Wow, complete stupidity! Entresto, nationally is on over 90% of the hospital's formulary. Also, it doesn't cost the hospital 500 a month. If you understood the hospital sales process, which you clearly don't, you would understand that patients are given 6 pills (at most) during their length of stay. This equates to $40 for the stay. Entresto doesn't even make a hospital pharmacy top 50 spend. So, cost is a non issue. Cards are the biggest users yes, but the mid-level providers, and in some cases, the hospitalists are instrumental in identifying and starting patients on after a consult.
The reality is, the TOC process and having providers do something different in the world of heart failure during a hospitalization is the challenge. It is called medical inertia and apathy.
More importantly, the company has decided to have way too many people calling on many of the same customers with absolutely nothing new to talk about. Couple that with 2 day ride alongs every 3-4 weeks, and excessive micromanagement. This dynamic exists for both the hospital and CV salesforce's. HAS' try to have their providers initiate inpatient, while the CV side chases signatures and fakes calls... it's all nonsense