PharmExec Blog

2014: End of the Road for the American Rx Salesperson?

2014: End of the Road for the American Rx Salesperson?
“The only thing you’ve got in this world is what you can sell.” Willy Loman Death of a Salesman
During my years with two major U.S. pharmaceutical companies, some of the most interesting individuals I got to know were field salespersons.  Certainly one of my favorites was a gentleman I met early in my career.  He had achieved “master salesperson” status with the firm and had amassed a sales record few could rival.  When I occasionally did a professional “tag along” with him in the field, just listening to his banter with doctors was more than worth the trip.
His entire being was centered on “the sale” — the presentation, the response to objections, and the closing of the deal with “his doctor”.  To me, his handling of these encounters was just this side of magical.  It was rare that he didn’t make the sale and he frequently told me, “There’s no better job in the world than being a drug salesperson.  I just love the hunt”…which was how he saw his Rx sales work.
That, of course, is not the situation today for the American Rx salesperson.  The “hunt” is pretty much done.  Overall, and based on the pharmaceutical sales layoffs of the last 36 months, it appears that fewer than 60,000 Rx representative positions exist in the U.S. today.  This is down from well over 100,000 in 2006 (http://goo.gl/fF8Kci ).  Indeed, Lilly announced less than a year ago that it was laying off 1/3 of its entire sales force (http://goo.gl/S5G4xU ).
There are, of course, several causes for the rapidly declining numbers of sales reps.  Lost patents on major drugs; the rise of managed care; and the steadily growing resistance of physicians who refuse to see “magical” representatives like my old friend are certainly contributing factors.
But if the past few years have been difficult for the American drug sales personnel, 2014 may shape up as the year that the dying breed known as the “pharmaceutical salesperson” really begins its slow walk into extinction.  The one-two punches of Obamacare, as well as the rapid rise of the “private employer health exchanges” could spell the end of this career designation, once and for all.  Here’s why…
Obamacare and the Rx Salesperson
As most of us realize by now, Obamacare for all its chaos and uncertainty, is very likely to become a lasting reality on the American healthcare scene.  If this premise is true, as I pointed out in an earlier article (http://goo.gl/4iGeyy ), we should understand that the underlying concept of Obamacare is “less is more”…That is, Obamacare is spreading out the current service that is “American healthcare” by clipping off the quality & quantity of care at the top of healthcare and using that “excess” to provide, for the first time, basic healthcare at the bottom…In so doing, Obamacare maintains that it increases and provides “more” care for more citizens in the United States.  “Less really is more” is the line of thinking.
And if less is more, how is the U.S. drug industry to be impacted?  It’s really quite simple.  On the healthcare cost-of-operating spreadsheet, the expense for Rx care, as with all healthcare services, must be reduced.  How is that to be achieved?  In the case of prescription drugs, fewer brand name drugs are being provided; most Rx drugs that are being prescribed are generic; and all drugs, whether brand or generic, are being subjected to dramatic demands for discounted pricing by the insurers who are providing the prescription drugs through either the state or federal exchanges.
Where does the Rx salesperson fit into this scenario?  First, it is not hard to see that if eventually 30
million Americans are receiving their Rx services through an Obamacare insurance program, the opportunity to “present, respond, and close the deal” is very likely going to be limited…if ever provided.
This is because the public exchanges are working through very limited offerings that each insurance provider has assembled for the four “metal” classes of care (http://goo.gl/19hbCP ) that are being provided to the public.  The idea of a salesperson walking the halls of say, Aetna Insurance, to “close the deal” for the Aetna “bronze level” of care in the California exchange ( http://goo.gl/3CIW5H ) is just not the reality of 2014.  If anything, Aetna is likely communicating with that salesperson’s pharmaceutical headquarters, indicating the drug categories that Aetna intends to offer in California’s various programs, and is requesting bids from the Rx company to determine if there is anything further to discuss.  The Rx firm dealing with California will engage the insurer via a very limited number of specialized company negotiators.  Thousands of sales field force reps pounding the pavement will have nothing to do with the outcome.
This scenario is being played out across America this year.  As Obamacare slowly finds its equilibrium, the cold, hard fact of where this new public health plan will leave the traditional drug salesperson is becoming quite clear.  That is, they simply are not be needed.
Private Employer Health Exchanges
But as the state and federal exchanges operating under Obamacare quietly close opportunities for Rx salespersons, another concept, potentially even more impactful than the public operations, has quickly become a major player in the life of Rx salespersons in this country.  This is the healthcare concept known as the “Private Employer Health Exchange”.
Not heard of this?  Check this out:  On January 1, 2014, more than 330,000 employees from companies like Sears, Darden Restaurants, Walgreens, and many others began utilizing the services of an employer health exchange (http://goo.gl/YRl4Or ).  And according to Buck Consultants another 400,000 private employees were just added to their private health exchange offering (http://goo.gl/2WNYfI ).  In fact, as all of the new private exchange participants are tallied over the next three years, it’s expected they will be running about even with the Obamacare signups – i.e., about 30 million.  If true, that would still leave another 140 million privately insured “defined benefit” employees who could potentially be brought into the private health exchange concept in the future (http://goo.gl/W8xXi4).
How do the private employer health exchanges work?  Unlike the public exchanges in Obamacare, each employee is actually given a “defined contribution” or amount of money to “buy” their healthcare needs.  The employee will then be provided with a series of insurance options offered through entities like Aon Hewitt, Mercer, etc.  The employee then chooses the best healthcare option that the employee can buy from the stipend provided.
Why is this so suddenly so popular with employers?  Because unlike the “defined benefit” healthcare approach that has been utilized since the end of World War II, the “defined contribution” literally puts a cap on healthcare spending for the employer.  In short, it saves money.
And how does this work for the employee?  Specifically in the area of Rx drugs, as with the Obamacare approach, the employees are experiencing limited formularies, which although perhaps a bit “richer” than those being offered under Obamacare, are none the less, reduced brand name offerings versus those that the employees were receiving under “defined benefit” plans.
These also feature large numbers of generics in their formularies.  The thinking here is that for employees who have become more cost conscious of their healthcare spending due to the “defined contribution”, using more generics will be accepted.  This type of consumer attitude will obviously reduce the number of brand name products dispensed in private health exchanges.
Which brings us back to our American Rx salesperson.  How do these folks fare under this rapidly expanding private care scenario?  As with Obamacare, not well.  Firms like Mercer and their competitors certainly are not making time for drug sales presentations from individual reps as they design the Rx offerings they are creating for the employers and insurers.  Once again, the “sales” of drugs to these massive “defined contribution” options is being undertaken by specialized Rx headquarters groups who carefully calibrate and bundle the best possible packages their firms can offer in an attempt to win large chunks of business from these private health exchanges.
Obviously, there is no place for the Rx salesperson in this scenario.  None.
The End of the Road for Rx Sales in the U.S.
Given all of the above, it does appear to be just about the end of the road for Rx sales in the U.S.  One-on-one sales, if occurring at all, now appear to be trending towards digital Skype presentations, or You Tube videos that a physician can watch whenever convenient (http://goo.gl/MSTweY ).  In many of these formats, the doctor can actually access a “sales rep” to question some aspect of an Rx product.  It’s similar to what we do when we contact an Amazon rep with a question about a sweater purchase.  In short, there are no “real sales people” involved.  Only Rx telemarketers.
So, my favorite old sales friend, who is now retired and spends his days caning antique chairs, no doubt wouldn’t recognize the Rx “hunt” of today.  Of course, it still exists.  It’s just that the mechanisms used to accomplish the goals of the hunt have changed.  Prescription drug companies are still making sales, and are still making profits, if greatly diminished as compared to the halcyon days in the 1990’s and early 2000’s…
But the days of the selling by a “Willy Loman” like Rx sales “magician” would appear to be over.  Replaced instead by digital algorithms, reams of user analytics, and highly trained pharmaceutical employees — who probably couldn’t artfully answer a physician’s “objection” if they heard one.

“The only thing you’ve got in this world is what you can sell.” Willy Loman, Death of a Salesman.

During my years with two major U.S. pharmaceutical companies, some of the most interesting individuals I got to know were field salespersons. Certainly one of my favorites was a gentleman I met early in my career.  He had achieved “master salesperson” status with the firm and had amassed a sales record few could rival.  When I occasionally did a professional “tag along” with him in the field, just listening to his banter with doctors was more than worth the trip.

His entire being was centered on “the sale” — the presentation, the response to objections, and the closing of the deal with “his doctor”.  To me, his handling of these encounters was just this side of magical.  It was rare that he didn’t make the sale and he frequently told me, “There’s no better job in the world than being a drug salesperson.  I just love the hunt”…which was how he saw his Rx sales work.

That, of course, is not the situation today for the American Rx salesperson.  The “hunt” is pretty much done.  Overall, and based on the pharmaceutical sales layoffs of the last 36 months, it appears that fewer than 60,000 Rx representative positions exist in the U.S. today.  This is down from well over 100,000 in 2006 (http://goo.gl/fF8Kci ).  Indeed, Lilly announced less than a year ago that it was laying off 1/3 of its entire sales force (http://goo.gl/S5G4xU ).

There are, of course, several causes for the rapidly declining numbers of sales reps.  Lost patents on major drugs; the rise of managed care; and the steadily growing resistance of physicians who refuse to see “magical” representatives like my old friend are certainly contributing factors.

But if the past few years have been difficult for the American drug sales personnel, 2014 may shape up as the year that the dying breed known as the “pharmaceutical salesperson” really begins its slow walk into extinction.  The one-two punches of Obamacare, as well as the rapid rise of the “private employer health exchanges” could spell the end of this career designation, once and for all.  Here’s why…

Obamacare and the Rx Salesperson
As most of us realize by now, Obamacare for all its chaos and uncertainty, is very likely to become a lasting reality on the American healthcare scene.  If this premise is true, as I pointed out in an earlier article (http://goo.gl/4iGeyy ), we should understand that the underlying concept of Obamacare is “less is more”…That is, Obamacare is spreading out the current service that is “American healthcare” by clipping off the quality & quantity of care at the top of healthcare and using that “excess” to provide, for the first time, basic healthcare at the bottom…In so doing, Obamacare maintains that it increases and provides “more” care for more citizens in the United States.  “Less really is more” is the line of thinking.

And if less is more, how is the U.S. drug industry to be impacted?  It’s really quite simple.  On the healthcare cost-of-operating spreadsheet, the expense for Rx care, as with all healthcare services, must be reduced.  How is that to be achieved?  In the case of prescription drugs, fewer brand name drugs are being provided; most Rx drugs that are being prescribed are generic; and all drugs, whether brand or generic, are being subjected to dramatic demands for discounted pricing by the insurers who are providing the prescription drugs through either the state or federal exchanges.

Where does the Rx salesperson fit into this scenario?  First, it is not hard to see that if eventually 30 million Americans are receiving their Rx services through an Obamacare insurance program, the opportunity to “present, respond, and close the deal” is very likely going to be limited…if ever provided.

This is because the public exchanges are working through very limited offerings that each insurance provider has assembled for the four “metal” classes of care (http://goo.gl/19hbCP ) that are being provided to the public.  The idea of a salesperson walking the halls of say, Aetna Insurance, to “close the deal” for the Aetna “bronze level” of care in the California exchange ( http://goo.gl/3CIW5H ) is just not the reality of 2014.  If anything, Aetna is likely communicating with that salesperson’s pharmaceutical headquarters, indicating the drug categories that Aetna intends to offer in California’s various programs, and is requesting bids from the Rx company to determine if there is anything further to discuss.  The Rx firm dealing with California will engage the insurer via a very limited number of specialized company negotiators.  Thousands of sales field force reps pounding the pavement will have nothing to do with the outcome.

This scenario is being played out across America this year.  As Obamacare slowly finds its equilibrium, the cold, hard fact of where this new public health plan will leave the traditional drug salesperson is becoming quite clear.  That is, they simply are not be needed.

Private Employer Health Exchanges
But as the state and federal exchanges operating under Obamacare quietly close opportunities for Rx salespersons, another concept, potentially even more impactful than the public operations, has quickly become a major player in the life of Rx salespersons in this country.  This is the healthcare concept known as the “Private Employer Health Exchange”.

Not heard of this?  Check this out:  On January 1, 2014, more than 330,000 employees from companies like Sears, Darden Restaurants, Walgreens, and many others began utilizing the services of an employer health exchange (http://goo.gl/YRl4Or ).  And according to Buck Consultants another 400,000 private employees were just added to their private health exchange offering (http://goo.gl/2WNYfI ).  In fact, as all of the new private exchange participants are tallied over the next three years, it’s expected they will be running about even with the Obamacare signups – i.e., about 30 million.  If true, that would still leave another 140 million privately insured “defined benefit” employees who could potentially be brought into the private health exchange concept in the future (http://goo.gl/W8xXi4).

How do the private employer health exchanges work?  Unlike the public exchanges in Obamacare, each employee is actually given a “defined contribution” or amount of money to “buy” their healthcare needs.  The employee will then be provided with a series of insurance options offered through entities like Aon Hewitt, Mercer, etc.  The employee then chooses the best healthcare option that the employee can buy from the stipend provided.

Why is this so suddenly so popular with employers?  Because unlike the “defined benefit” healthcare approach that has been utilized since the end of World War II, the “defined contribution” literally puts a cap on healthcare spending for the employer.  In short, it saves money.

And how does this work for the employee?  Specifically in the area of Rx drugs, as with the Obamacare approach, the employees are experiencing limited formularies, which although perhaps a bit “richer” than those being offered under Obamacare, are none the less, reduced brand name offerings versus those that the employees were receiving under “defined benefit” plans.

These also feature large numbers of generics in their formularies.  The thinking here is that for employees who have become more cost conscious of their healthcare spending due to the “defined contribution”, using more generics will be accepted.  This type of consumer attitude will obviously reduce the number of brand name products dispensed in private health exchanges.

Which brings us back to our American Rx salesperson.  How do these folks fare under this rapidly expanding private care scenario?  As with Obamacare, not well.  Firms like Mercer and their competitors certainly are not making time for drug sales presentations from individual reps as they design the Rx offerings they are creating for the employers and insurers.  Once again, the “sales” of drugs to these massive “defined contribution” options is being undertaken by specialized Rx headquarters groups who carefully calibrate and bundle the best possible packages their firms can offer in an attempt to win large chunks of business from these private health exchanges.

Obviously, there is no place for the Rx salesperson in this scenario.  None.

The End of the Road for Rx Sales in the U.S.
Given all of the above, it does appear to be just about the end of the road for Rx sales in the U.S.  One-on-one sales, if occurring at all, now appear to be trending towards digital Skype presentations, or You Tube videos that a physician can watch whenever convenient (http://goo.gl/MSTweY ).  In many of these formats, the doctor can actually access a “sales rep” to question some aspect of an Rx product.  It’s similar to what we do when we contact an Amazon rep with a question about a sweater purchase.  In short, there are no “real sales people” involved.  Only Rx telemarketers.

So, my favorite old sales friend, who is now retired and spends his days caning antique chairs, no doubt wouldn’t recognize the Rx “hunt” of today.  Of course, it still exists.  It’s just that the mechanisms used to accomplish the goals of the hunt have changed.  Prescription drug companies are still making sales, and are still making profits, if greatly diminished as compared to the halcyon days in the 1990’s and early 2000’s…

But the days of the selling by a “Willy Loman” like Rx sales “magician” would appear to be over.  Replaced instead by digital algorithms, reams of user analytics, and highly trained pharmaceutical employees — who probably couldn’t artfully answer a physician’s “objection” if they heard one.

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16 Comments

  1. Student of Pharma
    Posted February 3, 2014 at 3:46 pm | Permalink

    I have sat in research recently where docs say, “I’ll write what they tell me to write.”

    Essentially, because of the mass selling of physician practices to hospital-centered Integrated Delivery Networks (IDNs) and the formation of Patient-Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs), these docs have given up their autonomy to Rx what they think is best and they are told to use the formularies these orgs come up with.

    I’m not sure whose formulary will prevail; the IDNs or the insurance companies. But, what I think I do know is that docs don’t seem to care about the loss of autonomy, not when they can become a salaried employee with regular hours and they have a couple hundred thousand in tuition to pay off.

    These are, perhaps, more on-the-ground dynamics of why the American Drug Sales Rep is a dying breed. They call on customers who can’t be sold.

  2. Carl
    Posted February 6, 2014 at 11:48 am | Permalink

    Reps first started out “detailing” the product benefits so Dr’s could compare the drugs, it wasn’t about “selling”. It was about the medicine and it’s benefits, and the “pearls of wisdom” that reps shared about their product, that weren’t found in the literature. They didn’t sell off-label.
    Someday it may return to that, it may be that only a very small number of reps are needed….

  3. John
    Posted February 6, 2014 at 12:37 pm | Permalink

    skype and youtube are but a few of the electronic channels drug company’s are promoting their products. consider the influence of “banner” drug information provided to physicians each time they log on to their electronic healthcare record.

  4. Phormer Pharma
    Posted February 6, 2014 at 2:00 pm | Permalink

    I started in the pharma business in 1992 and my tenure lasted until my employer laid off approximately 60% of its primary care field force in 2012. Truth be told, if I wasn’t fortunate enough to find a career outside of pharma I would probably still be there, ‘waiting by the phone’ tomorrow to learn my fate during the latest restructuring, realignment, rightsizing, field force optimization, layoff, or whatever it is called this time around. 1992 was also about the same time, perhaps just before, doctors were given a television in their office that was typically placed next to, or on, their desk. The television would contain everything the doctor ever wanted to know about a certain drug. And it would be updated periodically. Think of it as a virtual PDR that ‘detailed’ to the physician a recorded message. I still remember a doctor, an old-timer, sitting down with me at his desk (remember those days??) and pointing at the television while saying, “that little tv is going to do away with drug reps”. With technology where it is today, the primary reason (only reason?) for a rep to see a physician is because the physician still has a bit of a choice on which drug to prescribe. Take that choice away, which seemingly is occurring more and more commonplace everday, and the primary reason for a drug rep needs to evolve or they will go the way of bag phones and VCRs: outdated.

  5. Jim
    Posted February 6, 2014 at 2:02 pm | Permalink

    Sure you can elucidate all of the reasons for the current and future demise of the Rx Salesperson. This has all been said for the last 10 years. As a 20 year veteran of this industry, I predict you will be proven wrong. As the consolidation of the big pharma players matures and we head for the next cycle of growth and innovation, pharma sales people will be in huge demand. What you don’t seem to understand is that, for deep pocket billion dollar pharma companies, nothing moves share like a persuasive, well trained, human being visiting a doctor. Nothing. And when physicians can choose between 2, 3 or 4 very similar drug options (which will always be the case), the human factor (the salesperson) wins the day. In other words, the company that has invested in the sales force will win the battle. It’s expensive, and there certainly will be other channels evolving to influence prescribing. But no other way of selling can match it and I feel sorry for any major company with a billion dollar drug that tries to go without it. By the way, when have you ever heard of that happening? Never. Which indicates the model that you prematurely state is dead is, in fact, alive and well. Today, the first thing any company does when they get approval or in license a drug is hire a sale force. Everything else is secondary. What you need to accept is that pharma sales people go hand in hand with branded pharmaceuticals. In the USA, we have a vested interest in keeping the branded sector (and its associated benefits of innovation, high end jobs, medical cost reduction) alive and kicking. Even if Obama has focused temporarily on care of the uninsured, America’s long history of fueling scientific innovation will win and that means pharma sales people are on the right side of the battle for the long term.

  6. Posted February 6, 2014 at 2:38 pm | Permalink

    I have written a number of articles about the diminishing role of the pharmaceutical sales rep. You can blame the increasingly managed healthcare market or ObamaCare or regulatory constraints but the real reason for the decline is that pharmaceutical sales reps no longer add value (to the customer or to the pharmaceutical company itself) in today’s prescription drug market. There was a time when pharmaceutical companies and their sales representatives played a major role in disseminating drug and prescribing information. Today, however, there is nothing a pharmaceutical sales rep can do or provide that a physician can’t get more conveniently from the internet, an e-mail, or some other digital source.

  7. BigDog
    Posted February 6, 2014 at 4:53 pm | Permalink

    F*** you Mike. You are such a hater.

  8. Terry Martin
    Posted February 6, 2014 at 9:23 pm | Permalink

    In 1984, when John Dingell D-Michigan launched a campaign against big pharma, everyone was worried that only generics would be available, no samples would be permitted and sales reps would no longer be needed. Well 30 years later we’re still here and we still have branded drugs–with samples–and drug reps still make calls every day. Granted, it’s not like is was in 1984, but we’re not dead yet.

    As long as lunch or bagels and coffee will get me in the door, I’ll keep going in. Yes sometimes through the side door. I still have a lot of friends in there, and I still make a difference in prescribing habits. I was the #2 rep for my company last year.

  9. BzyRep
    Posted February 7, 2014 at 12:50 am | Permalink

    While I can appreciate perspectives on both sides, I have to agree that there will always be a need for Pharma reps. Companies have become more patient focused and with Obama’s Accountability Care Act, physicians and hospitals are challenged more than ever. As long as reps bring value(and the good ones always do), there will be a place for them. When doctors succumb to path of least resistance to prescribe generics across the board, when there are better, newer medications available, then medicine will never progress. That will be a sure sign doctors have thrown in the towel and a day the Hippocratic Oath will dissolve, as that promise to deliver the best care for patients will be compromised.

  10. Ronny Weed
    Posted February 7, 2014 at 8:06 pm | Permalink

    I have been involved in the pharmaceutical, biotech and oncology sales world for 30+ years in sales, management and senior management roles. I completely agree with the comments by Mr. Norton. The “detailman” is a dying breed. The days of waltzing into a busy medical office and capturing 15 minutes of an MD’s time are vanishing especially when the RX companies developed the rep “mirror” system based on the “reach and frequency” selling model. For those unaware of this mechanism, drugs can have multiple indication and the big pharma companies decided years ago that hiring one rep for each indication for the same drug was somehow a good idea. So if you have an oncology drug indicated for breast, lung and prostate you magically see three RX sales people selling each one of those indications. It monopolizes the MD’s time on one drug. That crap is over. I can barely get 15 minutes with my own MD during my annual physical and they simply don’t have the time to waste with something as easily accessible as new drug data. As a patient, I object to an army of pharma reps handcuffing my MD with this model of stuffing the offices with reps and wasting valuable MD/patient interaction time. Now that the toys, trips, junkets and sham advisory boards are all taboo, any MD who takes a penny from a pharma company to act as a marketing shill to promote data to his local colleagues is a corporate whore in my book. The sunshine laws that will lead to lifting the veil on the dollars that MD’s take from RX companies will also have a chilling effect on the effectiveness of the “detailman” in a few months in 2014. Bottom line is that all the current RX reps will rail against my opinions and the article written by Mr. Norton just as the payphone makers in 1980 could not envision cell phones destroying their entire industry. The future will be online hubs for drug data, interactive websites and an expansion of the virtual medical specialty meetings. It makes sense – one sales rep costing $150K/year making 6 MD “touches” a day on a good day or an inside salesperson making 100 touches or a website making 500 touches a day. Where do YOU think the future lies?

  11. bunky65
    Posted February 8, 2014 at 12:57 pm | Permalink

    Some people just don’t want to face reality and have their head in the sand. The RX rep, as such, is on his way out. However, though that contingent is shrinking, what is being beefed up is the Clinical Consultative Specialist, someone who can actually “help” providers navigate the disease state, provide materials for patients that are relevant, connect people to each other, assist with the changing market place, etc. I have been in the industry for 13 years. I am glad to see the change. I often imagined myself as the doctor or nurse who got 5-10 visits / day from different reps. Oh Boy, I don’t think I could take it. I believe this is an inevitable change (fading of the traditional “primary care” Rep) and narrowing to fewer, more specialized, consultative Specialists (face-to-face). By the way, the “primary care” Rep has shifted into other disease states: Take a look at how many reps are out there with Oncology products. Can you imaging an Oncologist now having 10 companies call on him with 2-3 reps each? I am just not seeing that future.

  12. Biotrekker
    Posted February 10, 2014 at 7:05 pm | Permalink

    The job of the detail rep is that of a lobbyist. What the future holds will be impacted in no small by whether Obamacare leads to a national formulary. I’d say the chances of that are slim. The industry still wields considerable power in Congress and will continue to do so. Money still talks and always will.

    The number of reps will certainly decline. Anyone who has been in the industry in the past 20 years would probably agree that there have been too many reps in the field for years. The onc. example given above is dead on. There’s no need for a rep to work only with one indication on a multiple indication drug. So my view of the future is that reps will persist but will fewer people in the field.

  13. JVC
    Posted February 11, 2014 at 11:36 am | Permalink

    First, I have been in device sales for over 20 years and recently made the switch to Pharma for a more stable lifestyle and family reasons.
    I have worked, literally side by side with some of the pioneers of cardiac surgery as well as many cardiologist, hospital leaders and numerous IDN’s. I know both sides of the fence.
    Pharma is very different from device sales in that I am not in the room during procedures and not directly involved in patient care. I miss that.
    Where pharma and devices sales intersect is that there will always be the obnoxious and pushy rep that destroys the value that a relationship offers. Both industries have undergone change and as the pressures increase so does the bad behavior and thus the negative impressions.
    Another area where they are similar is the fact that healthcare is changing rapidly, guidelines, policy statements, quality measurements, physician pressure to do more and see more patients. The reassures are on everyone.
    That said, my job is to be self aware and know my boundaries. I’ve done this long enough to know when the timing isn’t right and thus when to walk away. I also know and feel confident in the fact that I bring value to the conversation as it relates to healthcare. I know what formulary coverage is, what the indications are for my products and what the clinical relevance and thus evidence based value of my products are.
    If I am truly good at what I do, physicians do not run away when they see me and in fact want to speak with me because they recognize I bring value that helps them and their practice.
    Of course there will always be change, and the potential for change, that is certain. If I had a nickel for every time I’ve heard the end is near(no matter the industry) I’d be rich!
    Finally, I would point out these closing observations:
    1. I am unaware of many physicians that have the time, now that they themselves have increased demands to see more and do more because they are employed, to look up on the internet specific drugs. The ones I work with complain they simply do not have the time given all the changes occurring in healthcare that are more pressing and have an impact on theim personally.
    2. As far as I know, there will still be many commercial plans( look up planprescriber.com to see how many offerings are in your specific zip code) available. Contrary to some beliefs, we have yet to move towards a socialized program and there are not enough generics per disease state to warrant a shift towards an exclusively generic based system.
    3. The “end is near” is great for eliciting drama and controversy. I’m glad for the opportunity to present another view point.
    In closing, we should all reflect of the various industries and professions that were on the brink of extinction, there are hundreds if not thousands of examples and yet, in some form or another most survive because they adapt. And if you don’t adapt, then yes you will surely go the way of the dinosaur.

  14. Doc
    Posted February 14, 2014 at 6:43 am | Permalink

    There will always be reps, just significantly fewer and moving forward, most will be PharmDs. They will evolve into a more Medical Liason position, which requires professional degrees in order to answer off label questions from providers. Their target list of providers will be greatly reduced to thought leaders and extremely high volume providers. Today’s rep can only spout the PI, no pearls or off label. The local reps managed care formulary knowledge is less important as what PBMs started, the ACA will finish – very strict limits on therapeutic choices with painful extra paperwork on the providers part for any non formulary choices. With more providers working for hospitals, etc access is already significantly reduced. A smart phone gives providers access to PI information when it fits their schedule, no need to see a rep. More samples are mailed and most every survey ever taken show free samples to be a primary reason providers see reps at all.

    With access restricted, formulary restricted, time pressure on providers, companies will figure it out, that they better be sending the most qualified people in to make visits and that means being able to have deeper medical discussions than the PI.

  15. Posted February 20, 2014 at 12:05 pm | Permalink

    At CMR Institute, we’re seeing the role of the healthcare sales professional evolve, and ultimately, that will benefit the industry by paving the way for more partnership and collaboration with our key customers. Today, payers, hospitals, large medical practices, and ACOs want to work with sales professionals who understand their business needs and can provide resources that will help them manage population health. The new breed of sales professional is really a hybrid account manager who can access company products and supportive resources to help customers address their ongoing clinical and financial challenges, such as readmissions, which affect quality and the bottom line. It’s an important role that doesn’t signal the end of the road for salespeople but rather a new road to follow for leaders in our industry.

  16. KFM
    Posted June 19, 2014 at 7:11 pm | Permalink

    I’ve been selling a biologic product now for over 7 years with additional 2.5 years of experience in headquarters. Like most other Fortune 100 “big pharma” firms mine has laid off a massive number of people, including thousands of reps. More blood-letting starts again next week. I agree with most of the authors points. I have a lot of friends in this business. Many if not most big pharma firms’ once great organizational culture of greatness has rapidly eroded and tarnished. What’s left is an industry that was once a shadow of its former glory. Yes, there will be reps around in the future. But, who want these jobs? They are mind-numbingly boring, repetitive, and robotic. Managed care has decimated the reps’ ability to influence physicians, and it will continue to dictate how this industry manages drugs and patients. Bottom line: I don’t know of a single colleague in “big pharma” who, if were laid off tomorrow, would even want to remain in this industry. Our CEO’s own daughter skipped working at our company and went to work for Google – and has had “meetings” in Hawaii (?). Why should I remain in this industry? Obamacare, managed care, a dearth of innovation, hardly any successful Phase III candidates, and painfully tiny amounts of access and time with MDs all equate to sales rep irrelevance and the long, slow extinction of this position. Every one of my peers has their resume ready to interview – and many outside this industry.

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