Can Pharmaceutical Sales Representatives Still Add Value?

If we are trying to figure out how sales representatives can add value, we must start with those who will determine whether or not there is value being added… the customer.  This may be obvious to some, especially sales representatives, but over the past several decades pharmaceutical industry management has characterized the “value added” in the context of what sales representatives can do for the company or the product and not what sales representatives can do for the customer.  So let’s start with the customer (which is not just physicians in the evolving new healthcare market) and what their needs are and how we can add value by meeting or exceeding those expectations.

I don’t want to get off on a tangent but the needs and expectations I’m talking about here are not for things like lunches being delivered or a return of the tchotchkes.  Unfortunately, the industry trained physician offices into developing these expectations in lieu of meaningful clinical discussions about products.

So let’s review some of the evolving market expectations for pharmaceuticals that the industry must be ready to meet, especially in light of healthcare reform:

  • Safe and effective products that can be differentiated (clinically proven and with label claims where possible) from currently available treatment options (including preventive medicines)
  • A clear understanding with supportive data for the basic science behind the product, its mechanism of action, and rationale for efficacy and potential side effects and adverse reactions.
  • Clinical data to support “comparative efficacy” and other claims of differentiation or even superiority (justify the premium pricing)
  • Personalized medicine supported by biomarkers and companion diagnostics that can predict response, determine extent of response, and anticipate side effects and adverse reactions with specificity and accuracy
  • Real world pharmacoeconomics data to support the economic value of the product and pricing that reflects the value being delivered. Again, justify the premium pricing.
  • Hospitals will want data and methodologies to demonstrate the impact of products on newly established quality metrics and outcomes data that will be used to force rank their institution performance against national standards.

One of the first implications of meeting these more demanding market expectations is that pharmaceutical companies must readjust their thinking to be more selective in their pipeline evaluations and  a lot more comprehensive in their approach to research and development.  In the past, you could just find a compound, identify the potential indications for use, do the clinical studies, get approval, and go to market.  This traditional “get it to market” approach to R & D will deliver products and data that fall short of market expectations and hamper commercial viability of products in the evolving new healthcare market.

It also becomes apparent that regardless of the representative’s scientific or technical expertise, even the best of sales representatives will struggle to address these market expectations if the research foundation and data are lacking.  I believe this is one of the reasons sales representatives are struggling today.  Pharmaceutical research has not kept pace with the demands of the market and sales representatives are being asked to compensate for limited regulatory product labeling, a lack of product differentiation, and minimal real world clinical data that can be used in product discussions.

But let’s assume your company is committed to a much more comprehensive research approach to deliver truly innovative new products with robust data packages.  This has significant implications for how pharmaceutical sales representatives can add value for customers.   You might be surprised by some of the implications we’ll discuss in our next post.  mike@pharmareform.com

  • Specialty Rep

    Mike some very good points here. As a long time Hospital/ Specialty rep I do have one concern with the pushing of CER (Comparitive Efficacy Research), as much of it is reductive in nature. Healthcare reform will be misusing CER to get to the CHEAPEST form of therapy and using studies which have very different efficacy definitions and adverse event definitions.

    I do think you have it correct in moving towards personalized medicine- instead of asking “Is the Red pill better than the Blue pill?” as CER does; let us move towards “For Whom is the Red pill better than the Blue pill?”

  • http://www.pharmareform.com Mike Wokasch

    Specialty Rep,
    Thanks for your comments. I am not pushing CER. In fact, I have commented on other blog sites and in my book, Pharmaplasia (TM), about the challenges and pitfalls of comparative effectiveness studies. The reality is that if Pharma doesn’t take a lead on doing them for their products, they will run the risk of dealing with the results from poorly designed, quick and dirty comparative effectiveness studies. I like your personalized red pill blue pill comment. Thank you. mike@pharmareform.com

  • Chris

    This article left out one big thing. Reps are going to need to have at least a cursory knowledge of benefit design, how the healthcare dollar flows, and how the doctor is being compensated on quality measures. If the reps don’t understand this, then the DM or director had better, so they know how to coach to it.

  • http://www.pharmareform.com Mike Wokasch

    Chris,
    Good point and you are absolutely right. Bullet point number 6 says “hospitals” but I should have included “physicians” which in the evolving new healthcare market are more likely to be closely aligned with hospitals rather than remaining in private practice settings. Good catch. Thank you. mike@pharmareform.com

  • http://www.linkedin.com/in/casskordecki cass

    I was one of those overpaid pharma reps let go after 10 years of consistantly exceeding quotas and winning awards. I have a masters degree in physiology, and always held to high ethical fair-balanced standards in my promotional practices, trying to deliver value on every call. I was one of the very few who was able to stay in the same territory for 10 years, but many of my colleagues were re-aligned, moved, etc…..having respectful trusting relationships with our providers and their staff was very helpful in our sales efforts. I was empathetic when the doctor shared his challenges with the prior-auths due to formulary changes, or his perspectives on quality measures. I knew when my offices were the busiest, and when not to push it, and if there was something I needed to discuss, I was able to gain the physician’s attention long enough to convey the message I needed to get accross….. It got challenging with the marketing department changing our message every 3 months, even if something was working, many of the promotional pieces were useless……My favorite manager said that a good rep can move business with only the prescribing information….Honestly, towards the end, if the only question the docs asked was what formulary is your drug on, why did we need highly compensated reps to answer that question? I am now a 100% commission sales rep with novel products. Dont make 1/3 as much money, and I have no expenses or budget for promotion….I am still gaining access to offices that see the merits of my products, and yes they invite me back to discuss….for free when I tell them I have no budget for lunch. Now I have to be alot more savvy. I need to know and empathize with the provider’s business…perhaps Pharma reps should have to work for a few months as an independent rep and earn their job, doing it the old fashioned way, listen and understand your customer….(we have 2 ears and one mouth) or better yet make the pharma marketing people and executives work in the field from time to time to keep their jobs….things would change, I assure you.

  • john

    The problem is that the reps cannot discuss anything of true value. Each company has so many rules and regulations that little if no information is provided by the company. As an ex rep with year of experience, i can attest to the fact that over the last 10 years we have received less and less from the company. Do to compliance, you cannot discuss anything else. Thus, why would a physician want to listen to the same 30 second commercial for 5 years. On a weekly basis at that. Due to narrowing down to just the top prescribers, frequency has increased and value has decreased. Additionally, companies provide less samples, less patient information and limit resources if used. It would be better to have one supported rep per state than a number of under resourced reps.

  • john

    Also, regarding studies, reps do not get studies on a frequent basis from companies. Less and less are available due to some sentence that may involve something that cannot be discussed. Many of the organizations only have PI’s to use. To top that, reps cannot even discuss information that is included in the PI at times.

  • http://www.pharmareform.com Mike Wokasch

    Cass, There is a lot of wisdom in the emotion and commentary you have provided. You have captured and characterized many of the frustrations and challenges that I’m sure many Pharma Reform readers will relate to. Thank you for sharing with us. mike@pharmareform

  • http://www.pharmareform.com Mike Wokasch

    John, I don’t want to get ahead of myself but having the data and label claims to support the discussions that should be taking place with healthcare providers, insurers, and payers, is a critical success factor for pharmaceutical marketing and sales in the evolving new healthcare market. Thank you for adding to our discussion. mike@pharmareform.com

  • pharmavet

    I have a suggestion that I’ve given my Marketing people to no avail. Quit wasting good dollars on focus grouping physicians to come up with a marketing message, hook, or spin. Doctors have little or no knowledge of DDMAC regs, and because of this simple fact they are usually not very helpful. If Marketing depts. can’t work internally with their own clinical and regulatory groups to come up with the right message, then the right people are not in place.

  • http://www.pharmareform.com Mike Wokasch

    pharmavet,
    Interesting. I could never understand how you interpret focus group information when you have to factor group dynamics. I do believe that getting market feedback and testing assumptions is critical to tempering organizational bias. Like any other tool however, even focus groups may serve a purpose but in your example of “coming up with a marketing message, hook or spin”, I would agree with you. To me, that would be like using a hammer to dig a hole. mike@pharmareform.com