Friday, February 13, 2009

Don't Come Knockin' On My Door

The pharma industry doesn’t need more stats to tell it that knocking on doors doesn’t work any more, but some new figures blast that cold reality. (A comprehensive review of what needs fixing in pharma's commercial model is in the December IN VIVO. Our take on Merck's stab at reinvigorating its commercial presence is here.)

The latest data comes from California-based market research firm SK&A, which found the percentage of doctors who require reps to make appointments for visits rose 22 percent between June and December 2008 from 31.4 to 38.5 percent (of doctors who see reps). The number of physicians who won’t even see sales reps at all rose from 22.3 percent to 23.6 percent (of all surveyed).

Put another way: about 40 percent of general practitioners--that is, the ones who see reps at all--now require appointments, up from 33 percent six months ago. The trend rose for specialists too-from 28.3 percent in June to 36.6 percent in December. Every kind of practice and specialty is getting tougher, although specialty physicians are more likely to completely bar reps than GPs. Among the toughest to get to: pathologists, diagnostic radiologists, and neuroradiologists. No specialty stood out as particularly friendly, although dermatologists, allergists, and diabetes specialists were least likely to impose total lock outs.

The survey didn’t ask why doctors are increasing their restrictions, but SK&A researchers do speculate. Doctors are busier, under pressure to see more patients – and, affiliated with large organizations that increasingly institute system-wide rules. Not surprisingly, then, health systems are the most restrictive: more than half require appointments and 35 percent forbid rep access altogether. Of free-standing medical practices, those owned by hospitals stand out: 44.6 percent of those that see reps require appointments, while 31 percent keep their doors shut.

Lest anyone dismiss this data as fly-by-night, SK&A says it conducted telephone interviews with 227,000 medical practices representing 640,000 doctors—that’s nearly all of the active practicing physicians in the U.S. The response rate was 94 percent.

There is a silver lining. Some 76.4 percent of those surveyed, including the group that requires appointments, still see reps. And those appointments could be more productive. The survey didn’t measure quality of interaction, but SK&A CEO Dave Escalante points out that doctors who agree to visits by appointment may be opting for higher quality time with their rep, which scheduling in advance could provide. SK&A, however, didn’t look at the reasons for the new barriers to access or the quality of doctor-rep relations, although multitudes of others have.

The message? Well it hardly needs to be repeated, but hard numbers always resonate: large armies of sales forces are a model that just won’t work anymore.--Wendy Diller

image from flickr user matt.davis used under a creative commons license.


Unknown said...

I feel sorry for the quality pharma reps that are out of jobs. But I have to say that the reason the docs don't value the reps is because they don't bring much value to the process. In my arena - laboratory/medical device/medical software the call point is the physician, the laboratorian, the pathologist or the technical user and they value the reps because the rep usually does know more about the product that the buyer does. Not so in pharma sales....Also, pharma companies post jobs requiring science degrees - chemistry, biology, etc. But I see the resumes coming out of these companies (pfizer, merck, glaxo, sepracor, J & J) and most of them have no technical/science background. Over here - we have strong biology, molecular, chemistry education (sometimes MS or PhD) and the sales skills.
Check us out at

Anonymous said...

As a member of the pharma industry for over 28 years - I will have to disagree with the medical sales recruiter's comment that the physicians know more about the pharmaceutical product than the rep. This is total inaccurate - Oh the Doctor thinks they know more- but in the majority of the time when they tell us how a product should be used - and what they perceive that it has indication for and the documented clinical side effects - they are off base. Remember physicians only take 3 hours of pharmacology in med school. They learn the majority of their prescibing information from their Attending physicians or other members of the residency staff. And when they graduate it is usually the fellow members of their practice that provide the "expert" information. If you really want to find out what litte physicians know about pharmaceutical - just talk to any practicing Pharmacist

Unknown said...

Anonymous: With everything there are exceptions and you certainly sound like one. But others within your area have not represented themselves as well in a number of areas: their professionalism in online groups - cafepharma?, their value in the interview process and their value to those physicians (this isn't my opinion it is theirs). There will be thousands of your peers that will remain unemployeed or consider themselves under-employeed once this all shakes out...but the real answer will be that they did not provide the value that they were compensated for....
One last thing: I have recruited and placed many pharma reps with BS or higher degrees in lab, chem, biology for sales positions into my arenas - medical sales, device sales and laboratory product sales. They are thriving (many promoted on to next level).

Anonymous said...

I do not agree with the medical sales recruiter. A sales personality cannot be learned, scientific info can. Also, cafepharma is open to everyone, not just pharma reps. People posting on that site look to sabotage and damage the image of reps. Alot of disgruntled/former reps also post there. So, don't even consider that as a reference for pharma reps and their knowledge.

Anonymous said...

By "appointment", I'm guessing that the author actually means "lunch". Calling it an "appointment" implies that the rep will get some quality time with the prescriber in question. More likely, the doctor may (or may not) pop in for no longer than it takes to fix a plate and run back to his/her office to eat in private.

In the meantime, the expenses associated with this "appointment" contribute to both higher drug costs, and a lower opinion of the pharmaceutical industry.

Anonymous said...

It used to be that the Pharmaceutical Representative WAS the company in the eyes of the physician, and highly valued. Over the last 15 years or so upper management decided more is better and over-hired sometimes 4 or 5 reps from the same company in the same geography(called "share of voice" as all the companies competed to have the largest number of reps). For a short time that seemed to work, but the quality of the hires naturally declined as the pressure was on to "hire" and it soon annoyed more and more customers thus leading to the current situation.

Anonymous said...

The problem as I see it .... a "downsized" Specialty Pharm Sales Prof. ... we can all take a lesson from Starbucks, a multi-Billion dollar company (it's stock has "split" 5 times, the sign of a very successful company).

Although the old saying holds true ~ the cream rises to the top (e.g., Veteran Reps) ~ recently, nearly all Pharmaceutical Companies, in order to cut costs, have removed "all the cream" in their cups of coffee now being given to the Physicians. However, in doing so, this newer and supposedly "improved cup of coffee" the Physicians are now getting no longer has the same "pleasant impact" as the cream-n-coffee of years gone by. Instead, this newer, albiet cheaper bland cup of coffee, brought in by the "new recruits", does nothing but leave a bitter taste in the Drs. mouths.

If Starbucks were to have a similar problem, they would eventually go out of business. Cheap, bland coffee simply doesn't sale well. That's why Starbucks has several flavored or creamed coffees. Hint...Hint.

Anonymous said...

Pharmaceutical sales reps is a misnomer. They dont sell anything.
They give away samples and free meals, and add a tremendous amount to the cost of drugs..
Most doctors are not interested in the one sided clinical data that may be presented..
In the present and future reality of the economics of the country this corporate welfare position should be retired

Anonymous said...

To those that say sales department raise the price of the product, you must have been cheated in college if you went or are a completely ignorant individual of society.

All companies have a marketing and research firm. These costs are going to be spent on ads, brochures, mailings, tv ads, and yes sales people. So is it cheaper to just bombard the tv with 30 sec canned spoof commercials or pay people to actually be a service to the people who write the products? That's the role of a true phara rep. Reps are the actual conduit from the prescriber to the company. No doctor in their right mind can keep track of all the meds let alone what is new with the products both good and bad. Like any person you meet, there are good and bad people, people who are genuine in doing right for people and helping the office as a partner. And then yes, there are those who are shady. The deal is 95% of people in this industry do go out and work and care about what they do. If they do good, they are rewarded but you are ignorant if you think for a minute a corporation is changing its budget so that it can lower prices, you can check any business model, if you do that, you sell less product and guess what... if you can't sell your product, then yes, you mr taxpayer will be paying for me to sit at home and collect unemployment. So think real hard next time you make those ignorant claims about why medicine costs so much. Next time look at your great governement who regulates this industry to the point it costs nearly a billion dollars to market a new drug. That eliminates just about anyone from trying to want to get into this line of work and you wonder why costs are so high. Thank DC and these lawyers who managed us into a problem that will never go away.

Anonymous said...

AMEN to the poster talking to the ignorant poster who thinks reps cause the price of medicine to increase. Most individuals do not realize that the cost to bring a drug to market these days is a BILLION dollars----drugs change peoples lives. Lets think of this concept, if individuals kept themselves healthy--ate right, didnt smoke, got off their fat asses and exercised they would not have to be on alot of the drugs they are on to begin with. No, people don't want to take responsibility for their own health---they want a quick fix---a pill and then want to complain about the cost. The cost of drugs are actually just 10% of the total medical care costs. It just irritates me that people will pay $200 for a haircut and getting their nails done but don't want to pay for their healthcare.