Last week brought a small but dedicated group of sales professionals to a CBI conference in San Diego with a clear mandate: to rate the future of the “detail man” — dead or alive?

Surprisingly, the consensus was that the function still retains its value, even as e-detailing and other online technologies are transforming the traditional way the industry interacts with healthcare professionals. One interesting data point is how provider attitudes toward working with sales representatives vary with the nature of the practice: survey research presented at the conference showed that while roughly a quarter of all physicians in the US now ban rep calls, including the bulk of all primary care professionals, 74 percent of specialist physicians still prefer that face-to-face contact.

What matters today is the relevance and quality of the interchange, and what physicians want most is the most current information available on the progress of clinical trial studies. This is no doubt a consequence of pressures from patients, which is why a key element in the curriculum of the new sales rep should be how to  build ties to disease groups and patient advocacy organizations. Another trend is making the rep more engaged in market access support through better awareness of the reimbursement policies and options set forth by payers. As this task of “fighting the insurance companies” takes a good deal of a physician’s time, the ability of the rep to synthesize and explain the rules on P&R can free the physician for the clinical interventions that save or extend lives.

The other topic for debate was the merits of GSK’s new formula for calculating performance bonuses among its US sales teams. It focuses heavily on informal feedback from healthcare professionals as to the quality and breadth of information received from the individual rep, rather than the traditional approach based on hard targets like scrip volume within each rep’s territory. GSK says its compensation plan will significantly reduce the potential for compliance problems, such as when sales reps skirt illegal behavior by promoting off-label prescribing.

That said, participants at the CBI event asked whether customer feedback is sufficient to ensure that the process of awarding bonuses will be objective and transparent. What happens when this subjective assessment of performance is at odds with the sales and revenue numbers? And does any of this really matter when payers are driving the agenda so completely in managing pricing and access?  There were no hard and fast answers, except for the premise that the safest ground is for the rep to link his own performance to the interests of the patient in getting timely access to the right drug at a reasonable price.

The survey incorporated responses from more than 4,000 physicians worldwide. Reps were rated on a number of criteria such as objective and ethical behavior, quality of medical information, and professional relationship. Physicians were asked to rank the leading three companies by the above criteria, according to their experience and perception.

In India, when physicians were queried about “quality of professional relationship”, domestic companies received better ratings, with Mankind, Cipla, Lilly and Lupin topping the rankings; in China, doctors rated domestic player Yangtze River well when it came to objective and ethical behavior, but also gave high marks for western companies like GlaxoSmithKline, Merck, and Pfizer.

In Brazil, Eurofarma, GlaxoSmithKline and Bayer scored best among secondary care specialists, while in Japan, when asked about quality of information provided, primary care doctors gave Tsumura, GlaxoSmithKline, AstraZeneca, Takeda and Shionogi the highest ratings.

“[T]he companies that have risen to the top have honed their ability and skills in terms of what doctors want,” Christopher Wooden, Cegedim Strategic Data’s director of global sales and marketing told Pharmaceutical Executive. “In the emerging markets they are taking their experience with them.”

For further survey results, click here.

A spokesperson told Pharm Exec that some reps will be moved to the company’s expanding vaccine sales group. Additionally, GSK will be designating its North Carolina location as its sole headquarters.

While some pharma companies are moving to a geographic sales structure, GSK chose to reorganize reps by therapeutic areas. “In the past, some of our teams were organized by where they reported to, whether it be Philadelphia or Research Triangle Park,” GSK spokesperson Mary Anne Rhyne told Pharm Exec. “Geography is still a concern in terms of making sure that reps are in the right places in the country, but we think this plan will allow us to provide healthcare professionals with more of the specialized information that they are looking for.”

For example, a rep could visit with a doctor and discuss all of GSK’s respiratory medicines instead of just Advair. This gives the company a corps of specialized sales reps who know a lot about a few drugs rather than a little bit about everything.

There are no plans to outsource positions to a contract organization as other pharma companies have recently done.

“This is about trimming the people that we have and making sure that they have the absolutely best training to offer this kind of information,” Rhyne said. “Our marketplace and portfolio are evolving. In the past year we had four different medicines that we lost to generics, but at the same time, we’ve added two new vaccines in the last quarter, and we’ve launched six different products in the last year. We need the kind of flexibility to be able to take those medicines to the sales staff so they can talk to the doctors about them.”

The restructuring is expected to be complete by the end of the year. GSK recently restructured its oncology division by merging the discovery and development divisions.

Correction and Update: GSK will not be eliminating its Philadelphia branch. The company has designated North Carolina as its headquarters but we will continue to have a significant presence in Philadelphia. No employees will be moved or released from the Philadelphia location.