How is the Krystexxa launch going

Anonymous

Guest
I heard the training is over and you started the launch few days ago. How is it going?
I was very close (in my opinion at least) to get one of the positions, but it did not work out. Oh well.

Good luck.
 
























Honestly, what is an easier job. Selling a novel, one of a kind, specialty drug and working through reimbursement with relevant stakeholders, or selling a Statin in a crowded market with a specialty that doesn't want to deal with another rep for perhaps the rest of their careers.

Let's not overrate what we do on a day to day basis. Some of us have been lucky with good formulary coverage, large teaching medical centers, etc., and that combined with hard work will eventually take an average rep/manager to the top of the heap. Appreciate what you have, because it could be gone in a flash due to circumstances beyond our control. However, if you let past success go to your head, well, there may not be many people willing to help you/us out if things don't work out here after all.
 






Honestly, what is an easier job. Selling a novel, one of a kind, specialty drug and working through reimbursement with relevant stakeholders, or selling a Statin in a crowded market with a specialty that doesn't want to deal with another rep for perhaps the rest of their careers.

Let's not overrate what we do on a day to day basis. Some of us have been lucky with good formulary coverage, large teaching medical centers, etc., and that combined with hard work will eventually take an average rep/manager to the top of the heap. Appreciate what you have, because it could be gone in a flash due to circumstances beyond our control. However, if you let past success go to your head, well, there may not be many people willing to help you/us out if things don't work out here after all.

Please explain what you mean by could be gone in a flash ? You'd still need reps if a buyout occurs.
 


















Please explain what you mean by could be gone in a flash ? You'd still need reps if a buyout occurs.


If a "buyout" occurs, which is highly likely and the reason we are even here now, then we are gone, the lot of us. No company is going to buy a salesforce, they want the drug and the expanded indications NOT THE SALES REPS. The last thing any company needs is reps! We are here to pad the spreadsheets for the investors to see "penetration", so Krystexxa looks better on paper, they had to have a temporary sales force at least attempt to sell this and they are using us like pawns for metric reports. But that was part of the deal, I am not complaining, I use them just as they use me. Part of the game, this industry is not what it was 10 years ago. It is all about making it look good on paper for the street and hope that another big pharma swoops in and over pays on the stock and makes the board and CEO rich, and we will be tossed like yesterdays news in a heartbeat. That is how this works. Most of us have been through this before, many times.
 












And just who is going to tie up that much $ for even just 1 or 2 patients in the hope of being reimbursed 5-6 months later ?


I agree, all of the targets I have been super blitzing are gun shy on this cost and reimbursement snafu, as aspected. They all tell me, we can treat their gout like we always do, which is basically blowing down the flares and using the generics, there is no hurry in their eyes and that is all that matters, we can wait until Krstexxa gets some real coverage with our few patients that we would consider infusing at some point.....this has been the status quo from the clinics and leading teaching institutions, the comm. base rheum simply just laughs and says "who is paying for this", thanks for the free lunch, see you in 4 weeks.......my major hospitals and health networks will take a long time and will have to be convinced on cost and reimbursement ratios, they will not eat the cost anymore like they used to, especially now with the economy in the crapper. that the community at large will adopt this new protocol and that will take a long time. I just wonder if we will have jobs by then. Probably not, they need business now, not in 6-8 months. My RBD is a bit of a kook and does not understand this will be a long cycle product and that it will be baby steps to even get this in front of the right people. Based off his comments, we do not have time to walk doc's through, it is put up or be moved out mentality at this place.
 






I agree, all of the targets I have been super blitzing are gun shy on this cost and reimbursement snafu, as aspected. I just wonder if we will have jobs by then. Probably not, they need business now, not in 6-8 months. My RBD is a bit of a kook and does not understand this will be a long cycle product and that it will be baby steps to even get this in front of the right people. Based off his comments, we do not have time to walk doc's through, it is put up or be moved out mentality at this place.

Also agree for the most part.There are pts out there; some good coverage policies too, but docs not wating to tie up their $ for months and months. Can you elaborate: How do you mean by not having the time to walk docs through this, but it's put up or be moved out ?
 






Also agree for the most part.There are pts out there; some good coverage policies too, but docs not wating to tie up their $ for months and months. Can you elaborate: How do you mean by not having the time to walk docs through this, but it's put up or be moved out ?


I can add to this as well, and agree that this is a micro managed culture, I knew that going in so not a big element of disappointment there at least not yet. I can still tune him out while I look for a better option and continue to get paid. My docs so far are not so down on the drug, my biggest guys see a need for a couple of patients, its funny they can name the couple of patients they have in mind for this in a second, but I don't feel like they will ever be on product as these same docs are also the most skeptical when it comes to them buying and stocking in their practice and then not getting the results or being able to talk the patients into it. Most of the patients are controlled or when they flare, they can put the fire out without Krystexxa. That is the biggest problem I have heard so far, they think it is a nice little option but "little" being the key word. They view it is a light as a last resort and a resort that has uncertainty with coverage. I have had 2 offices call the hotline for reimbursement assistance and they were told that they were just gathering the patient info and then calling the insurance for the patient, that is not doing much of anything but eliminating a step for the MA who already do this all day long. Our hotline will not be much of a help in securing coverage they are basically admin secretaries calling insurers on behalf of the patient, that will not help with a reimbursement. The second piece is the big one, the hospitals are not playing this game with pulling in product either, they are not going to budget in losses like they did with rheum's in the past. The last product I sold the hospitals absorbed a portion of the cost, that will not be the case with this and it has me very doubtful on the launch. Just my 2 cents, what do I know, I am just a peon rep lucky to have a job when so many I know have been unemployed for 6 months with no offers or interviews!
 






I can add to this as well, and agree that this is a micro managed culture, I knew that going in so not a big element of disappointment there at least not yet. I can still tune him out while I look for a better option and continue to get paid. My docs so far are not so down on the drug, my biggest guys see a need for a couple of patients, its funny they can name the couple of patients they have in mind for this in a second, but I don't feel like they will ever be on product as these same docs are also the most skeptical when it comes to them buying and stocking in their practice and then not getting the results or being able to talk the patients into it.

How is it already micro managed ? it's not a mass market drug.
 






And just who is going to tie up that much $ for even just 1 or 2 patients in the hope of being reimbursed 5-6 months later ?


That is the posters point, very few docs will put up the cash and then play russian roulette on getting a proper or profitable reimbursement. Those days are long gone, the rheumys are now wise to this racket. At least my RBD is aware that this a a niche limited use product and for now understands that the reception and adaption rate will be slow and the docs from the clinical trials who had patients on drug are really the only business that Savient will see up front. I just worry how long we have, the pressure is high and we are getting paid a truck load of money to make miracles happen, for those of us who have been around, we know that the knee jerk reaction by management could mean we are all replaced with "rent a reps" and a contract sales force is the near term if the big K does not start rolling in a quick pace.
I got a bad taste in my mouth about this already, hopefully they cut us slack with no managed care and the fact that we launched with no resources and support in place for reimbursement. I doubt it though, this is a dog eat dog company and the track record of the RBD's are unimpressive at best, which makes even the most confident reps a little twitchy as the hands behind the trigger are non trustworthy. But that is this business now a days.
Its all going to contract reps and short term temporary hires who can be dropped at a moments notice, its turning into the NFL, no contracts and non performance at any level will be a ticket out of the league and lets be honest Savient is not exactly the NE Patriots!!! It is more the Grand Rapids Rampage of the minor league arena league!!
 






If a "buyout" occurs, which is highly likely and the reason we are even here now, then we are gone, the lot of us. No company is going to buy a salesforce, they want the drug and the expanded indications NOT THE SALES REPS. The last thing any company needs is reps! We are here to pad the spreadsheets for the investors to see "penetration", so Krystexxa looks better on paper, they had to have a temporary sales force at least attempt to sell this and they are using us like pawns for metric reports. But that was part of the deal, I am not complaining, I use them just as they use me. Part of the game, this industry is not what it was 10 years ago. It is all about making it look good on paper for the street and hope that another big pharma swoops in and over pays on the stock and makes the board and CEO rich, and we will be tossed like yesterdays news in a heartbeat. That is how this works. Most of us have been through this before, many times.


Exactly. Ditto. Whatever term you want to use, this is spot on. What exactly are our "reimbursement teams" that HO deployed doing on a daily basis? smoke and mirrors. I could give them a list of 25 docs who need an immediate visit from our "specialists" that are supposed to be out in the field storm trooping the big guys.

This seems like a bullshit ass backwards rodeo to me, have heard my teammates make similar comments. This baby is torpedoing into the abyss. I love how the "reimbursement hotline" does nothing but write down patient info and then call the insurance company who then says we do not cover this product and gives them a laundry list of options for a medical necessity letter to be submitted on the denied claim. I do not know one doc who is going to sit back and wait for that bullshit process to play out, they will easily just move back to what they were treating with or tell me to get the fuck out of their office and stop wasting patient time with non covered junk infusions for 3 of their patients out of 1000. What did I get myself into to? Dumb dumb dumb, and I had a real job unlike so many who took this job out of pure desperation.

The way I see it we have a few months until the brass pull the cord on the bloated salaries and bring in contract reps. I hear that was a very real consideration back in November but did not have time to contract that out with Ventiv, PDI or Quintiles. Shit they could have already revisited that idea and we wont know until the emails hit our box with the news.
 






Exactly. Ditto. Whatever term you want to use, this is spot on. What exactly are our "reimbursement teams" that HO deployed doing on a daily basis? smoke and mirrors. I could give them a list of 25 docs who need an immediate visit from our "specialists" that are supposed to be out in the field storm trooping the big guys.

This seems like a bullshit ass backwards rodeo to me, have heard my teammates make similar comments. This baby is torpedoing into the abyss. I love how the "reimbursement hotline" does nothing but write down patient info and then call the insurance company who then says we do not cover this product and gives them a laundry list of options for a medical necessity letter to be submitted on the denied claim. I do not know one doc who is going to sit back and wait for that bullshit process to play out, they will easily just move back to what they were treating with or tell me to get the fuck out of their office and stop wasting patient time with non covered junk infusions for 3 of their patients out of 1000. What did I get myself into to? Dumb dumb dumb, and I had a real job unlike so many who took this job out of pure desperation.

The way I see it we have a few months until the brass pull the cord on the bloated salaries and bring in contract reps. I hear that was a very real consideration back in November but did not have time to contract that out with Ventiv, PDI or Quintiles. Shit they could have already revisited that idea and we wont know until the emails hit our box with the news.

Contract reps for orphan drug? doubtful.
 












Contract reps for orphan drug? doubtful.



Extremely possible. Why would this be doubtful. Many companies of late have hired out contract reps for very small sales forces and products. There are big time advantages in the current day pharma model with contract reps and full contracted out sales franchises, times have changed dramatically in this area over the last 2-3 years. . I agree with this poster 100%, if Savient would have had more time to make a decision and have to throw together a sales team at the midnight hour, I think the contract rep idea would have got major steam and would have been a realty.

It would not surprise me to see this around the horizon in the near term. If this goes as slow as it appears to be going, contract reps make a whole lot of business sense and new CEO has been around the block and seems to be one who will adapt to the new industry trends a lot faster than other people that were on board here before.

I loathe the idea as much as you as it would be our fate but I also think the possibility is very real for a product like this and a market like this. Savient was not crazy about even hiring the 60 of us and the RBD's, if they had more time I think they would have done things differently with staffing and launch plans. I base this on the conversations I have had with more tenured Sav. people than myself and a RBD who really seems to get this place much more than the average bear.
 






The truly insane thing here is that the same guy is actually having an online conversation with himself in the middle of the day !!!!

Give it up !



Hey RBD you are a fucking stool pigeon POS. I was in an office today sitting in the waiting room with 3 other reps and 2 of them were on their Blackberrys and posting away on cafe pharma as well and we all had a good laugh. Time of the post no longer carries any reference, mid day posting is irrelevant with modern technology, everybody has a smartphone and reps post on this board at all hours, why because they can and it is funny to hear managers try and claim that the time of the post has anything to do with the truth behind it. Fuck off. Tomorrow at 2pm when I am yet sitting in another waiting room with my Iphone waiting for a doctor to ask "where do I sign", I will post a special hello to you during "work hours". Asshat.