Fire All Your Reps

Fire All Your Reps Image BlogOkay, that may be a bit extreme. But marketing drugs to HCPs is no longer a guarantee of sales.

As the US healthcare system has shifted its focus from “fee-for-service” to the dual goals of increasing quality while decreasing cost, the power of the individual HCP has been on the decline. Centralized systems of care (ACOs, IDNs, large hospital systems or physician group practices) function to meet these goals by implementing standard methods of delivering care, that the individual provider executes—including the menu of drugs he or she has to choose from, and when.

Consider the September 24 Wall Street Journal article detailing the refined sales strategy that pharma companies are taking. Focusing on the sales call of a “key account manager” to a large system administrator (rather than the 2,600 doctors within the system), the article details much of the impact that pharma is seeing from the changes to our healthcare system. As insurers and the federal government increasingly implement payments based on the effectiveness of care, large systems take control of how care is delivered to manage the costs. A handful of decision-makers at these organizations control how care is delivered—eradicating the influence of the rep on the prescribing doctor.

Pharma has already shifted away from the sales rep who makes the pitch to the doctor. Consider the information from ZS Associates, a consulting firm: 50% of the doctors in the US are considered “access restricted” in some way, and in 2005 pharma companies employed over 100,000 sales reps—which is down to 63,000 in 2014.

While the role of the individual provider has become less influential, the sales rep still has a role to play. Pharma’s marketing and sales approach needs to mimic what its customers are doing—coordinating efforts across all levels and locations of care, and providing targeted support at the pivotal interaction points. Pharma companies have piloted and implemented these integrated sales teams at key locations, and their prominence will only increase as HCP access continues to decline. As emerging delivery models become more sophisticated, the traditional “clinical data” approach will become only a small piece of the drug value story, while economics, efficiency, care coordination, adherence and wrap-around support share the spotlight.

So fire all the reps? No. But we need to redefine their role to better support the new world we live in.

 

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