Four Ways Proactive Physician Profiling Is Better For CMS Submissions—Part I

Mohammad Ovais
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Mohammad Ovais
January 29, 2018
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Physician profiling—if everyone in the pharmaceutical compliance space isn’t already doing it, they will be doing it. It’s the next natural step when it comes to spend reporting and risk management.

We’re curious to know why some teams insist on a reactive approach—i.e. starting physician profiling after something goes wrong—such as a troublesome headline or an outlier that demands a detailed explanation from regulators. Done manually, it’s true that the profiling exercise can be confusing and very resource-heavy. Despite its operational appearance, the benefits of physician profiling spill out in positive externalities as well.

For Your Sales Team: Should big (read expensive) sales teams pursue small, or diminishing accounts? We didn’t think so either. But that has happened, and continues to happen in companies where there isn’t enough visibility over the returns gained per account.

This is not to say that your “spend versus prescription” relationship should have a perfect +1 correlation. It simply means that sales teams should not invest their efforts where, thanks to insights gleaned from historical data patterns—they can be assured of poor or little returns.

Conversely, some members of the sales team might be under- or over- rewarded, depending on the nature of the HCP involved. For instance, does it take as much sales effort to sign on an ENT drug as it does a post-surgery-recovery opioid? Is it fair then, to fix the same commission per sale to team members?

For Your Budget: After viewing a submission analytics dashboard, one of our clients remarked on how much his company was overspending on a physician relative to other pharmaceutical companies. Did the spend result in additional brand assisting activities, knowledge events or prescriptions (over and above the competitors’)? No. Did it guarantee any form of relationship loyalty or industry heads up for the drug brand? No. Was the physician a KOL? No.

Aided by pre-submission analytics on HCPs, the audit/finance team can pinpoint where a good spend area has run its course, and when it’s time to diversify the investment: Physician profiling—done cyclically, is also a form of due diligence in reverse—the first round would tell you which HCP to spend on. Round two tells you which physician deserves:
a) Less spend
b) More spend
c) Spend retrenchment
(And why).

It’s also a way of discovering potential red flags in the physician community without drawing unnecessary attention.

Mohammad Ovais

About the Author

Mohammad Ovais is the Founder & CEO at qordata and has spent a decade building analytical solutions and applications for Fortune 1000 companies. Prior to this, he served as the Managing Partner/Co-Founder at Streebo.


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