Plenty of Work for Pharmaceutical Sales Representatives, if only…

In our last post we discussed the increasingly comprehensive approach that R & D will need to take in order to deliver products that can meet increasing market expectations.  Before we get into the implications for the pharmaceutical sales representative it is important to understand what needs to happen for one of these more advanced products to be used appropriately so as to optimize the clinical benefits and to realize the potential value and cost benefit.  The intent here is not to draft a marketing plan (and I’m sure I’ll miss something anyway) or bore you with all the details about launching and promoting a product but rather to highlight the enormous task at hand.  Here are just some of the steps and hurdles to adoption and appropriate use that will be needed to get the most (clinical benefits for patients, economic benefits for payers, and financial reward for the companies that do it well) out of innovative new products with more comprehensive product profiles:

  • The market must be made aware of and educated about the product, who it is for, what it can do clinically, what patients can expect if they take the drug and why it has value as a therapeutic option
  • Healthcare providers and laboratory personnel must be educated about the companion diagnostics including the potential use of genomics testing. (What the tests are, who should be tested and who doesn’t benefit from testing, how to do the testing, what the tests can and can not tell you, and how to interpret the results).  Insurers and providers also need to understand the economics of ordering and using a test (when does it make economic sense, when is it cost prohibitive).
  • Formularies must have the data they need to evaluate the product, its appropriateness for their patients and the potential clinical and economic impact on their patients and plan or institution.
  • Prices and reimbursements must be negotiated
  • Supply chains must be informed and stocked (potentially includes lab testing and handling supplies)
  • Government decision makers, hospitals, insurers, and physicians will need to understand the clinical value, cost benefit, and impact on quality metrics and patient outcomes
  • Hospitals in particular, will need to understand how to evaluate the product (have validated designs and models) for determining the impact on quality metrics, patient outcomes, and pharmacoeconomics within their own healthcare systems.
  • Physicians and patients must understand how best to use the product for optimal clinical benefits
  • Patients must understand the importance of compliance and adherence and the consequences of neglecting to take the product as prescribed

Some might argue that these are the same issues and tactics that have to be dealt with in the market today.  None of this is a lot different than what companies are doing or at least should be doing now.  If that is true, then with all this to get done for so many products in a large very complex market, why is it that so many pharmaceutical sales representatives find themselves out of a job today with an increase in discussions about the lack of value being delivered and the potential extinction all together of the pharmaceutical sales representative job?  We’ll explore that further in the next post.

mike@pharmareform.com

  • CJ

    “If that is true, then with all this to get done for so many products in a large very complex market, why is it that so many pharmaceutical sales representatives find themselves out of a job today with an increase in discussions about the lack of value being delivered and the potential extinction all together of the pharmaceutical sales representative job?”

    The answer to the “why” is in the 90’s and early 2000’s the industry grossly expanded its sales forces in a misguided ‘Share of Voice’, battle, eg Pod Selling. The market (ie physicians) clearly told us, in a variety of ways, such as limiting access, that they do not need 2,3,or 5 different reps delivering the same information, for the same product, for the same indication, from the same company, every 2-3 weeks! What other industry operates like this?…Telemarketers…and we all know how “valued” they are! You don’t need 5000 reps to easily accomplish what 1000 reps could cover, hence the reason why so many reps are out of work. In all honesty how many times can you repeat the same messages and safety and efficacy aspects about a product and expect it to change prescribing habits? For whatever reason we ignore the law of diminishing returns. The current sales model is broken, but the profits keep rolling in so why “buck the system”? This mentality has gotten “us” locked out of many clinics, hospitals and universities, with more coming.

    We need to remove the “sales” from our titles and job descriptions. We need to have a reality check on what we really are and what we really do, which is deliver information. I have not received one purchase order in all my years of biopharma. What am I selling? And recently a Federal Judge agreed that “detail reps” are not “sales reps” since no transaction takes place! I guess you could say I am selling information with hopes that the information I provide gets the physician to use my drug more often or longer or before the other one’s etc. This is not sales! Also the impact that a “rep” has on prescribing is close to last amongst: formulary status, physician training, accepted treatment algorithms (think NCCN) , cost, insurance coverage, generic availability, capitation, and risk. Pharmaceutical Executive Magazine publishes the factors that influence prescribing. Recently the rates ranged from 1% to 3% in some high risk specialties(oncology, HIV, MS) and a bit higher in commodity mass market products which is why we still have reps. 1% of a billion market is a lot of influence! The more we understand this, the more we can adjust to the real needs of our customer rather than the heavy handed needs of our companies to sell more drug…

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

    CJ,
    Thank you for your thoughtful and well written commentary. You have captured many of the issues and hit on some important considerations for where to go from here. A very worthwhile contribution to the discussion. Thank you. mike@pharmareform.com

  • OutOfPharma

    Mike – Will you be addressing the years of “management/marketing inbreeding” that has taken place. I am referring to the good old boy network that has helped fuel the current state of affairs. Many of these “hey it worked for me” people are now running the show. Change is not in there vocabulary. They will fight tooth and nail to keep the system as is. Maybe I am wrong.

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

    OutOfPharma,
    I hate to sound like I am just selling books here, but one of the major unintended consequences of growth that I write about in Pharmaplasia™ is the dilution of management expertise, the progression of inexperienced managers, and the impact that had on the industry over time. As you point out, they continue to have an impact. It is only one of the reasons they resist change however. mike@pharmareform.com