Communiqué to sales reps: With today's docs, it's the medium and the message

Almost half of doctors bar their doors to pharma sales reps some way, somehow. What with all the talk about rep access to physicians, that state of things may seem quote-unquote normal. But it's not. Just 6 years ago, the numbers were quite different.

Back then, not even a quarter of physicians restricted rep access, according to ZS Associates' annual look at the state of the pharma-rep world. Year by year, more and more doctors put reps on their restricted lists. Cities where docs have been most accessible are tightening down. And now, even "rep-friendly" specialties such as dermatology and gastroenterology are getting into the act.

Plenty of reasons for all this, including the ethical questions that prompted medical schools and teaching hospitals to clamp off rep access--and subsequent consolidation, where restrictive hospitals bought physician practices and smaller facilities, extending their rep limits along the way.

But let's look at the effects instead. As ZS Associates points out, reps spend a lot of time trying to call on doctors who aren't interested. That, in turn, costs drugmakers plenty of money. About $1.4 billion a year, in fact. (That's down by about 50% from 2008, however, the pre-patent cliff years when companies were fielding thousands upon thousands more reps and spending a lot more money overall.)

What to do? ZS Associates notes that doctors must be listening to someone--or something--when making decisions about which drugs to use. Given that doctors-in-training are working in environments where reps are restricted, newly minted physicians are likely to be in the habit of seeking info and advice elsewhere, rather than from reps. (They're also more likely to prefer mobile contact, but that's another story.)

Each doc--new or old--has individual preferences, with some preferring email or website visits versus others relying on journal articles or pharma speakers. And still others that prefer face-to-face with reps.

"While it's discouraging that doctors may not meet as often with pharma reps, most physicians still view these reps as valuable sources of information," said Pratap Khedkar, principal and leader of ZS's pharma practice.

So, ZS postulates, a rep's job has to change accordingly. Pharma companies have already been talking a lot about identifying physician preferences and tailoring communications to those preferences. Doctor visits need to be as much about determining those preferences as they are about transmitting info. That's the pharma rep's job description now: The orchestrator, conducting messages to various doctors via various instruments, all in the name of making quota.

"The definition of detailing needs to be broadened to include channels in addition to the traditional face-to-face call," Khedkar says in ZS's report.

Taking this a step further, Khedkar says that companies need to find qualitative ways to measure reps' effectiveness, if they haven't already. Tracking the number of sales calls? Forget it. Tracking engagement is the way to go. With reps orchestrating contacts via digital means, some tracking will be a matter of totting up clicks and open rates. Sales calls themselves will have to be measured, too, however companies decide to manage it.

"It's not that these doctors object to receiving information from pharmaceutical companies," Khedkar says. It's just that the trend is toward a mix of channels. And with 50 or so channels available--webinars, social media, etcetera etcetera--sales reps "must play a critical role" to coordinate the various messages with marketing, and make sure docs get what they need, and when.

- read the release from ZS Associates

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