Where is the value in a pharmaceutical sales conversation?

Erroin A. Martin

Von Gehr Consulting Group

Twentieth Century Fox released a movie about a month ago titled “Love And Other Drugs.” The film is about a pharmaceutical salesman who meets the love of his life at a doctor’s office, a romantic-feel-good-comedy film for the 2010 holiday season. This article is not a review of the film. Instead it is a review of the current lack of value in present day pharmaceutical sales.

First, back to the film. If you have seen the trailer or even the movie then you will know that it portrays a pharmaceutical representative as vain, flirtatious, and all about delivering food, gifts, flowers, etc. to the staff of physicians and the doctors themselves. All the stops are pulled out in pitching the marketing message to get the doctors to write more brand x. In the case of the movie it is Viagra™.

You might say that this is a stereotype. It is. As with all stereotypes there is a hint of truth to them that cannot be denied.

In the case of the pharmaceutical representative the stereotype is clear about one thing: they no longer really provide value in conversations with physicians.

The most common industry payments to physicians have taken the form of gifts, such as meals… pens, mugs, and other tchotchkes that prominently feature the names of companies or their products.” – Robert Steinbrook, M.D.

No value in the interaction

It starts with the regulatory requirements and laws surrounding how a pharmaceutical product can be marketed. Everything from the wording, the colors used on graphs, which studies to promote and what are appropriate “give- a-way” items must go through a regulatory review process. The speech of the sales representative is bound to what has been approved by the regulatory review process. Anything that is outside the review process is “off-label” and punishable through employee termination, fines and possible jail time.

It is understandable why these regulations exist. They are there to protect the public from unverifiable claims, misuse of prescription products, and overall for general safety. Yet, these regulations are at odds with what physicians do on a daily basis: prescribe off-label.

From the very start a representative’s conversation with a physician is not of value. The representative must stay on message and on-label. The physician wants to be educated in all the uses of a particular product. Yet, under current regulations and laws that second discussion is forbidden.

 

“Anything that is outside the review process is “off-label” and punishable through employee termination, fines and possible jail time.”

 

Does this mean that all regulations should be removed and that pharmaceutical salespeople should be allowed to make any claim they want? Absolutely not. Again, those regulations are there to protect every point of contact in the healthcare delivery system.

What it does mean is that the industry should be honest with itself about the nature of sales conversations. First, they are not really sales conversations about finding the need of the physician and providing a solution for that need. Second, the information is considered biased by a majority of physicians. Third, leading physician organizations, teaching institutions, and government organizations recommend physicians’ distrust any interaction with a pharmaceutical representative.

There is no such thing as free lunch.” – Milton Friedman

The view of the physician is that a pharmaceutical representative has no educational role in teaching him / her how to use a certain product and / or treat a condition. The physician believes that the representative only cares about the use of the product they are promoting and not in the patient outcome.

There is a positive lining though. In a recent study looking at the attitudes of physicians towards pharmaceutical sales representatives, it was found that healthcare providers did like the free food, pens, textbooks, and samples. Basically all of those things that play into to the drug rep stereotype mentioned above.

How to return value to the conversation

It will start with the industry and healthcare providers acknowledging a few simple facts:

1) Healthcare is a business – from large companies to the small family practice.

2) Considerable wealth is spent on creating new treatments.

3) Considerable wealth is spent on training new physicians.

4) Human beings influence and are influenced by numerous factors / people everyday – it is called life.

5) In order to control costs, treat patients effectively, and generate innovation into every facet of the healthcare, everyone must work together.

It is without a doubt that healthcare is a business. While some wish it were not so, it is. With any business there are costs, investments, and (here the ugly word will be used) profits to be made. The latter pays the costs, is re-invested, and pays for salaries. This is true of the large global pharmaceutical giants and the small solo practitioner out in the middle of nowhere. The laws of business govern each one.

 

“The single criterion of performance tends to hold companies back from making explosive growth.”

 

Business owners / leaders value their time. Therefore they will invest in any product or service that helps them increase their time to focus on profitable ventures.

Under the current system the nature of the conversation does not address any of the items the business owner values. In fact it has created an environment where it steals time creating a confrontational relationship.

“Physicians emphasized that medical practice is a business. ‘Obviously people have to have some sort of business sense, some ability to recognize that medical practice is also a business.’”

The industry would best be served by addressing the business reality of healthcare and treating each physician, hospital, clinic, etc. as the businesses they are. This means a radical shift from the “educational” role on product use and into a consultation role. This means understanding the spectrum pressures that bear on the business owner – from hiring to business planning to cost control to earning a profit – and providing solutions or paths to solutions. This means having conversations that are sophisticated, educated, and at times uncomfortable. Yet, it will results in conversations that are of value.

The industry needs to kill the stereotype of the pharmaceutical representative only good for bringing food, gifts, tchotchkes, and samples. Reinvent the role into one of a collaborator, consultant, and educator of the complex business environment for the healthcare provider aka the Small Business Owner. The result will be a representative that is a valuable solution for the needs of the physician.

References:

1. Medical Association. “Interactions with Pharmaceutical Industry Representatives.” http://www.ama-assn.org, 2010:

2. Deborah Korenstein, MD, Salomeh Keyhani, MD, MPH, Joseph S. Ross, MD, MHS. “Physician Attitudes Toward Industry.” Archives of Surgery 145, no. 6 (June 2010): 570-577.

3. Fred W. Markham M.D., James J. Diamond Ph.D. , Kristopher Fayock M.D. “The Effect of a Seminar Series on Third Year Students’ Attitudes Toward the Interactions of Drug Companies and Physicians.” The Internet Journal of Family Practice 7, no. 1 (2009):

4. Laura L. Loertscher, MD, MPH, MS Andrew J. Halvorsen, MD Brent W. Beasley, MD Eric S. Holmboe, MD Joseph C. Kolars, and MD, MPH Furman S. McDonald. ” Pharmaceutical Industry Support and Residency Education .” Archives of Internal Medicine 170, no. 4 (February 2010): 356-362.

5. National Council on Farmworkers Healthcare. “Pharmaceutical Representatives: An Evidence-Based Review with Suggested Guidelines for Clerkships.” , 2010: 1-5.

6. Orentlicher, David. “SYMPOSIUM: The Effects of Health Information Technology on the Physician-Patient Relationship: Prescription Data Mining and the Protection of Patients’ Interests.” Journal of Law, Medicine &amp, Ethics 38 (2010): 74.

7. Phyllis Marie Jensen, Karen Trollope-Kumar, Heather Waters, Jennifer Everson. “Building physician resilience.” Canadian Family Physician 54 (May 2008): 722-729.

8. Sahana Misra, Linda Ganzini, George Keepers. “Psychiatric Resident and Faculty Views on and Interactions With the Pharmaceutical Industry.” Academic Psychiatry 34, no. 2 (March-April 2010): 90-91.

9. Robert Steinbrook, M.D. “Physician–Industry Relations — Will Fewer Gifts Make a Difference?” New England Journal of Medicine 360 (February 2009): 557-559.

10. Twentieth Century Fox “Love And Other Drugs.”

About the author:

Erroin A. Martin is a Business Advocate with the Von Gehr Consulting Group, LLC, a business coaching and consultancy provider for business owners, executives, and entrepreneurs. He has fifteen years experience working within the pharmaceutical, manufacturing, natural resources, medical devices, software, technology, business services, and agriculture industries in various levels of leadership across six continents. He has led diverse teams in sales, marketing, planning, and in the Army. He currently coaches business leaders and physicians in the tools needed to plan for their success. Learn more about the Von Gehr Consulting Group, LLC at www.vongehrconsulting.com or call +1 203 433 8079. You can follow him on Twitter at @Erroin.

What value do pharma sales conversations provide?