Pharmaceutical companies face new challenges as the balance of power changes within the UK's National Health Service. To cut costs, GPs are increasingly being guided on what to prescribe by new Primary Care Organisations (PCO), which typically recommend just three treatments for any illness. Pell says: "Unless your product is on the PCO shortlist, it will not be prescribed in any volume. Pharmaceutical companies which continue to sell into GPs make fewer sales, and can spark anger and resentment from the powerful new specifiers in the PCOs."

Pell argued that the answer was to find out what the PCOs wanted from pharmaceutical companies and so he interviewed 60 staff at PCOs.

VIA found huge differences in how well the pharmaceutical companies were working with the PCOs. Some large companies had hardly got round to acknowledging their existence. Others were using hard sales tactics, which simply switched them off. "In many cases, pharmaceutical companies were treating PCO advisers much as they would normal GPs - they did not seem to appreciate their need for more in-depth information."

What emerged, above all else, was that PCOs wanted to develop longer-term relationships with account managers. "They want to work with them, rather than having sales messages shouted at them," said Pell. Indeed, 44pc of respondents wanted a strong, long-term relationship (see diagram), whilst just 12pc felt that this was what was on offer from the pharmaceutical companies today."

Pell argued that this sort of research can also throw up very clearly what customers and partners want: "We thought that all the PCOs would be clamouring for more money and investment. But this wasn't the case at all. In fact, this rated right at the bottom, way below other priorities such as 'increased honesty and transparency' and 'more relevant information' (see diagram).