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Physicians in Europe Rate Novartis #1 on Service Delivery, While Merck Earns Top Honors in the US


Even Among Companies Doing Well, Relationships Weaken in Many Countries

NEW YORK, NEW YORK — New TNS Healthcare research shows that physicians in four out of the five major European countries—the UK, Germany, Spain and Italy—give Novartis top marks for effectively delivering key sales and service activities. Merck takes the top spot in the US and ties with Novartis in the UK and Germany. In 2008, Merck and Novartis tied for the top spot in the US, with the highest ratings across all service activities. This year, Merck pulls ahead in the US, with stronger ratings for both its web-based physician services and its patient information programs.

Pfizer, AstraZeneca, Sanofi-Aventis and GlaxoSmithKline also earn high marks for their service model from physicians across the US and Europe. Pfizer and GlaxoSmithKline tie for second place in the US, pulling ahead of Novartis, which places third this year among American doctors. In addition, Pfizer ties for first place in the UK and Germany. GlaxoSmithKline also is among the companies tying for a first place finish in the UK. It ties with Novartis for top honors in Italy. Sanofi-Aventis leads all of its competitors in France, becoming the sole first-place winner. It also ties for the top spot in the UK and Germany.

“We saw several fascinating trends in how physicians rate companies for their service delivery this year,” said Andrew Brana, Senior Global Consultant, Sales Force Optimization for TNS Healthcare. “For example, in the UK, 10 of the 17 companies we measure tie for first place, with top ratings across all service areas. Unfortunately, this does not indicate a high level of performance across the board. Rather, it shows that companies are undifferentiated in the UK market. This conclusion is borne out when we look at our TRI*M™—or rep relationship—scores in the UK, which show that British doctors see less differentiation among companies than physicians in any other market.

“In the US, companies score well on rep attributes—such as knowledge, expertise and professional conduct—and the new service elements, such as web-based services, educational programs and patient support. Although scores are lower for the new services than for traditional rep attributes, they are generally respectable and indicate that US companies have made effort and investment in these important areas. There is, however, still room for continued improvement.

“This need for continued improvement on service activities is even more pressing in Europe, where scores for the new services are particularly low—below average in most European countries. Clearly, there is significant opportunity for companies in Europe to improve and differentiate their offerings through brand support services they can provide to their customers.”

TNS Healthcare results are based on an Internet survey with more than 1,500 general practitioners across the US, UK, France, Germany, Italy and Spain. The survey measured the performance of 17 top companies across ten areas, including rep conduct; rep knowledge and expertise; quality of sales visits; patient management, education and support; physician education and information services; practice and staff support services; Web-based services for physicians; Web-based services for patients; brand experience; and corporate reputation. It also assessed information channel preferences and evaluated the strength of physician/rep relationships for each measured company, using TNS Healthcare’s proprietary TRI*M™ Index.

Relationship Scores Fall even for Top Companies

Even for companies earning high ratings among physicians, rep relationship scores have fallen since 2008. In the US, for example, the average TRI*M score—a measure of relationship strength—fell from 78 to 75. Although 75 is still a good score, the downward trend shows a weakening of the traditional bond between doctors and their reps. Relationship scores also fell in Germany, though they still remain at healthy levels. Scores in France and the UK remain relatively low, continuing to show great challenges in those countries. Spain bucks the trend, as the only country showing a significant jump in its TRI*M relationship score, from 66 to 74.

The downward pattern in relationship scores is even more noticeable at the company level. In the US, for instance, 11 of the 17 companies measured have seen their scores fall over the last year. Although it ties for first place in terms of relationship strength with Pfizer, Merck and GlaxoSmithKline, Novartis shows the sharpest drop, falling from 89 to 81. Pfizer and Merck also are watching their scores fall, in spite of their first-place standing.

“There are many possible reasons for the downturn in US rep relationship scores,” says Brana. “The recent US elections with the accompanying focus on healthcare issues and costs, often targeting the pharma industry, certainly may have played a part in driving scores down. In addition, the negative press around industry payments to doctors and the recent tightening of promotional guidelines also may be playing a role.

“We also suspect that sales force structure and strategy changes could be having an impact. Many companies significantly reduced and reorganized sales forces during 2008, which could have a direct effect on rep interactions, particularly if changes don’t go smoothly. Disruptions in relationships, new faces and weakened morale all may be hurting the quality physicians believe they are getting from their reps.”

The US is not the only country where companies are seeing relationship scores fall. For instance, nine of the 17 companies measured in Germany watched their scores tumble. Though the UK’s TRI*M™ score overall remains fairly low, individual companies are seeing mixed results. GlaxoSmithKline and Novartis, which were in first and second place last year, are experiencing significant declines and have dropped out of the lead. In contrast, Boehringer Ingelheim, Bristol-Myers Squibb, Merck and Pfizer are seeing substantial improvements in their physician relationship building scores. For BI, this improvement put it among the lead UK companies this year.

While Novartis’s relationship score has weakened in some other markets, it has soared in Spain to 94—the highest TRI*M score achieved by any company in any country. Pfizer places a close second in the Spanish market. The significant TRI*M score improvement across companies in Spain set it apart from other countries this year and reflects a strong relationship between the industry and physicians in that country.

Physicians Value New Service Elements

While sales force attributes continue to be most valued by physicians—with sales rep conduct the most valued attribute across all six countries combined—the new service experiences are becoming increasingly important. When looking at the US and five European markets, more than three-quarters of doctors place a high value on physician education and information services. We see the most significant value increase in the US, where the percent of GPs rating physician education as important rose from 66% in 2008 to 71% in 2009. More than 70% of physicians in the UK and France and more than 80% in Germany, Spain and Italy also place high value on physician education.

In addition, physicians place great value on practice and support services, with more than half of the GPs surveyed putting high importance on those types of offerings. Almost half of physicians across the US and Europe also place high value on both physician Internet services and patient management, education and support.

When asked where they are seeing the greatest improvements in service, about 80% of physicians note positive change in Internet programs for doctors, while 60% indicate better Internet programs for patients. In addition, close to 70% see improvement in physician education programs, while almost half say that they are benefiting from enhanced patient management programs.

“Interestingly, across all countries combined, only about a third of doctors report seeing a change in their overall interactions with pharma companies,” says Mark Sales, Global Practice Leader, Stakeholder Management for TNS Healthcare. “This is down from last year when almost half—45%--noted a change. This may be due to the fact that alternative channels, such as Internet services, have not yet filled the gap left by sales force reductions. It also may be a reaction to some of the new promotional guidelines and regulations that have prohibited more traditional ‘services,” such as theater tickets, free lunches for office staff, golf balls and other non-medically relevant gifts.”

It is important to note that doctors are finding value in many channels of communication, in addition to traditional rep visits. Continuing medical education (CME), medical and treatment support, peer-led discussions and events and Internet sites are the four information channels that physicians value most.

About TNS Healthcare…
TNS Healthcare provides market research consulting to the worldwide pharmaceutical, biotech and medical device industries, as well as health-focused ad agencies, media and analysts. It offers globally consistent solutions and custom advisory services to support product introductions; brand, treatment and sales performance optimization; and physician and DTC promotional assessment.

Informing decisions across the life cycle, TNS Healthcare offers action-ready insights for pre-launch landscaping, market and opportunity assessment, segmentation, positioning, message and campaign creation, pricing, forecasting, attitude and awareness measurement and post-launch tracking. It deliversinformation across stakeholders—including physicians, patients and consumers—to help companies anticipate and impact customers’ behaviors. TNS Healthcare provides both qualitative and quantitative offerings, using traditional and on-line methodologies, combining worldwide reach with local expertise.

About TNS…
TNS is a global market information and insight group.

Its strategic goal is to be recognized as the global leader in delivering valueadded information and insights that help its clients make more effective business decisions.

TNS delivers innovative thinking and excellent service across a network of 80 countries. Working in partnership with clients, TNS provides high-quality information, analysis and insight that improve understanding of consumer behavior.

TNS is the world’s leading provider of customized services, combining sector knowledge with expertise in the areas of Product Development & Innovation, Brand & Communications, Stakeholder Management and Retail & Shopper. TNS is a major supplier of consumer panel, media intelligence and audience measurement services.

TNS is the sixth sense of business™.

About the Kantar Group
The Kantar Group is one of the world’s largest research, insight and consultancy networks. By uniting the diverse talents of more than 20 specialist companies— including the recently-acquired TNS—the group aims to become the pre-eminent provider of compelling and actionable insights for the global business community. Its 26,500 employees work across 80 countries and across the whole spectrum of research and consultancy disciplines, enabling the group to offer clients business insights at each and every point of the consumer cycle. The group’s services are employed by over half of the Fortune Top 500 companies. The Kantar Group is a wholly-owned subsidiary of WPP Group plc. For further information, please visit

Contact Information:
For more information on TNS Healthcare’s new research on physician experience preferences and company ratings, please contact Mark Sales, Global Practice Leader, Stakeholder Management at +44 (0) 1372 825974.

For more information about TNS Healthcare, please contact Ilene Siegalovsky, Senior Vice President, Marketing and Communications, at 201-836-0040, ext. 225 or or visit our Web site at


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