Internet Killed the Pharma Sales Star

Well it doesn’t exactly roll off your tongue like the iconic hit, Video Killed the Radio Star by the Buggles, but the title is perhaps foreshadowing to the inevitable…the reduction of pharmaceutical sales rep and their role in the drug marketing process.

The infamous Accell report (“Through Our Customers Eyes”) find many revelations in regards to pharmaceutical sales and marketing. There is lots of data in the report, but my key takeaways include –

• Between 1995 and 2000 the number of pharmaceutical sales reps almost doubled, yet the sales generated were not nearly proportional to the increase in reps


• About 10 years ago, adding a rep to the sales force yielded 750,000 visits per year. By 2000, the number dropped to just 17 visits per year. Today, more than 90,000 drug reps compete for the attention of 768,500 doctors.


• For every 100 visits, only 8 reps succeed in speaking to a physician and being remembered.
  

What gives? Did drug companies loose sight of the value that solid pharma reps provide to the physicians? Is the proportion of reps to physicians at its saturation point? Do the physicians simply no longer trust a typical rep? I believe it to be a combination of the later and the three major reasons why eDetailing is on the forefront of many product manager’s minds and also of execs with companies such as Pfizer, Seprocor and GSK who have slashed their sales forces. Bob Dylan said it best…Times are a Changing.

Against the backdrop of the Accell report, electronic detailing (eDetailing) has emerged as an increasingly popular alternative, with 31% of physicians participating in eDetailing according to Forrester Research. For more on eDetailing see (en.wikipedia.org/wiki/E-Detailing).

So will eDetailing kill the pharma star? In my opinion most likely - in due time of course. Like many industries, methodologies and processes, the internet and technology have revolutionized how people do things. Traditional drug detailing is no different. Today’s physicians have less time, are embracing technology and want to talk science. Studies indicate that physicians do not listen or care for pharmaceutical reps. The most impactful value proposition that a rep provides is samples.

There are research firms out there that walk a fine line on this issue suggesting that both eDetailing and traditional detailing can co-exist in harmony by allowing the reps to focus on details for “willing” physicians and leave eDetailing for the hard to reach folks. That doesn’t make a whole lot of sense to me. Why not use the eDetailing machine to detail all physicians in a consistent, ethical and regulated manner yielding better educated physicians who can make the right therapeutic decisions. There’s also the potential of adding eSampling to this whole mix! On the flipside there is something to be said about relationship building between the rep and a physician for the pharma company, but as a consumer that’s exactly what I’d like to not happen.

Let’s face it, regardless of how unbiased a rep is, it’s in his/her best interest to spin the data and facts in favor of the company that they work for. If Joe Rep is counting on a huge bonus around the holidays to pay for his wife’s new Tag watch, Joe Rep is going to say and do what he has to, to establish credibility with the physician to net more prescriptions. You may want to take a look at a recent New York Time article (Dr. Drug Rep). The article is an example of the types of behavior that has shed severe scrutiny on pharma sales reps and the traditional marketing process.

Pharma companies are smart…really smart and are facing other promotional issues such as ghost writing, CME, and patent expiration for small molecules. Add the pressure of cost cutting and mergers and you get a perfect storm begging for a clearing. Enter eDetailing. It’s not the answer to all of pharma’s problems, but just may help them sing a different tune and revolutionize medical promotion by enhancing reach and message quality, while performing details with the highest integrity. Perhaps that tune would be Honesty (Billy Joel), or I could be completely wrong and we’ll all be singing Dream On (Aerosmith).

Why the trend towards biologics?

When sanofi-Aventis sold its share of Exubera to Pfizer for $1.3 billion in 2005, they must have known what they were doing. Exubera which offers diabetes patients an alternative to injected insulin via inhalation of powdered form of the insulin has been made light of due to its resemblance to a marijuana bong. While comical, I don’t think that’s why Pfizer has canceled it’s agreement to market and distribute the drug. I imagine it has something to do with its lack luster performance this year of $12 million dollars and if I can venture a guess the unknown efficacy profile. Regardless of Exubera’s poor performance pulling a compound off the market that does not possess a poor safety profile is unprecedented. Abbott and NovoNordisk beware.
Form your opinion and say what you will about Exubera, one point is clear…even the big boys are focusing on developing biologics as opposed to traditional compounds. Certain analysts have called the failure of Exubera the largest failure in pharmaceutical history. Pfizer is no dummy, why would they risk so much on a biologic?

They wanna be like Mike
Michael Jordan was arguably the greatest NBA player of all time. Baseball is another story. MJ established a brand that provides automatic patent protection because of what he did and how he did it Do you think his performances will ever be duplicated or his compensations for that matter? You couldn’t just take any old players silhouette and put it on a sneaker that was not Nike. Who would buy it? Let me rephrase…who would want it? Biotech companies are similar to MJ, where they have innovative products to which the process for creating and duplicating them is way too complicated for generic manufacturers.

The biotechnology industry has always felt a need to break free of patterns set by traditional pharmaceutical firms since most products run into patent expiration after 8-10 years. Now the industry is trying to avoid the usual fate big drug companies suffer (aka MJ scoring 50 on them) when their top-selling drugs lose patent protection. Currently there are no laws to allow manufacturers to create generics for biologic drugs and a debate is percolating regarding this issue (stay tuned).

They’re trying to do the right thing…
Pharmaceutical organizations are so often accused of doing just enough for patients even though there mission statements are patient focused. Often comedians and analysts compare big pharma to drug dealers…stating that there is “more money in treatment as opposed to the cure”. Biologics allow a company to focus on the root causes of a disease, as opposed to flare ups and indications created by a disease. So what of the pundits? Of course pharma and biotech companies are trying to make money…it’s a business, however they are trying to also help physicians to effectively treat diseases which have been untouchable by traditional therapeutics. So can we all hold hands on this issue? Probably not…the treatment costs for biologic drugs are 10, 15 or even 20x greater than non-biologic drugs. Who’s gonna take care of those bills?

Times are a changing…
It’s hard to change on a dime especially when you are instituting change within a large drug organization. Different organizations such as Lilly have taken a path of creating in house biotech innovations centers while others such as sanof-Aventis have went on purchasing sprees gobbling up biotech left and right. Regardless of the strategy the time for biotech is now and traditional methodologies for sales representatives are changing due to marketplace demands. Did someone say e-Detailing?

Physicians are inundated day in and day out with messages, education, health care reform etc etc. The bandwidth for a physician is diminishing; therefore the traditional pharmaceutical sales rep faces challenges to keep a physician’s attention. (Side Bar: Honey please take note of this section). Physicians look primarily to increase their knowledge with continuing medical education (CME) and they often get this through highly knowledgeable biotech representatives. There is a rep of the future which is more knowledgeable and more scientific than today’s rep. That’s the rep that physicians will speak to because they get better educated not only a drug’s mechanism, but more importantly they gain information on disease state and emerging research trends which the may not have picked up in the literature.
Other reasons or comments? Please post.