We all know that in sales, the outcomes you get are the outcomes you incent. This is especially important for large field forces such as pharma, where a very large number of influencers are being targeted and sales compensation is computed based on terabytes of external data! Good incentive compensation (IC) plans combined with well administered execution can motivate the sales force and drive the right behaviors to align with corporate goals. But how do we know if the measures we’ve selected contribute to an intelligent incentive plan design?
TRx (total prescriptions) and NRx (total new prescriptions) have always been two of the most reliable indicators of brand performance, yet in some instances, use of these metrics can be misleading and at worst detrimental to promotional activities.
TRx and NRx metrics both track new patients and patients renewing existing prescriptions, with the latter often comprising a large portion of the data set. TRx data will also include refills. As such, the most prevalent trends may be considered more representative of historical marketing efforts than the impact of current promotions. Additionally, drawing insights from only TRx or NRx data may shield the true influence of certain market events, particularly those affecting new patients and prescribers. If your product is heavily reliant on new patients, refill or renewal data included in TRx and NRx metrics may be problematic.
New-to-brand prescriptions (NBRx) offer a straightforward workaround to the issue of refill or renewal data obscuring new patient trends. By considering prescriptions only for patients that are completely new to the brand, NBRx data provides the opportunity to isolate and observe prescribing patterns specific to new patients. Taking this a step further, the use of NBRx data in incentive pay plans can help reps learn to focus and adapt their targeting strategies to encourage new-to-brand patients. The obvious caveat to NBRx use is the fact that patient retention holds no value, a precarious risk if your business relies on patient continuation. Additionally, NBRx data coverage at territory level is typically not IC grade and should be aggregated before use, which brings in another set of challenges. So when should NBRx be a consideration for inclusion in your IC pay plan?
Guaranteed Refills/Low Risk of Brand Switching:
Since product refills require little to no energy to secure, rep effort is better spent procuring new patients rather than focusing on patient retention. Rewarding the gain of new patients through NBRx data use encourages reps to shift to promotional behaviors focused on therapy initiators, rather than prescribers simply continuing therapy.
Territory level NBRx data is not robust enough to be used in incentive compensation, and even region level capture rates tend to fall around 60% - 70%, with variation by brand and therapeutic area. However, specialty brands tend to see higher NBRx capture rates – as much as 90%, making NBRx data easier to use and more reliable.
Low Disruption Threshold:
NBRx data use largely does not change the rep/physician dynamics as the rep’s overall goal of achieving new patients remains consistent. Switching to an NBRx plan measure typically causes limited sales force disruption and therefore may be considered even where promotional relationships are key.
While NBRx use has a powerful upside, there are also clear limitations. Aside from the previously mentioned loss of refill and renewal data, a main hindrance is the lack of robust data requiring aggregation before incentive plan use. Region level goals tend to be fair as they inherently account for regional biases, yet utilizing plan measures at district or region level risks rep disengagement due to the perception of equal earnings. As such, many sales ops teams employing NBRx data will use other territory level data sources in tandem to maintain focus on individual performance. In addition, if using NBRx market share even at an aggregated level, NBRx volume or NBRx volume growth will typically be used as well for added confidence. Given these drawbacks, NBRx data can still be a powerful component of your incentive plan if used under the right circumstances. Alternatively, territory level NBRx data can be used in incentive rank-based plans, IC contests, or kickers, so that lack of robust data is less of a concern.
In summary, NBRx data can be a powerful tool if used intelligently, and the life science industry is beginning to recognize this. Already, a steady shift towards the selective replacement of NRx or TRx incentive plan measures with NBRx metrics can be seen moving through the industry with increasing importance, and for good reason! The utilization of NBRx can help refocus sales forces to better align with brand strategy in products targeting new-to-brand patients, and introduce promotional efficiencies that reflect current brand and market new patient trends. Effort wasted detailing physicians that would prescribe your brand regardless of any rep interaction can be better allocated elsewhere. However as mentioned, NBRx data should be used with caution due to the exclusion of existing patients and quality of data.
Using aggregate NBRx data in combination with other data sources and territory level metrics can ensure IC data quality and avoid rep disengagement while reaping the benefits of attracting new-to-brand patients. If the points in this blog resonate with you, it’s time to reach out and get connected with an Axtria subject matter expert. An increasing number of companies have made the switch to NBRx – is it your turn?
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