Extremely insightful and accurate post!! Unfortunately, some of the assumptions and suggestions you make moving forward are either flawed or will never happen. I was in a similar role as RAD as well and I think I know who you are OP and, if you are who I think you are, I know your motivation behind the above post is positive.
Your entire history of the hospital/Integrated Health system teams here at ALKS is extremely accurate. The big problem here now is GA will not take your advice or anyone elses advice. He's doubling down on the KAM role probably because the KAM's were his idea. Get this, there is a big push to have the KAM's contract with IDN's. How absurd!! Viv and ARI are definitely not IDN contract drugs except for the few places where the system takes on full capitation and I'd say that makes up at most 10 to 15 % of the total USA market. The problem is that KAM's do nothing for sales. They spend over 50% to 80% of their time in criminal justice because there is nothing they can do to increase sales in the short term in IDN's. BUT, GA has to find a way to make KAM's show some type of worth to the company even though there is little to none in what they do. They are all pretty good people just not needed with the products we have. Although, that's not stopping GA from figuring out a way to jam in some type of utility spin that they produce sales in any way. It's sad to watch it happening. My fear is that they will start contracting with IDN's and we will realize it is a recipe for double dipping of rebates and another huge waste of time an resources. If the IDN is not fully capitated then they will have to follow the patients health plan formulary anyway. This is true in over 90% of the country. The only place where they don't have to follow the health plan formulary would be in the hospitals and you eloquently made the point of how pointless it is to try to change or work through that. We've tried for years and anyone who has been on those teams knows it is not going to happen.
So, here we are with another sales force that are KAM's again who are asked to do something the market will not allow so they hide in criminal justice and make their TBM's jump through activity hoops so they can claim they are helping the field produce sales all so the KAM's can get paid "activity" bonus and GA is trying to find a way to make it look like they are doing something that truly impacts sales. Thing is they don't! One might say that all the "activity" fire drills they put TBM's through take away from sales. It is a sad game to watch. Do you know how the KAM's are bonused??? Would it surprise you if they had no aspect of their variable compensation tied to sales? How ridiculous is that? That tells you all you need to know.
I agree that GA has to admit that not only the FRM's and Hospital team was a foolish move, but that also the KAM team was. Stop trying to show that they bring value because they don't. It's not the KAM's fault, it's the companies for creating them (AGAIN!!). We'll probably keep changing what they do and spend more time and resources on them only to cut them in a couple years. Foolish is as foolish does.
Maybe we need to purge the entire Astellas stain from this organization before we can begin to think straight again and move forward. I think that would be a good start! Jim R really moved this company in the wrong direction and we are trying to move away from what he did. I think there are some of his team that still remain that are making it harder for us to make that directional change. If they are shown the door, we could pivot a lot quicker and start moving in the right direction faster.
Just the thoughts of someone who has been here for a long time and loves this company and the important products we have that help patients.