Medical GoToMarket – Organization and Processes

Our new website is online!
31 August 2017

Medical GoToMarket – Organization and Processes

The “health” sector, described in the latest OASI report 2016, shows a fragmented Italian Health System in twenty-one Regional Health Services, given their profound diversity.

This is the typical challenge that healthcare products and services companies produce and distribute since the State-Regions agreements have dominated the delegation to the regions in terms of public health management.

To address these diversity, without having to necessarily create twenty-one micro-organizations within the company, you need to have a commercial management model that can take into account the diversity in a common approach to the end customer.

An organization needs to develop timely relationships with all stakeholders who are very “mobile” in terms of roles, functions, and activities involved in decision-making and buying processes.

Experience and common sense lead us to say that every situation is specific and different for every business and, in making choices about the processes and organization to be implemented, each manager is led to select the options most at hand To the necessary and effective ones.

For the first time for many years, good news is reported about the accounts that are finally “squared” in almost all Italian regions.

This often means a more aware and competent stakeholder activity, which is also increasingly geared toward managing healthcare efficiency and efficiency.

However, to counterbalance the balance of the accounts, there is still a strong imbalance between regions in terms of quality of services, with a 1.5% increase in inter-regional mobility, mainly from south to north.

This implies an organization capable of developing a strong verticalization approach, even in a framework of guidelines – from central to health development topics.

A reference model

The above-described model has the purpose – described in the center of the image – to identify for its own reality:

  • One or – very often – more market-based approaches to the market “GoToMarket”:
    • A GTM process consists of several “steps” to go to accomplish the goal at the end of the path
    • depending on the GTM, the number, content, and duration of each step varies greatly, but four macro steps can be identified that can be applied to any type of contribution that is provided to the customer (Investments, Devices, Consumables or Services)
      • Access
      • Education
      • Management
      • Realization
  • The organization of its own “sales system”, which includes every individual who has the opportunity to show himself to the client in every “moment of truth”, is rather complex, as are the channels to communicate the value of his proposal. The model therefore suggests that the channels are first qualified in:
    • Direct
    • Indirect

To indicate whether individuals within these channels are directly or indirectly managed, or more simply, whether framed as employees or non-employees.

  • Another important way to qualify the channel’s contribution is to determine whether the approach is:
    • Specialist
    • Relational

Indicating the orientation of the content of the interaction with the stakeholders, namely, the deeper understanding of scientific and technical elements of the product, rather than relational and contextual aspects.

To get the definition outlined above by choosing the correct setting for your reality, there are two “streams” of analysis that should be activated. Referring to the model image, on the left we have the Internal analysis, while on the right the External analysis of your target market. Let’s look at the two types in detail.


Internal Analysis

A company that operates in the Medical field may have one or all of the areas of products and services listed below:

  • Investments – Machinery and tools that represent the most significant “capital expenditure” part and duration for the customer. For example, laboratory diagnostic tools such as MRIs or TACs or the like
  • Devices – Work tools that involve relatively fewer investments than the previous ones and which can be depreciated in relatively shorter times, even for the most intense use intensity. These are, for example, Points Of Care, Resuscitation Tools, etc. etc.
  • Consumables – “disposable” products, typically high rotation
  • Services – Every type of service sometimes integrated with the products above, sometimes in their own right

The analysis of your Value Proposal should be carried out for each value area / single product or service, through a few key elements:

  • Technology – which added value by technology allows you to consider your product / service innovative
  • Applications – Which therapeutic areas and specializations best apply their own products / solutions
  • Health Benefits – What value they represent their products / solutions for patients and how it can be demonstrated
  • Impact on Customer – What is the value for the different operators who interpret the key value elements to attribute to the product / service: Users (how does the process on which the product apply), Technicians (how does it integrate with Existing products, systems and structures?), Administrative (price and purchase methods are compatible with the rules and budget foreseen?) And Cheap (what are the benefits for short and medium term structure in terms of quality Of the service provided and the impact on the typical indicators that determine the Return of the Investment?)

What you get from this analysis is a clear definition of Key Differentiators that will have to be exposed and emerge in each interaction with your customers, and indirectly determine the skills needed to make it work effectively.

External Analysis

The ultimate purpose of this analysis is to obtain a clear indication of the level and the way to carry out the “hedging” required to market both active and potential customers.

The key variables identified are:


  • Decision-making processes – mechanisms applicable to different “stakeholders”, typically homogeneous by specialist area, but very different at individual level due to the inevitable difference in seniority and role-playing ambitions they intend to undertake. Assessing these processes is always very complex, but that is what is generally termed as “customer journey”, the journey undertaken by every single individual in his approach to a choice of change, that is, what is ultimately a purchase
  • Purchasing Dynamics – These are all the processes and purchasing procedures that customers perform in a very different way depending on the type of decision making reality: ASL, Hospitals, Private or Conventional Clinics, Association, Institute ofResearch, etc. etc. The aforementioned realities have become accustomed in the years to rather “animated” dynamics in composing and redesigning the buying system and attention to these ongoing movements is an essential part of the “Access” phase, to properly orientate their educational effort into Communication of key differentiators
  • Territorial Dynamics – At a logical level higher than the previous one, there are territorial dynamics that sometimes presuppose the individual decision-making processes and purchasing dynamics of stakeholders and individual realities operating on a territory typically managed with political logic derived from Regional and governmental administrations that meet the needs of the population represented

The above-described complexity needs to be passed through some evaluation elements acting as “filters”, useful to give order and priorities in the definition of the ideal coverage level given the variables analyzed and the real possibility to put it into practice .


  • Market Situation – What is Offered Target Customers Defined to Fit Value? What needs are still to be met and what trend exists with respect to the demand? What niche, if any, can be identified within the complexity of target customers
  • Clinical-Therapeutic Management – This area is part of the analysis that identifies management practices typically adopted by stakeholder and territorial reality, as well as, of course, central government guidance. This is the typical area of ​​”Disease Management”
  • Access and competition – This analysis impels the pursuit of the level of engagement with stakeholders and territorial realities needed to activate the Education phase and this analysis can not ignore the already existing competition and the presence of the spaces of conversation that is possible Activate with the customer
  • Key Customers – Realizing a business development plan is planned and implemented, typically, by its most important clients with whom it has been best to set up a relationship that has enabled Project Realization and profitable value exchange for both parts. Customers similar to these are the key target customers whose first use is to define the degree and scope of coverage needed to succeed.

Always lower margins require more attention to sales costs

For Italian medical companies, it is increasingly evident that the margins of products and services, which are already falling, are inexorably destined to fall again, unless they are strong product / service innovations, which are able to synthesize the need for better quality and greater Efficiency of public and private health.

Sales costs do not, however, fall, in proportion to marginality. Especially in Italy, the Management is basically managing a form of “re-seller” relationship that purchases from the mother-house products with expensive costs, and little can do to make production efficient to lessen the prices and discounts practiced.

The original structure of many Italian medical companies is also a culture of “distribution and resale”. It is not uncommon for cases in which the parent company has acquired the pre-existing distribution reality in the current “country”.

This implies having a “legacy” structure that is strongly geared to managing stakeholder relationships by a sales force typically contracted as an agency. Alternatively – and often also at the same time – Italian companies have commercial staff as employees, typically in the role of “Area Manager” and “Sales Specialist”. In the experience of living experienced in the Sales Transformation projects, more often than not, despite the good intentions of distinguishing roles based on the contribution, little is done in defining within the business process, “who does what “And” how. “

At a time of strong contractions of marginality, it is crucial to devote attention to the management of the contributions by the actors of the trade process.

The above internal and external analysis can help in defining the alignment of the Business Process that is needed to overcome business challenges, and the Sales Organization best suited to carry it forward.

So, what is the balance between Direct or Indirect Sales and a Scientific Contribution, densely of scientific content, and Relational, which is largely based on what has been achieved, or is likely to, come into contact with stakeholders Market and key customers.