<h5>Introduction</h5>The global pharmaceutical industry is renowned for its high profit margins. This financial success enables companies to invest heavily in promoting their products to prescribers, such as doctors and other healthcare professionals to generate sales.In developing markets, this promotional effort is driven by a vast network of Medical Representatives (MRs) and their managers who engage directly with healthcare providers to drive prescriptions and product adoption.For instance, according to estimates, the Indian pharmaceutical sector employs over 600,000 medical representatives [1] across the country, with some of the top companies maintaining field forces exceeding 10,000 representatives [2] each.<figure class="image"><img style="aspect-ratio:1400/942;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-14_1751992214.png" width="1400" height="942"></figure>This extensive manpower deployment, which is as much as the deployment of the country’s FMCG sector, demonstrates the industry's belief that more representatives translate to greater doctor coverage, improved brand visibility, and higher sales. Consequently, in pursuit of growth, pharma companies continuously add to their field force.<figure class="image"><img style="aspect-ratio:1405/771;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-15_1751992250.png" width="1405" height="771"></figure> Though adding more representatives generates some results, this strategy faces diminishing returns. While a direct comparison between top FMCG and pharmaceutical companies may not be entirely appropriate, it does offer useful insights. Notably, the revenue-to-remuneration ratio is significantly lower for pharmaceutical companies, as expanding manpower is a far more costly proposition in this sector. Further, most field forces operate at only 60%-70% of their true potential. Ineﬃciencies rooted in inadequate planning and delayed engagement with high-priority doctors limit their impact. For example, compliance with visit frequency hovers between 30%-40%, and doctor coverage remains below optimal levels.<figure class="image"><img style="aspect-ratio:1300/675;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-16_1751992288.png" width="1300" height="675"></figure>In order to improve field force eﬃciency, pharmaceutical companies frequently invest in digital transformation initiatives —such as automated reporting, performance monitoring, and Customer Relationship Management (CRM) systems. However, these interventions often fall short of their intended goals—namely, ensuring timely, highly productive, and targeted doctor engagements across different geographies. With the cost of lost sales as high as 60%,[3] firms see no option but to continue to invest in the field force.<figure class="image"><img style="aspect-ratio:1395/801;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-13_1751992396.png" width="1395" height="801"></figure><h5>Challenges in pharma field force efficiency</h5>Disruptions in Monthly TourOne of the most significant issues in trying to improve field force eﬃciency lies in the execution of Monthly Tour Plans (MTPs), the blueprint for field visits by Medical Representatives (MRs) and their managers. Despite being meticulously planned, MTPs often fail to achieve their intended goals due to a range of operational disruptions: 1 | Unplanned deviationsLeave and availability issues: Medical representatives often face unexpected challenges such as unplanned leaves, doctors being unavailable on scheduled days, or conflicting administrative tasks. These disruptions lead to cascading adjustments that compromise the effectiveness of the entire monthly schedule. Missed visits and clustering: A missed visit early in the month often results in subsequent visits being clustered too closely to meet monthly metrics and increasing the likelihood of further non-compliance with the plan. 2 | Travel ineﬃcienciesPoorly optimised travel routes lead to excessive commuting time, reducing the number of productive visits an MR can complete in a day. This results in missed opportunities to engage with high-priority doctors. 3 | Disjointed planningMTPs for subsequent months often fail to consider actual visits from the previous month. This lack of continuity leads to uneven visit intervals, with some A-class and B-class doctors experiencing extended gaps, affecting product recall and relationship-building efforts. 4 | Cherry-picking and ineﬃcient coverageMRs often focus on convenient or receptive doctors while neglecting others on the list. This results in an imbalance where visit count and doctor count metrics appear high, but overall coverage remains suboptimal—often below 70%. 5 | Administrative and logistical overheadsTasks such as report submissions, compliance tracking, or travel coordination consume valuable time, reducing the number of productive visits. <h5>Challenges for Line Managers (LMs)</h5>While Medical Representatives (MRs) grapple with the execution of Monthly Tour Plans (MTPs), First Line Managers (FLMs) and Second Line Managers (SLMs) encounter their own distinct challenges. The following issues accrue from their need to balance timely oversight with on-ground realities: 1 | Unequal time distributionFLMs may concentrate their efforts on certain MRs or operational areas, neglecting others. 2 | Coverage deficienciesEnsuring consistent and timely visits to A-class and B-class doctors often becomes diﬃcult, leaving gaps in doctor engagement. 3 | Conflicting plans tourWhen LMs co-visit doctors alongside MRs, either the LMs’ or the MRs’ schedule is prioritised, often at the cost of other planned visits. This disrupts overall coverage and adherence to visit frequency norms. 4 | Capacity wastageLMs often end up spending their bandwidth on less critical tasks, such as co-visiting C-class doctors, detracting from their ability to focus on high-priority engagements. 5 | Disconnected strategic alignmentSLMs, tasked with strategic planning and guiding FLMs, often struggle with aligning broader objectives with daily field realities. This disconnect results in misaligned efforts across the hierarchy. 6 | Underutilised high-priority engagementsKey opportunities, such as maintaining regular interactions with high-potential doctors or addressing cross-divisional coordination, are often overlooked, weakening the company’s market presence and trust among stakeholders. <h5>Structural and systemic issues</h5>Beyond individual challenges of the field force, systemic problems exacerbate the ineﬃciencies in demand generation strategies: 1 | Inconsistent coordination between teamsSynchronising plans among MRs, FLMs, and SLMs is often complex. Whether using a top-down or bottom-up approach, frequent misalignments lead to overlapping visits or neglected doctors. 2 | Static and overloaded MTPsCompanies often overload MTPs to utilise MR capacity fully on paper. However, any deviation or missed visit leads to cascading effects, creating an unmanageable backlog. Conversely, under loading plans allow flexibility but result in incomplete utilisation of MR bandwidth. 3 | Disconnected divisional strategiesHigh-priority doctors often engage with multiple divisions of the same company. The lack of integration across divisions results in over-visitation by some teams while leaving others neglected. Addressing these challenges is essential to improving the effectiveness of demand generation. When left unresolved, ineﬃciencies ripple through the system—doctors may feel disengaged or overwhelmed, MRs face the burden of unworkable plans, and market penetration stagnates. These issues not only hinder immediate business outcomes but also jeopardise long-term trust and relationships with healthcare providers. <h5>The crux of the problem</h5>The field force's primary objective is to maintain timely and impactful interactions with doctors and pharmacists, fostering strong relationships and sustained brand recall among prescribers. A critical performance metric is the interval between visits, which must remain within optimal limits for each doctor category to maximise engagement. While a fixed plan is the preferred approach to optimise time, cost, and visit intervals, MRs are often forced to deviate from it to accommodate uncertainties and additional responsibilities, disrupting eﬃciency and consistency. This challenge is further compounded when MRs must coordinate their schedules with managers, adding complexity, variability, and ineﬃciencies to the process. <h5>A better way forward: Flexible Journey Plans (FJP)</h5>Flexible Journey Plans (FJP) present a dynamic alternative, shifting the focus from adhering to rigid schedules to prioritising timely visits and effective engagement. Automated and accessible to all stakeholders, FJP streamlines planning by adapting to real-time conditions, ensuring doctor visits occur as needed while sustaining relationships and enhancing brand recall. Key principles of FJP1 | Timely visitsVisits are determined based on the elapsed time from the last visit, ensuring optimal recall intervals.Ideal visit intervals are predefined by doctor class:A-class doctors: Every 10 days (tolerance: 8-12 days).B-class doctors: Every 15 days (tolerance: 13-17 days).C-class doctors: Every 30 days (tolerance: 28-32 days).Outstation doctors: Every 45-60 days, based on company travel policies. 2 | Priority-based schedulingDoctors are assigned priority colours based on the elapsed time since their last visit.For example the below buffer is for A class doctors<figure class="image"><img style="aspect-ratio:1325/104;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-18_1751992883.png" width="1325" height="104"></figure>White: Visit not requiredGreen: Early window (visit not urgent)Yellow: Medium priorityRed: High priority (must visit soon)Black: Critical priority (immediate visit required) 3 | Dynamic planningMRs focus on geographical areas, with a planning horizon of 2-3 days.A geographic area summary shows the count of doctors by priority:<figure class="image"><img style="aspect-ratio:1389/576;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-17_1751992921.png" width="1389" height="576"></figure>MRs prioritise patches with the highest counts of black and red doctors, ensuring eﬃcient resource allocation. 4 | Streamlined doctor lists<ul style="list-style-type:square;"><li>The list is arranged in descending order starting from Black -> Red -> Yellow -> Green. Doctors who are not due for visits are not shown.</li><li>Within each colour, an A-class doctor is shown first followed by a B-class and then a C-class.</li></ul> 5 | Visibility of 2-3 days planThis means MR has a ready reckoner to plan for the next 2-3 days. Based on his visits today and elapsed time from previous visits, the next day’s patch-wise summary is automatically updated. <h5>Synchronising FLM and SLM plans</h5>The FJP methodology can be extended to FLMs and SLMs to ensure alignment with MR plans. For this visit intervals for FLMs and SLMs to doctors are calculated similarly to those for MRs, though, as noted earlier, the visit intervals of line managers will be longer. Let’s take the example of an FLM. Suppose their visit frequency is as follows:For A-class doctors: Every 60 days.For B-class doctors: Every 90 days.Their priority-based scheduling will look like this:<figure class="image"><img style="aspect-ratio:1325/104;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-19_1751993011.png" width="1325" height="104"></figure>Nevertheless, these visits must be along with the MRs. But, since the FLMs planning interval is 30 days to move from Green to Black (see image above), this means that there will be three opportunities for the FLMs to sync up with MR plans for the same A-class doctor. This will ensure that they will have common doctors due for visits. However, the FLM still must decide on which MR, doctors and which geographic area/patch to visit and when. The FJP guides this as well. It provides a comprehensive plan to FLMs to select MR, patch and doctor by offering a report that looks like this chart below and shows FLMs which doctors have moved into the “visit as soon as possible” zone (Red/Black) and their respective MRs who are also in the same zone.<figure class="image"><img style="aspect-ratio:1492/617;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-20_1751993052.png" width="1492" height="617"></figure>In the above example, FLM can select MR C, since that MR has the highest number of high-priority doctors for him. Once he does that, he will get a geographic patch-wise bifurcation of Black and Red doctors generated by the system. Since these Black and Red doctors for FLM are also due for MR visits, there is no compromise on the plans of either of them. The exact same philosophy is then extended to second-line managers or any level of managers above them by selecting a set of doctors and deciding on visit intervals. <h5>Results achieved with FJP</h5>The implementation of FJP in developing markets has demonstrated significant improvements in coverage, compliance, and sales performance: By increasing the number of doctors covered and ensuring recall, we were able to achieve >10% delta growth above the market while maintaining the highest market share in the covered market in the territory.<figure class="image"><img style="aspect-ratio:1575/675;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-21_1751993121.png" width="1575" height="675"></figure><figure class="image"><img style="aspect-ratio:1575/663;" src="https://web-assets.vectorconsulting.in/storage/editor_uploads//driving-pharma-sales-22_1751993128.png" width="1575" height="663"></figure><h5>Final thoughts</h5>By transitioning from MTP to FJP, pharmaceutical companies can achieve transformative results in doctor coverage and sales growth. These strategies not only enhance market penetration but also improve brand recall and strengthen relationships with healthcare providers. This approach sets the stage for sustained growth and a competitive edge in developing markets. Further optimisation can be achieved by extending these principles to pharmacy visits, promotional activities, and other facets of demand generation, which will be explored in future articles.

Key Takeaways

Explore how pharmaceutical companies in developing countries can drive higher sales and efficiency by replacing rigid monthly tour plans with dynamic, real-time Flexible Journey Plans tailored to doctor priority and geography.

Driving pharma sales in developing countries

<h5>Driving pharma sales in developing countries</h5>

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