Doctors To Sales Reps: Take A Hike
12 CommentsBy Ed Silverman // May 7th, 2010 // 6:56 am
We all know that more doctors are seeing fewer reps, but here are some numbers that underscore just how dramatic the trend has become – last year, the number of docs willing to see most reps fell nearly 20 percent, the number of prescribers refusing to see most reps increased by half and the number of management-planned sales calls that were nearly impossible to complete topped 8 million.
Just 58 percent of prescribers were accessible reps, which was defined as meeting with at least 70 percent of the reps who came knocking, according to ZS Associates, which monitored interactions involving 500,000 docs nationwide. This is down 18 percent from a study last spring showing 71 percent of docs met with at least 70 percent of reps. At the same time, the number of prescribers who saw fewer than 30 percent of reps rose to 9 percent from 6 percent. The report classified 33 percent of physicians as “rep-neutral,” meaning they see 31 percent to 69 percent of reps.
And more than 20 percent of prescribers considered “rep-accessible” in a study in late 2009 fell to a “rep-neutral” rating in this spring, while 11 percent rated “rep-neutral” shifted to “rep-inaccessible” during the same period. And docs classified as “rep-accessible” became more discriminating, ZS reports. In this category, 94 percent of primary care providers and 83 percent of specialists did not see even the best reps more than twice each month. “Best” wasn’t defined, though.
But don’t blame the reps, whose ranks have shrunk to roughly 81,780 in last year’s third quarter from 101,818 in 2005, a nearly 20 percent drop, according to SDI Health. “The findings exonerate many sales representatives,” says Chris Wright, who heads the pharma practice at ZS Associates, in a statement. “…certain prescribers simply won’t see any representatives — and they won’t do it under any circumstances. Sales management should accept that you can’t reach these doctors simply by telling the reps to ‘try harder.’ Instead, managers must modify the call plan to connect best with each individual physician.”
Pharm D
the best reps will always get in, regardless of individual doctor or hospital policies
for the masses, they never made it anyway
Dave Mittman, PA
What makes this report more interesting is that the 200,000 PAs and NPs who can prescribe in all 50 states are ignored in the results.
How does that skew the results? Are they being seen? By which companies. half the PAs have gone into specialties also which complicates matters.
We should not use the word doctor anymore and only use prescriber as it is much more accurate.
Dave Mittman, PA
pharmavet
Here’s the chain reaction that will get access back:
1) Obamacare takes full hold
2) Third party payors shrink reimbursements by 20%+ as cost of insuring the previously uninsurable rises.
3) Government imposed new rules take effect, requiring doctors to hire more administrators.
4) More office personnel plus lower payments mean salary cuts to keep overhead costs in line.
5) Admin staff, working on lower salary says that gourmet food previously brought by reps i had saved them 20% on their weekly grocery bill.
6) Dr relents to appease staff, calls pharma company, tells mgr to send reps back in with pizza, burgers, Starbucks, Panera brownies, BR ice cream in five flavors, sloppy joes, and that ever-present case of diet rc cola to wash down all the calories.
7) Staff is happy, doc is happy and rep is happy.
END OF STORY.
Lilly K
Chris Wright, who heads the pharma practice at ZS Associates is looking for business from the Pharmaceutical Industry.
Just recently, there were more than seven reps. at my doctors office. Three reps with their medicine cases were sitting in the same room with the patients, waiting to see the doctors.
The Pharmaceutical Industry has numerous trade and marketing companies promoting AND SELLING medication.
Pharma companies are the biggest lobbyists on Capitol Hill. Obviously, pharma companies get a return on their investment or they wouldn’t spend this kind of money–
Are Americans over-medicated?
Our law makers should promote preventive healthcare and less toxic medications.
pharmavet
Lilly, based on current trends only 2 of those seven reps will get to see the doctor for max. of five minutes. Assume a minimum of 30 minutes wait time/rep, that works out to 3.5 hours of wait time for 10 minutes of access, or roughly 3.3% of total rep time available. For the five reps that did not get to see the doc (maybe their pizzas had fewer toppings), that works out to $1250 of lost business for that brief time frame, based on an industry average of $250/rep/visit.
I know that this is worst case scenario, but based on these loss rates, some major pharma companies will have to discharge 90% of their FTE reps within two years just to break even. Since the remaining 10% essentially means no access at all, most intellectually honest forcasters like myself would only recommend a future drug rep job to someone who will work as contract rep for $35,000/year, compared to today’s rep, which earns $100-140,000 with full fringe benefits.
Lilly K
PHARMA VET— ARE YOU WORRIED ABOUT SALE REPS AND PHARMACEUTICALS MAKING MONEY OR PROSCRIBING MEDICATIONS ONLY IF NECESSARY? MEDICINE IS TO SUPPOSED TO HEAL—NOT HARM!
Paul
Lilly’s comment on ZS is spot on. That’s the same consulting company that for years has been telling companies to add more reps and fueled the “arms race”. Now they are advising companies how to cut back. Don’t you love the consulting business?
pharmavet
Paul, check out ZS’s recent press release re. opening a new office in China. This should tell us where the biz is going. For every rep fired in the US Big Pharma cos. can hire 2-3 reps in emerging markets and get same bang for the buck and not worry about FDA breathing down their necks.
SteveM
Re: pharmavet
Yeah, only good luck trying to get good margins from the Chinese.
First of all, they’ll make their own generics.
And second of all, they’ll steal branded IP and make their own versions of the still under patent drugs.
The biologics, they won’t even consider because of the price. The Chinese rich enough to afford them, will get them off shore.
I’d like to see the ZS sales force model under those constraints.
Kim
The final nail in the coffin of the rep-driven promotional model will be the move to prospective payment for physicians based on clinical outcomes. This will occur slowly but steadily over the next five years. It will mean that pharmas will need to become risk-bearing partners with providers. The account management function will become more important, as will MSLs, but the idea of someone without a professional license (RN, RPh, Pharm D) conveying product information to a physician will become as obsolete as a buggy whip by 2014.
Deborah
Being someone not on the “inside” of the drug cartel practices but seeing the devasting end results of their practices I say HORRAY!!!! It’s about (and well past actually) time that doctors STOPPED thinking of all the “perks” these reps give them and start putting the welfare of their patients first. The way it used to be.
Get rid of pharma lobbists in DC is the next step. Remove pharma’s ability to advertise in every media outlet known to man. And finally regulate the hell out of these drug companies so what they make in way of “cure” isn’t worse than the damn diseases!!!!
Hopefully this trend will continue so I don’t have to look into the face of another rep trying to sell their posions.
Fred Pane
The sales and marketing model should have changed years ago. When I was an Administrator of Pharmacy and chairperson of P and T, we selected formulary drugs based on Clinical Efficacy, Safety, then cost. We had to track what 3rd party payers had on their formularies also, because the managed care divisions of pharma negotiated tier 1, 2, 3 products for outpatients and we needed to coordinate discharge meds. There were hospital only injectables, but oral solids-pharma never coordinated their managed care with acute care sales staff. Cancer care is driven by protocols. If you are part of an NCCN, cooperative Oncology Group Protocol, your product will be used regardless of sales. With Healthcare reform, I just presented at a meeting a few weeks ago to pharma and device manufacturers and the take away was, clinical efficacy/comparative effectiveness will sell a drug, not sales and marketing. Payers and the FDA are going to demand more clinical studies and rightly so. There is NO MORE acute care and non-acute care model. It is Accountable Care Organizations and Continuum of Care and reimbursement/Bundled Payments are going to reflect this. Preventive care is oging to get more recognition.