Healthcare Market considerations for Eliminating Pharmaceutical Sales Representatives
There has been considerable debate about the role of pharmaceutical sales representatives in the evolving new healthcare market. Do they have any role, what is it, and are they worth keeping around at all? It is clear that the market has had enough of the sample dropping reps specializing in the social, relationship building, access gaining tactics like “lunch and learns” and “dine and dashes” that contribute little to physician education. I believe that despite some of these questionable tactics of the past, pharmaceutical sales representatives have played a far bigger role in physician education about drug treatment options than most physicians, other healthcare professionals, and certainly academics would want to admit. I’ve always wanted to do a package insert test of doctors who regularly see pharmaceutical sales reps verses those who do not.
This is more than a debate about what information is now available on the internet and the potential for distance learning. It is about timely awareness and comprehension of treatment options and best practices. It is about knowing how to use a drug correctly, in the right patients and knowing about potential side effects and adverse reactions that might occur.
It is nearly impossible to stay current merely by having access to the internet, despite what some websites might want you to believe. Besides, how many hours per day can physicians commit to staying current (remember it is not just drugs they have to be current about)? CME requirements to maintain a medical license vary by state but range from about 20 hours to 50 hours per year. Not a lot of hours considering the pace of science, technology, and advances in medicine today. Also, keep in mind that many physicians earn a good share of their CME credits by attending conventions and conferences (subsidized and often sponsored by the pharmaceutical industry). So what’s my point?
Take the rep out of the picture. How do physicians find out about new treatments? The newspaper and television most likely. Who educates physicians about new drug treatments? The local medical school? Most towns and cities don’t have one. At the local hospital monthly grand rounds? Which disease or product treatments are covered this month, by whom? In a year’s worth of grand rounds do they cover everything a physician needs to know about drug therapies? The physician waits to hear from an expert at the next conference? What if the topic isn’t covered? The textbook on their shelf? When was that written and more importantly, when did it finally get published? How many medical journals are physicians skimming through to stay current? When were those articles actually written? Who is writing the articles? People who have done work with the drug (hopefully they weren’t paid by the pharmaceutical company to do the clinical trial because they would be biased) or another “expert” who has merely read some articles and summarized a bunch of studies about the new drug?
While I agree that some of the sales tactics of the past contributed little to educating physicians, the collective drug education impact of the industry should not be completely dismissed. There is a need and role that could and should be filled. If the healthcare market feels there is no role for pharmaceutical sales representatives in physician education, then the healthcare market and academics in particular, must be ready to accept the responsibility for providing better alternatives for physician education (there are more than 600,000 physicians in the US) than putting stuff on the web or just going to meetings and conferences to passively learn about new drug treatments. It will be especially challenging to reach the more rurally based physicians and those who can barely keep up with the minimums of CME credits because of their workloads or financial constraints of their practices.
Few societies, medical organizations, CME providers, or even medical schools have stepped up to do mass market education (especially about a particular drug). Even those that are doing CME are not doing it on a mass market basis (ensuring that they get to most physicians) and few are doing CME without funding from the pharmaceutical industry.
So my point is, if there is a role for pharmaceutical sales representatives in the evolving new healthcare market it is to be a credible source of scientific and medical information that can help physicians stay current with best practice treatment options. These are not traditional sales roles (you don’t get paid a bonus or commission) but more therapeutic area experts who know the literature, know all the drug treatment options for a disease, and can speak knowledgeably and objectively about competitive products as well as their own company’s products.