Great article and so true. The future pharmaceutical field "sales" force will consist of low paid customer service reps who do nothing more than distribute samples and drop off the occasional patient education piece and who will not even be allowed to engage in any kind of clinical discussion with a customer. The sad part is, that 20 years ago, the pharma companies held the cards in that they controlled their products and how they were marketed because customers wanted and needed useful therapies for their patients. Then, as an industry, they began to shoot themselves in the foot.
In the 90's the "me too" phenomenon took off when companies realized that, instead of truly innovating and developing new mechanisms of action and unique solutions to customers, they could make enormous short-term profits by changing an insignificant segment on an existing molecule give them a "unique" product that used the same mechanism of action and had the same safety profile and efficacy rates as every other drug in the class. I remember selling Zestril when there were at least a dozen branded ace inhibitors on the market and this was happening in every class of drug for almost every therapeutic area.
This lead to the insane idea, propagated by so-called experts (consulting firms), of share of voice, which brought us armies of sales forces, with 10 or more reps from every company calling on the same customer. When this wasn't enough the late 90's also brought the advent of DTC advertising, marketing abuses inherent with large under trained sales forces and advances in electronic communication that offered customers access to information without the need of seeing any of the dozens of drug reps lined up in their waiting room. How many of us are ashamed of this industry when we have to, with our children, sit through a commercial that discusses erectile dysfunction or dryness during intercourse during prime time? Or that idiotic Go Crestor! guy? Is it any wonder we were losing credibility and pissing off our constituency?
With all of this going on, insurers had no choice but to begin to limit their formularies as a way to try to control premiums and the insurance companies gained more power in the marketplace. Government control, while always being a factor with Medicaid, the VA, FDA and DEA, grew exponentially with the introduction of Medicare Part D in the early 00's. Governmental pressure also played a role in the development of the Pharma guidelines for product marketing, which drastically limited the scope of marketing and sales activities and made the job of a pharma rep less relevant even as companies continued their hiring frenzy in the interest of greater share of voice. Oh, and by the way, Medicare Part D is proof that Republicans believe in big government intervention and control every bit as much as the Democrats do. But I digress. Now we are faced with the reality do Obamacare and the certain eventuality of a single payer system which will signal the end of the industry as we know it, the end of innovation in truly new products, and the end of thousands and thousands of high paying careers in the industry.
All the while, our leadership was constantly saying things like "we believe this is a good thing as it will drastically expand our potential market", or "we sant to participate in the negotiation process because we feel that if you don't have a seat at the table, you'll end up being served as the main course".
And now we don't hold any cards. The insurers hold some and the government holds the rest, because for the last 20 years, while Rome was burning all around them, industry leadership refused to take a stand and like Nero 2000 years ago, fiddled.
Agree. Hospitals are next, as the old 'fee for service' days are ending. Hospitals used to lick their lips when they discharged some patients, because they know that like prisons, those discharged would be back soon. Now that there is a penalty for re-admissions within a month AND everyone is hip to hospital's game of shifting DRGs for re-admitted patients, they are staring at massive reduction in income in the next 3 years.Pharma co's are old line (100 yr old companies) with a monkey see-monkey do, herd mentality. The USA has been the last happy hunting ground worldwide for past 20 years. That's coming to an end.. Now the cubicle ranches in HQ are wondering what to do next..(We're in good company.
The docs and hospitals are also seeing their part in the healthcare party end as well..people are starting to ask the dreaded question of "how much does that cost?" now that their deductibles are going up)...the open bar is closing soon for healthcare here.
The majority of massive health issues; hypertension, diabetes etc can be treated in 75%+ of patients with cheap generics. The future of pharma sales is orphan type drugs, where the number of reps is very small. The target audience is small, prices are high to justify any size salesforce. Small molecule, blockbuster drugs for large population diseases will become the exception not the rule.
This scares me. I need at least another 20 years. Do you think I'll get it?
I just simply can't believe that Pascal thinks we need a sales force as huge as the one we have now. He HAS to be planning significant cut sometime in 2014. Twice last week, docs mentioned to me that we have too many reps pushing dapa, etc.! Nexium will be off patent in a few months, followed by XR and Crestor by 2016. Huge losses for AZ with nothing to replace them. Ooh, I forgot the constipation drug. Go ask Takeda how Amatiza is doing in that market!
The need for large sales forces has past. The model should and has to change. It will over the next few years.
Yeah, Malaria only kills about a million a year, not to mention dengue and plenty of others. Is it any wonder that Rx representatives don't get interviewed for other jobs, when they're living in an utter complete bubble?
True, Malaria , Dengue affects millions of people worldwide BUT..that potential market is also located in the POOREST parts of the world..pts. who's average income is $150 per YEAR aren't going to make you rich. Look at the HIV products and political drama of pricing to get product to those places..NO REPS NEEDED HERE..negotiations will be with individual countries (GOV"T CONTROLLED PRICING) and major NGOs (ie. World Health Organiztion, Gates Foundation etc...)..not many cases of these diseases here in the States...a small team can handle Charity pricing to those locations and win big money while not looking like their screwing out the pitifully poor countries. So until global warming kicks in good, with swarms of malaria borne mosquitoes hitting the mainland USA, us reps still won't have anything much to sell.
True, malaria, dengue, tuberculosis, even HIV, are primarily diseases of poorer developing nations with little money to spend for pharmaceuticals and healthcare. These people are not the target of Pharmaceuticals.
What Pharma wants are diseases like hypertension, hyperlipidemia, diabetes, heart disease, things that are treated for the long term where you can get on a pill and stay on it, yippee ki yay!, filling the coffers of execs and shareholders alike.
A little charity looks good now and then, but even that in the way of medicines seems to be getting stingier.
Profits First!
Yeah, you're right. Treatments for all of the conditions you listed aren't necessary, until you have a heart attack, stroke or amputation due to not taking your meds. Idiot.
Not doing this you won't. ObamaCare is the final nail in the coffin. Soon we will have a National formulary like European countries and the government will pick winners and losers not the Docs. They don't want to pay doctors and nurses for treating patients and you think they will be willing to absorb the cost of marketing and sales in the drug costs? Ain't gonna happen. We will be as extinct and useful as a VCR and Cassette player.This scares me. I need at least another 20 years. Do you think I'll get it?
Not saying you don't need to treat them. Think about it though - hypertension, hyperlipidemia, diabetes, heart disease, strongly related to developed countries where excess is possible.
Convert currency?? We get paid in dollars, Euros, Yen or Swiss Francs, those poor countries in Africa don't have any of the above , they are broke, they can't pay Period. Sure we'd get brownie points for a miracle drug..then we'd get hammered in press and politics for not giving away Free this miracle drug that took $$$$ to discover...Easier to come up with the 5th product in class for Hay Fever and make more money.
My training when I joined specialty biotech 17 years ago was three months of study and memorizing 147 studies plus several PIs. This is a far cry from the message responding today.
