Before we begin these are my personal views and don’t necessarily reflect the views of my employer. Whilst researching pharmaceutical sales force recently I realised that I couldn’t find one positive piece of reporting on this highly important part of the pharmaceutical business. And please remember that it is a business, and that drugs are developed ultimately to be sold. It follows that many positives have resulted from this fact such as drug awareness sites, patient forums which in turn have led to greater patient empowerment and better products to meet this new and sophisticated educated consumer base.
So where has this bad press come from and why is it important? Firstly we don’t want to come to a point where only big brand drugs are found in doctor surgeries, patients deserve to have the best possible treatments. An example of this being the Pfizer Bextra incident where they were fined $2.3 billion for fraudulent off label marketing and kickbacks but to be fair $102 million of this went to the six whistle-blower’s. The thing to note about the Pfizer case is firstly it was caught and secondly it was found that both the marketing and sales teams of the Bextra campaign were at fault as well as upper management not just the pharmaceutical reps. It also heightened the mistrust of the pharmaceutical industry by the medical sector.
There is also the misconception that pharmaceutical sales force are becoming defunct, take Novartis as an example, announcing cuts in US sales and marketing teams in April 2010, a week later they announced expansion of their sales force in China. We also have reports that sales calls by pharmaceutical reps are down but this does not mean much if the face to face meetings figures are not reported or the sales figures themselves! Calls SHOULD get longer and less people called once you have built a solid client base, so I do not feel these figures allow us to gauge whether a sales campaign is working or not working.
The other misconception is that sales force are just the pharmaceutical reps; however the term sales force actually applies to sales and marketing within a sales team. When I ask my clients about their sales teams and marketing, in this case the social media marketing; the general feeling is that social media marketing is definitely important but it should add to the sales strategy NOT replace it. I feel it actually goes further than this, social media should also complement and be tailored to existing offline sales and marketing techniques. Taking into account demographics, therapeutics areas, culture’s and surveying both patients and HCPs to really find out what their preferences and overall needs are. It is in this way a sale can and should become personalised too. This would be the natural progression.
Social media aims to be as human as possible, which makes perfect sense; this is its very essence, to connect, to pass on information, to engage other humans, to give other human’s something useful, something they need. How then do we substitute human beings in our sales campaigns? Can social media substitute humans and human relationships? A marketer will say yes, a seller will say no and I am a seller.
Social media is obviously an important part of the sales and marketing campaign but so are human beings, you leave your essence, your personality in the social media campaign to connect with other humans because humans are your key consumer. Logic would then dictate that the natural progression would lead to humans on the phone to further engage and build rapport with other humans and finally long lasting relationships through phone work and face to face meetings. Rapport is not the same as engaging. You ENGAGE someone’s attention by them reading a blog or an article on your website; you build RAPPORT between two human beings. Rapport is a human action, a subconscious communication between two beings when they connect on some level.
Is it right to deny doctor’s the right to a human connection, after all they value the human relationship with their patients and their patients trust. In this way a pharmaceutical rep and doctor could also have the same type of relationship where all the physician stands to gain is customer service and the best possible information and treatment for their patients.
And yet it is sometimes the doctors themselves who do not want this relationship as we have seen with the now famous ZS Associate report stating that only 58% of doctors in the U.S. were rep accessible in 2009 falling by 20% from the previous year. Astoundingly a survey in 2009 by TNS Global shows that things aren’t so bleak in the EU with 70% of physicians in the UK agreeing that physician education via sales force is important. Admittedly these figures are from 2009 but this report does indicate that EU doctors are far more receptive to visits and sales force information than their U.S. counterparts. The report also indicates that pharmaceutical reps should know their market and product inside and out.
So where did it go wrong, doctor’s tend to be mistrustful of pharmaceutical companies as a whole, so it is up the rep’s to build that trust as they become the face of their company. The majority of physicians agree as does the EFPIA Code that medical reps are a valuable source of information so this just leaves sales techniques. From experience if more than one person calls a prospective client during a campaign or a client is called too much, that client is less likely to be receptive to that company, this could be another reason for the drops in rep accessible physicians.
In the U.S. there is 1 rep for every 6.3 physicians this is an extremely high number. It is simply too much for an account managed sales industry. In the UK pharmaceutical sales calls are governed by the EFPIA Code. This is where problems arise when the code is interpreted to mean you can only call a physician a certain number of times. What happens is that a rep will use up their number and another rep will jump in to call the same physician, a kiss of death to any campaign or rapport building exercise and to be honest annoying to anybody receiving these calls. All that needs to be used here is common sense perhaps keeping the same person on the same zip code and if you must hand over to a new rep leave a responsible length of time between switches.
I feel the pharmaceutical industry is listening to physicians and after the economic downturn we did see companies merging sales force teams or splitting massive sales departments and delegating them to brand or therapeutic area. With this hurdle jumped pharmaceutical companies can finally build rapport and trust with physicians because in the end it is the patient that will benefit from this relationship. This is not to say that physicians cannot find their own sources of information and do not gain a lot from e detailing. But it makes sense to check every source possible and it would stand that a pharmaceutical rep would be another excellent source of information.
Once the rapport, the human relationship, is built with a rep physicians ultimately have more control over the number of calls and visits they receive. If a physician is only dealing with one rep, then it would stand that all drugs from that brand will go through them. When they see one rep they are more likely to have frank discussions about efficacy, as the rep will not risk destroying a long lasting relationship with misinformation. They also have more power over the information and treatments for their patients, if there is a better drug out there shouldn’t the physician know about it? And who better than a rep who knows the brand inside out to give them the necessary information. This relationship of connecting doctors with pharmaceutical companies is actually a highly important one which physicians can use to their advantage.
If a physician is really clued up they could use these long lasting relationships to gain better prices. The physician could tell them the current prices they are paying for drugs and find out which context to take e detailling information from other companies. It will be in this way that healthy competition is built between companies and clinical trial data or e detailling starts to presented in different ways, as doctors demand more transparency through their reps. But then again you don’t know each other now, do you……..
Michelle is a health industry veteran who taught and worked in the field before training as a science journalist.
Featured by numerous prestigious brands and publishers, she specializes in clinical trial innovation--expertise she gained while working in multiple positions within the private sector, the NHS, and Oxford University.