A group
of people is chosen who do not have
the outcome of interest (for exam-
ple, myocardial infarction). The
investigator then measures a variety
of variables that might be relevant
to the development of the condition.
Over a period of time the people
in the sample are observed to see
whether they develop the outcome
of interest (that is, myocardial
infarction).
In single cohort studies those people
who do not develop the outcome of
interest are used as internal con-
trols. Where two cohorts are used,
one group has been exposed to or
treated with the agent of interest and
the other has not, thereby acting as
an external control.
Retrospective cohort studies: These
use data already collected for other
purposes. The methodology is the
same but the study is performed
post-hoc. The cohort is “followed
up” retrospectively. The study period
may be many years but the time to
complete the study is only as long
as it takes to collate and analyse the
data.
Salient Features:
ØØ Cohort studies describe inci-
dence or natural history.
ØØ They analyse predictors (risk
factors) thereby enabling calcu-
lation of relative risk.
ØØ Cohort studies measure events
in temporal sequence thereby
distinguishing causes from
effects.
ØØ Retrospective cohorts where
available are cheaper and
quicker.
ØØ Confounding variables are the
major problem in analysing
cohort studies.
ØØ Subject selection and loss to
follow up is a major potential
cause of bias.
2. Case-Control Studies
A case-control study identifies
patients on the basis of an outcome
of interest, using either incident
or prevalent cases, and is generally
considered to be a retrospective
study design. Cases are defined as
patients who have experienced the
References
1. Porta M (editor). A dictionary of epidemiology. 5th.
edition. New York: Oxford University Press, 2008.
2. Black, N. Education and Debate: Why We Need
Observational Studies to Evaluate the Effectiveness of
Healthcare. BMJ 1996; 312:1215-1218.
3. Mann, CJ. Observational Research Methods. Research
Design II: Cohort, Cross-sectional and Case control Studies.
Emerg Med J, 2003; 20:54-60 doi:10.1136/emj.20.1.54.
In an observational
study investigators
observe subjects and
measure variables of
interest without assign-
ing treatments to the
subjects. The treatment
that each subject re-
ceives is determined
beyond the control of
the investigator.
“

”
Observational Research in Healthcare | Shafaq Shaikh & Javed Shaikh
outcome of interest, for example,
a disease under study (e.g. atrial
fibrillation), or an adverse event of
interest (e.g. veno-occlusive dis-
ease). Controls are selected on the
basis of being free of the outcome
of interest and representative of
the source population from which
the cases arise. Exposures are then
assessed by looking backwards in
time at patients’ medical records or
patient interviews. The case-control
design is often used to identify and
characterize the etiology of rare
diseases because of its efficiency in
terms of its ability to inform with
respect to cost and time.
Salient Features:
ØØ Case-control studies are simple
to organize.
ØØ Retrospectively compare two
groups
ØØ Aim to identify predictors of an
outcome.
ØØ Permit assessment of the influ-
ence of predictors on outcome
via calculation of an odds ratio.
ØØ Useful for hypothesis genera-
tion.
ØØ Can only look at one outcome.
ØØ Bias is a major problem.
3. Cross-sectional Studies
In a cross-sectional study, individ-
uals are assessed at a single point in
time with respect to an exposure of
interest and outcome under study.
The distinguishing feature of a
cross-sectional study is the inabil-
ity to establish a time sequence
of events between exposure and
outcome; therefore, cross-sectional
studies cannot be used for causal as-
sessments. However, they are useful
in the effectiveness evaluations of
risk management strategies and as-
sociated risk minimization activities.
The cross-sectional study design is
also useful for survey research, and
in knowledge, attitudes and practic-
es (KAP) studies of patients and or
health care providers.
Salient Features:
ØØ Cross sectional studies are the
best way to determine preva-
lence.
ØØ Are relatively quick.
ØØ Can study multiple outcomes.
ØØ Do not themselves differentiate
between cause and effect or the
sequence of events.
Summary
The use and scope of observational
research studies within the pharma-
ceutical industry has increased over
past decades to include clinical, pa-
tient-reported, economic, and other
health outcomes endpoints, thereby
giving value to multiple stakehold-
ers for as many different purposes.
Unlike randomized clinical trials,
observational studies allow for the
evaluation of the use and effects
of healthcare products (including
drugs, biologics, devices, vaccines)
under conditions of usual care in a
real world setting.
Globally, the use of real-world
data in demonstrating the value of
medical technologies is increasing-
ly relevant to reimbursement and
market access decision making.
Whether prospective, retrospective
or cross-sectional, observational
research has a critical and growing
role to play in driving a better un-
derstanding of the health outcomes
of medical technologies, and sup-
porting appropriate product use in
everyday clinical practice. -SS & JS
Globally, the use of real-world
data in demonstrating the
value of medical technologies
is increasingly relevant to
reimbursement and market
access decision making. Wheth-
er prospective, retrospective or
cross-sectional, observational
research has a critical and
growing role to play in driving
a better understanding of the
health outcomes of medical
technologies, and supporting
appropriate product use in
everyday clinical practice.
“

FFE 2013 Registration
Registration
Delegate Fee for FFE 2013
Pharma Delegates - INR 8,500 + 12.36% service tax
Service Providers - INR 9,500 + 12.36% service tax
Register Online at medicinman.net/ffe13-registration or submit the details below to
anupsoans@gmail.com/arvind@kmv.co.in
Pay by Cheque
Payment must be made in INR by Cheque / Bank Draft and must be received prior
to the conference. Cheques to be issued in the name of “Knowledge Ventures”,
payable at Mumbai.
Send Cheques to:
Arvind Nair,
The Event Secretariat,
B-205, Ahimsa Enclave,
Off New Link road, Chincholi,
Malad West,
Mumbai - 400064.
Pay by Account Transfer
NEFT DETAILS
Bank: ICICI BANK
Branch: Malad Link Road Branch, 6/7 Linkway Estate,
Malad (West), Mumbai - 400064.
Account Name: Knowledge Ventures
Account Type: Current
Account No: 122105500002
IFSC Code: ICIC0001221
Personal Details (To be sent along with details of payment)
Name:
Company:
Designation:
Address: Email: Mobile:
Details of Cheque/ NEFT Transfer:

Patient Reported
Outcome Measures in
Pharmacoeconomics
A
patient-reported outcome (PRO) is a direct
subjective assessment by patients about aspects
of their health, including symptoms, function,
emotional well-being, quality of life, utility, and satisfac-
tion with treatment. PROs evaluate the impact and func-
tional implications of the disease or treatment to reflect
their interpretation of the experience, which is influenced
by their internal standards, intrinsic values, and expecta-
tions of the patient.
The World Health Organization (WHO) defines health as
a state of complete physical, mental, and social well-being.
The WHO’s International Classification of Functioning,
Disability, and Health (ICF) was developed to provide a
standard language and framework to describe and mea-
sure health and health-related states. Within the ICF sys-
tem, health outcomes are classified according to the effect
upon body function, body structure, limitations in activi-
ties, and limitations in participation. Health outcomes that
measure body function include measures of physiological
functions of body systems (e.g., ejection fraction, glucose
level, depression, pain, etc).
Health-related quality of life (HRQoL) instruments mea-
sure the broad concept of health (physical, mental, and
social well-being) by inquiring into the extent of difficulty
with activities of daily living (including work, recreation,
and household management) and how difficulties affect
relationships with family, friends, and social groups,
capturing not only the ability to function within these
roles, but also the degree of satisfaction derived from
doing them. HRQoL instruments often contain items that
measure body function (e.g., pain, depression, anxiety)
and limitations with activities and participation.
Economic analyses include methods to evaluate different
effects (death, effects of stroke on HRQoL, effect of reduc-
tion in acne on HRQoL) in the same metric. One way to
create the same units is through the concept of preferenc-
es. Utilities and values are different types of preferences.
Whether dealing with utilities or values depends on how
questions on measurement instruments are framed; are
participants being asked to consider outcomes that are
certain (values) or uncertain (utilities).
The Standard Gamble is the classical method of measuring
utility, based directly on the axioms first presented by von
Neumann and Morgenstern (utility theory) that describes
how a rational individual “ought” to make decisions when
faced with uncertainty. The Time Trade-Off2 is a measure
of values. It asks participants to imagine living their lives
in their current health states and to contrast this with
the alternative of perfect health in exchange for a shorter
lifespan (preference-based measured). The administrator
provides alternatives of years of life in the present health
state versus years of life in perfect health.
Patient-reported outcome measures provide information
gathered directly from the patients about their experiences
with the disease and its treatment. Because of the unique
perspective offered by patient-reported instruments, direct
measurement of health from the patient’s perspective is
popular and has replaced more objective measures as
the primary outcome of interest for a broad spectrum of
clinical conditions. To make wise management decisions,
patients and clinicians need to know the magnitude of the
effect of treatments on a variety of outcomes, including
patient-reported outcomes. Investigators must choose an
informative method to present their findings to enhance
the interpretability and applicability of their results in a
clinical setting. -MR & NL
References:
1. Von Neumann J, Morgenstern O. Theory of Games and
Economic Behaviour. Princeton, NJ: Princeton University
Press. 1944.
2. Torrance GW, Thomas WH, Sackett DL. 1972. A utility
maximization model for evaluation of health care programs.
Health Serv Res 7(2):118–33.
Mahendra Rai & Nishkarsh Likhar
mahendra.rai@gmail.com
E

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