GSK Takes an Important—and Successful—Risk


Changing your sales and marketing approach can pay off

By Deborah Waterhouse, SVP and Business Unit Head Primary Care, US, GSK

Change, although a constant, is still a difficult and anxious process for a company to go through, all the moreso if you’re a major pharmaceutical enterprise. It takes effort, detail orientation, wisdom and more than a little luck to turn around a ship the size of GSK.

Yet we did that, and the results bore out our strategy. GSK decided to change how we approach trust within the industry. The removal of sales force incentives based on sales in an individual’s territory and HCP payments, along with data transparency, are all part of a new operational model focused on putting the patient of the heart of everything we do.

In general, this is a concept nearly everyone can sign onto. But what does that look like on a daily basis, and how do you ensure that your culture backs up your promise?

I am in charge of the respiratory and diabetes business units for GSK US. I also run strategy planning and operations for the whole GSK US pharma operation. On my way to this position, I made sure to gain experience in all the major areas of the business, so I knew what the hurdles and goals looked like. I worked in HR, R&D, sales and marketing. It gave me an ideal background for bringing together all these elements for my current position.

To put the act behind the words about patient dedication, we had to be willing to take some radical steps to demonstrate that this is absolutely what we meant and is reflected in what we did. Part of this is a determination to listen and correct. Alter how we operate commercially and clinically. Be transparent about what clinical studies tell us. The question hanging in the air, of course, is can you do good and do well at the same time? Serve aspirational goals and the bottom line?

We wanted to be sure we were building a strong, trust-based relationship with patients and physicians, and we didn’t want the physician/patient relationship to be inappropriately influenced by anything we do.

Creating real change in any organization requires two key elements: thoughtful and thorough planning, and buy-in from your people. When we set about reimagining our incentive program, we were creative and detailed in our approach. We created a complex program with several items: scientific knowledge, selling skills, various empirical assessments. But, despite the best of intentions, we missed the mark. The program was too complex. How did we know this? Our sales professionals let us know! They did not understand what they needed to do to be successful, and they told us so. Some felt it took away their competitive edge. So we sought feedback to course correct.

In this case, our planning was careful and disciplined, but the real key to our eventual success was listening to our employees. In other words, creating and protecting that open feedback loop is part of the disciplined process that brings about results. Instead of digging our heels in and enforcing a policy that was not well understood, we developed a simpler system that is directly connected to the quality and effectiveness of conversations.

How could we make it as simple and engaging and patient-centric as it needed to be, and still motivate the sales force? The basic job of a sales professional is to educate physicians on your medicines. So we decided to pay a bonus to differentiate those who are the top performers in that area. In other words, they were paid on scientific knowledge and the quality of calls that they deliver. The calls are judged on whether a physician is able to to understand the benefits and risks of the GSK medicine for the right patient. Managers ride along with the sales people and observe and coach and give feedback. The basic measure is the quality of dialogue.

The results speak for themselves, and I believe that our ability to demonstrate openness and commitment to our sales force encouraged them to stick with us and trust the new program. In a 2015 employee survey, 75% of respondents agreed that our US pharma organization is making the changes necessary to compete and 81% said they were proud to work for GSK. We attribute this success to have an active feedback loop where employees know that they will be heard.

The other initiative was to stop paying HCPs to speak for us. As a patient, you want to know that your doctor has all the information needed to decide what the right medicine is for you. But you might not be so comfortable if you knew that the HCP had spoken for financial reimbursement in support of that medication.Pc0110100

Deborah Waterhouse talks about change at eyeforpharma Philadelphia 2016

The solution was to have physicians employed within GSK talk to healthcare professionals. We have global and local medical experts, professionals involved in academic research. There’s a multi-layered medical organization inside GSK. The volume of interactions at face-to-face meetings has remained the same, but the nature of the speakers has changed. They’re now all GSK employees.

Again, we have to look at the results to judge success. Our market research shows that the quality and impact of these interactions are similar to the external speakers we used to use.

We are also invested heavily in multi-channel interaction. We don’t always want to push information out, but create a tailored menu of opportunities that allow our customers to interact with us when they want to: webinars, video and educational materials, click-to-chat with medical staff.

For all of the interactions we have internally, we ask one vital question: if the patient were in the room with us now, what would they think?

Now to the metrics. In our 1Q 2016 report, we saw an 8% increase in revenue and earnings per share. There was also a large increase in the trajectory of launch brands. A larger proportion of revenue is now coming from new products than at any other pharma company. That trend continued in Q2 2016. It won’t be a surprise to you that this has been very positively received by both analysts and shareholders.

At the heart of the commercial model change, we wanted to make sure that GSK was building a strong, trust-based relationship between the company, patients and physicians. We looked at our way of operating through this lens and realized that—despite the risks involved in pursuing unprecedented changes—the long-term risks to our business were even greater if we did not take urgent steps to protect this relationship.

Reshaping a company is excruciatingly hard work, and there are many challenges and learnings along the way. The need for simple processes and a means for internal feedback are best practices we applied when implementing how we incentivize our sales people and interact with healthcare professionals. I’m pleased to report that this was well executed and well accepted.

When you make a major change, you will naturally face resistance and skepticism from people who were used to “the way it was.” But if you follow the process with deliberation and a strong feedback process, your odds of success are enormous.

Deborah Waterhouse SVP and Business Unit Head Primary Care, US, GSK

Deborah is a business leader who has managed P&Ls across multiple geographies (both developed and developing) with extensive Government Relations experience. Her positions at GSK have included SVP and Business Unit Head US Vaccines, SVP and Regional Head Central and Eastern Europe, and VP and Country Manager Australia and New Zealand. She has been a strong leader, working across many cultures, with a track record of developing clear strategies, strong alignment and excellent execution driving shareholder and customer value. Her extensive M&A experience includes a key role in acquiring and integrating Novartis Vaccines. Deborah is passionate about working in healthcare and motivated every day by the opportunity to serve customers and make a difference to patients.


GSK is a science-led global healthcare company that does research and develops a broad range of innovative products in three primary areas of Pharmaceuticals, Vaccines and Consumer Healthcare. It has a significant global presence, with commercial operations in more than 150 countries, a network of 89 manufacturing sites, and large R&D centers in the UK, USA, Belgium and China.


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