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Happy birthday POM to P

So POM to P switches are 25 years old, but for me everything changed in 2002 with the publication of the list by a RPSGB led working group of potential candidates for reclassification from POM to P. At the time there was talk of an avalanche of switches coming through the system, the industry got itself all expectant, the pharmacy profession was nervously excited and everyone prepared themselves for the new era.

So what happened? Despite all the positive hype, it hasn’t quite worked out as hoped for, either for the industry or the profession. Certainly the avalanche never arrived, and I doubt now it ever will.

I think if you asked industry executives, hand on heart, has switching been commercially successful, so far most would admit it hasn’t. If we believe POM to P has a role to play in the future of treatment management, and that pharmacy has a key role to play in diagnosing and managing conditions – both of which I passionately believe in – we really need pharmacists to start proving that they believe it too.

I have no doubt that for a host of conditions and ailments, the best place to treat and manage (and even diagnose) is in the pharmacy. Some 30 per cent of GP consultations are for minor or self-limiting conditions, most of which are in areas that pharmacists are either well or sometimes better equipped to deal with.

Couple this with the fact that our healthcare system has disenfranchised so many people and that vast tracts of patients/consumers are increasingly looking to their high street clinician – the pharmacist. One begins to wonder how it could go wrong.

I run a communications agency and over the years I’ve worked on a host of switches. I’ve spent a great deal of time talking to pharmacists about their role, their attitudes to conditions and treatments, and most importantly how they interact with their customers.

We develop training and tools to support pharmacy knowledge, and to help create a positive dialogue with customers around a condition or treatment. We also spend a great deal of time talking to the pharmaceutical industry about how to support pharmacy – so I do see things from both the industry’s as well as the profession’s side.

As far as the industry is concerned, innovation drives growth. Generic proliferation and own-brand competition mean that you can’t sit still. POM to P switching provides a huge area for innovation. It’s a ready-made pipeline of proven products for key conditions and it can breathe extended life into brands coming off patent.

With the new community pharmacy contracts and the evolution of pharmacists into service providers, the case to move more chronic care into pharmacy is compelling. Diagnose simple and even not-so-simple conditions, and the management of complex conditions follows closely behind. Whether pharmacists acknowledges it or not, the industry believes that the high street has a vital role to play in the future health management of the nation.

There is no doubt that the pharmaceutical industry produces fantastic support for pharmacy. The quality of support that exists for POM to P switches keeps getting better and better. The extent of investment in pharmacy for launches is now greater than I’ve ever seen. And it’s not unrecognised. Pharmacists acknowledge it openly. So why is it so difficult to get lift-off with a new POM-P medicine?

We acknowledge that the industry believes in pharmacy, but I believe, more importantly, that consumers believe in pharmacy too. So who is missing from this picture?

In truth, no one. Industry, consumers and the profession are passionately committed to an extended role for pharmacists. So it’s a perfect storm then? Sadly not. Because whilst the profession is supportive, there is a latent caution that affects launches so overtly that it brings to question whether switching is a viable long-term option.

From conversations with pharmacists this new world seems exciting, but quite daunting too. Diagnosis, long-term management, counselling, guidance, advice… all words that to a greater or lesser degree create nervousness. This new way has an impact on the way pharmacists operate – much more front of counter, the visible face in the store, more time intensive. So who sorts out the prescriptions? Who does the things that keep pharmacists so busy normally? Are they really able to diagnose? It’s a brand new world, and for many a scary one.

In reality switches should be the ideal conduit for this transition. The regulatory framework around switching is rigorous, designed to protect all, often to the detriment of efficacy. The products switched invariably fulfil a clear consumer need, and driving new people into pharmacy for new solutions should be good for all.

Consumers are open. They too like innovation, they want better treatments, to be able to quickly fix problems, get an appointment on their terms.

Sure it’s true that they are not yet used to more complex discussions with pharmacists. They feel a bit uncomfortable, unsure – but that’s easy enough to fix, isn’t it? Professionals, on the high street, ready to put people at ease? Perhaps the truth is that pharmacists aren’t used to these sorts of discussions either or just scared to have them.

The traditional role of symptom management will never disappear, but with the competitive environment the industry operates in being unsustainable without innovation, the truth is that without pharmacy engaging with POM to P switching and supporting it as a category, the industry will have to change tack. It cannot afford for innovation to go unrewarded in terms of sales.

This brings me to a final conundrum. I regularly hear cynicism from the profession that POM to P switches are just a route to GSL, and that pharmacists are being ‘used’. There is a truth that brands switched from P to GSL see improved sales performance, but for me it’s just a natural extension of life cycle.

An established brand with a profile for broader access, one that doesn’t need the time commitment from pharmacists, should be GSL. It’s not some conspiracy; it’s just a business reality. I worry that if pharmacy does not start to properly support POM to P switches, their cynical worrying becomes a self- fulfilling prophecy.

Pharmacists must demonstrate that they believe they are the rightful place for condition treatment and management to exist. This is so important, because once this true partnership is in place, the value of the consultation and improved experience for consumers will not only enhance their view of pharmacy as a solution, it will radically change the industry’s view. Why switch to GSL a brand where the role of a pharmacist is so intrinsic to the consumer’s experience?

This post also features in this months Pharmacy Magazine supplement reviewing 25 years of POM to P.

OTC Awards 2008, Park Lane, New York, NY

Hope everyone enjoyed the OTCs last night as much as we did. Well judged, great food, lots of laughs all round. Huge congratulations to those who bagged an award. Very deep thanks to organisers Debbie and Val for letting us sponsor the event with our charming honey vodka-issuing ladies Ebony and Danielle. We trust everyone had a chance to sample our nectar. All together now: 1, 2, 3, 4, Hive!!

Fact: the green stamp WILL fade eventually - don’t panic. (If anything has worked for you please let us know.)

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OTC preparation

All of us here are getting ready for the OTC Marketing Awards. A few last minute emails to write, one job bag to put to print. Hope to bump into you there, after dinner enjoy a shot on us.

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Retail vs detail - gaining brand engagement in pharmacy

A recent comment from a client made me think about how pharmacists act as brand enhancers for patients/consumers.

Pharmacists are highly educated healthcare professionals. Patients have long relied on their valuable skills and used their advice to make a purchase. However, it has been traditional for organisations to communicate with them principally in business terms. This retail-led approach creates dissonance between the relationship pharmacy has with a brand’s manufacturers and the one they have with the brand’s users.

The new Contract, however, changes things. Although the uptake of enhanced services seemed slow to begin with, pharmacy’s growing relationship with patients is now much in evidence. (As it is with other HCPs: the growing weight of pharmacy has strengthened links with prescribers.) With almost 2 years since the independent prescriber act, there are far better opportunities to be had than talking “stock pressure and profit on return”.

Instead, manufacturers who understand and enhance the close relationship between pharmacist and consumer will gain more end-user engagement. A recent study showed that when pharmacists intervened in the sale - not by recommending, but by providing an informed brand initiation - patient compliance increased and patients were more likely to make a repeat purchase. Proof that what can be good for profits can be great for patients.

As the professional identity of the pharmacist sinks in, their challenges revolve around setting the clinical scene and promoting new services to patients. Pharmaceutical companies must continue to track areas of progress and deliver a rounded offer that benefits in-house experts and their patients.

Retail vs detail - gaining brand engagement in pharmacy

A recent comment from a client made me think about how pharmacists act as brand enhancers for patients/consumers.

Pharmacists are highly educated healthcare professionals. Patients have long relied on their valuable skills and used their advice to make a purchase. However, it has been traditional for organisations to communicate with them principally in business terms. This retail-led approach creates dissonance between the relationship pharmacy has with a brand’s manufacturers and the one they have with the brand’s users.

The new Contract, however, changes things. Although the uptake of enhanced services seemed slow to begin with, pharmacy’s growing relationship with patients is now much in evidence. (As it is with other HCPs: the growing weight of pharmacy has strengthened links with prescribers.) With almost 2 years since the independent prescriber act, there are far better opportunities to be had than talking “stock pressure and POR”.

Instead, manufacturers who understand and enhance the close relationship between pharmacist and consumer will gain more end-user engagement. A recent study by one of our research partners showed that when pharmacists intervened in the sale - not by recommending, but by providing an informed brand initiation - patient compliance increased and patients were more likely to make a repeat purchase. Proof that what can be good for profits can be great for patients.

As the professional identity of the pharmacist sinks in, their challenges revolve around setting the clinical scene and promoting new services to patients. Pharmaceutical companies must continue to track areas of progress and deliver a rounded offer that benefits in-house experts and their patients.


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