How doctors prefer to engage with pharma: part one

In this new series, we will be interviewing five oncologists from a range of different demographics to find out how they prefer to engage with pharma and how this could be improved in the future.

Building on our previous series exploring what doctors want from pharma, in this new interview series we will be exploring what interaction doctors want from pharma and how they wish to engage.

In order to get honest feedback, we shall be keeping the doctors anonymous.

Throughout this series, we are looking to learn:

• What information the physicians regularly need from the pharma industry.
• How they would prefer this information to be shared with them.
• How they would like to be able to feedback to pharma.
• How they think engagement via online doctor communities compares with direct engagement with pharma.
• Whether they think pharma should be trying to build its own online doctor communities and why.
• In the digital age, whether they think pharma sales reps are still necessary.
• If they could completely redesign the way doctors and the pharma industry interact, what this would look like.

Our first interview, conducted by pharmaphorum's Rebecca Aris, is with a male Consultant Medical Oncologist, whose clinical and research interests are in Urological Cancers. He will be referred to as Doctor A in this interview.

Interview summary

RA: What information do you most need regularly from the pharma industry?

DA: The most important aspect is information on new drugs as they come to market. Being an oncologist, the issue that we have a lot of the time is access to new drugs.
Once a drug is licenced for use that's where things start really for us., Since we don't usually get automatic access to those drugs, there has to be a significant process whereby we can start to access those drugs in the real world. We often go now to the Cancer Drugs Fund to gain access to new drugs. If the drug is eventually NICE licenced, then we might be able to get it in a more direct way after that. So the drug company is obviously very important in terms of being able to facilitate those processes – to gain information about new drugs, and then secondly to help us in order to get access to those drugs. That often requires quite a lot of support from the company.

RA: How would you like this information to be shared with you?

DA: With regard to new drugs as they come through, we are often interested in the clinical data to support the use of those drugs. A lot of the initial contact with a rep regarding a new drug would be surrounding data on the clinical benefits, and side effects of the drug and how to manage the side effects. Also any other clinical guides as to how to use the drug, drug interactions, dose reductions and so forth. That type of information is really important in the initial phase whilst clinicians are getting a familiarity with the new compound.

RA: Conversely how do you want to be able to feedback to pharma or ask ad hoc questions?

DA: It's useful to have a single point of reference. Reps fulfil an important role in that regard because once you develop a rapport with a rep or sales advisor then you have a point of contact. If you have any issues with regard to a drug, its usage or any other queries or issues relating to the use of the drug then you often go to the rep in the first instance. Even if it's a query that the rep isn't able to deal with themselves, they can usually point you in the right direction or put you in touch with someone else within the company who is able to assist. That direct single point of contact is very useful.
Beyond that, some kind of website which is easily accessible and where there is clinically relevant information, would be useful. It would need to be designed more for clinicians, than for public information, or patients. That may mean some kind of secure access, but it would actually give clinicians a resource to go to in order to get queries concerning a drug answered.

"...once you develop a rapport with a rep or sales advisor then you have a point of contact."

RA: How do you find engagement via online doctor communities compares with direct engagement with pharma?

DA: Online forums can provide a more real-world type experience. They can be useful because you can share experiences and share practice. This is undoubtedly a useful thing, particularly again in the initial phase of using a new drug. The information that you get from the pharmaceutical company directly or through the rep directly is more in line with information that is available in text on product datasheets and so forth. It's much more based on the average experience or the experience in trials and that type of thing. But sometimes individual anecdotes and experience is also valuable, and you probably don't quite get that through the pharmaceutical company directly.

So I think they both have a role actually. I don't think they're either / or, I think they're both important in their own way."

RA: Do you think pharma should be trying to build its own online doctor communities and if so why?

DA: I think I guess yes and no. Yes in the sense that it would be useful for clinicians to have that type of forum. The difficulty will be time elements, so if it's an open ended forum then that might not be successful because it relies on people to go on to these things in their own time and share experiences, and everyone is very busy and they probably wouldn't do that. I probably wouldn't actually to be honest. But if there was a more dedicated window of time in which they were to arrange a real-time online discussion, that may be more successful because you can put time aside to do that and you can really sit down and focus on it.

"The best interactions between doctors and pharmaceutical companies are where you get a two way dialogue."

RA: In the digital age do you think we still need pharma sales reps, and why?

DA: We do still need pharma reps because even though we're getting more and more different forms of and easier to access information, you still need a personal element to it. It's always very useful when you're faced with a new agent, or? a new drug, for a particular indication, to have a rep as a point of contact if you need further information. They're also useful for propagating educational activities within departments. We work as a regional network so they often do provide educational meetings for clinicians to discuss and share experience. So those are also really useful and I guess they fulfil a really important role in facilitating that type of interaction as well.

RA: If you could completely redesign the way that doctors and the pharma industry interact what would this look like?

DA: The best interactions between doctors and pharmaceutical companies are where you get a two way dialogue, and when there is a mutual interest and mutual benefit.
The pharmaceutical company has an interest in engaging with clinicians in order to get them to prescribe their products. Clinicians need the support in terms of prescribing the new drug, gaining information, and accessing that drug, and also being able to hold educational meetings and enhance education, and training within their department. Some clinicians are also involved in research as well, and often seek funding or grants from pharmaceutical companies in order to really facilitate that. So clinicians also want to get something out of the interaction.
So I think the best interactions are ones where there is an understanding that you both want to gain from it.
Going back to the question, as a starting point, look at that mutual interaction and mutual gain, mutual benefit, and then work things out from that point onwards. Then you have an understanding that there will be some kind of educational element within your department which you can gain from the pharmaceutical company, and also perhaps some research funding or grant. At the same time you will work with the pharmaceutical company in order to prescribe and use their products.
RA: Thank you for taking part.

The next interview in this series can be read here

About the interviewee:

Doctor A is a male Consultant Medical Oncologist, who was awarded a PhD by Imperial College London for his research in Prostate Cancer. His clinical and research interests are in Urological Cancers.

This article was coordinated by Doctors.net.uk, the UK's largest professional network of doctors. Available to UK-registered doctors in primary and secondary care, Doctors.net.uk is an effective digital channel and a trusted source of medical education, research and communication. It is used by approximately 40,000 doctors every day.

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