The Death of Pharmaceutical Rep Detailing?
Posted on 26. Apr, 2011 by Tom Young in Health, Pharmaceuticals
Most prescription pharmaceutical and therapeutic devices are marketed through “details.” Traditionally, detailing involved a personable, well-dressed professional visiting a physician’s office sharing news, clinical results and product samples with a physician. The meetings involved a good amount of banter and were part of a cordial relationship. In the modern era, detailing became sophisticated and personalized, where very compelling messages were tailored for specific doctors.
But somewhere along the way, there was a counter-reaction to detailing, and it has become a lot more difficult.
Source: Jupiter Images
Looking back, we saw the first wave of doctor resistance starting in the late eighties and nineties, maybe earlier. This seemingly-principled action from certain doctors criticized the relationship and generally revolved around the idea that patient care and the doctor’s integrity were compromised when the doctor is getting pens, pads, free lunches and much more from detailers— and taken to extremes and made famous in the recent movie “Love and Other Drugs.“ There is a history of abuses— doctors listening to drug information as the detailer gases up the physician’s car— but these early “detail rejecters” were on the fringe. As commentary, we would suggest that in cutting off the line of communication with the pharmaceutical manufacturer, these doctors lost more than they gained. The percentage of doctors who ended relationships for this reason is assuredly in the single digits.
Economic Rejection – Managed Care Boxes Doctors In
The next wave of detail resistance started in the nineties and continues to this day. The driver of this wave was the intrusion into clinical practice by managed care companies in the name of cost-containment, which has resulted in increased doctor workloads and intense pressure to complete clinical tasks quickly. Insurers started looking very closely at doctor billings and set firm reimbursement rates. They also brought into play multiple models for reimbursement, and in some markets started managing the healthcare delivery process with integrated delivery networks, where the insurer is the doctor’s employer. At this point, there is hardly a consumer out there who cannot tell you the difference between “in-network” and “out-of-network.” As doctors’ workloads increased, detailers have become less welcome in their offices and in hospital hallways – nothing personal, pure economics.
So now we see offices where detailers are invited to drop off samples with staff, but see doctors only within a specified time period, or not at all.
For Pharmaceutical Marketers Who Rely on Detailing, It Gets Worse
A third wave in the battle against detailing is happening within the hallways of pharmaceutical companies. We know, for example, that ten years ago, there were about 40% more detailing representatives than there are now. The doctor-to-rep ratio has gone from 6-to-1 to 10-to-1. At the same time, as we are seeing doctors decreasing access, there is quite a bit of evidence that when a doctor sees a rep, it is for less time – in our surveys, we see a little more than half of the consummated discussions last four minutes or less.
That the number of detailers has decreased shows that pharmaceutical companies have accepted that there are alternate marketing channels. Even where there is not an alternate channel readily available, sometimes the best solution is to keep marketing dollars in pocket. The third wave is exactly that: the requirement that detailing’s ROI is demonstrable and clear, in an environment where that ROI is probably decreasing.
So What Keeps Detailing Going?
Source: Pharmainfo.net
There is much to admire about the detailing process. Every piece of information that a detailer may share with a doctor has been through intense scrutiny by the manufacturers and by regulators. And detailers tend to be very on-point, diligent and professional.
We like the elegance of the detailing system. For doctors who get to know their detailers, there is a wonderful two-way communication conduit, and a place to turn for more information when needed, and an ally when dealing with side effects, a refractory patient or an otherwise tough case.
Our business has us looking at the economics of detailing for our clients, and we know from experience that most detailing is cost-effective when the number of details is “right-sized.” Better detailing strategies often involve smaller sales teams covering larger groups.
In pharmaceutical companies, the culture favors the detailing experience. There is no doubt that experience talking to practicing physicians is very valuable, and many pharmaceutical companies look for that experience for their managers. At times, this leads to “detailing-centric” decisions, and accounts for situations where resources should be allocated to other marketing channels.
And doctors still are voracious information consumers – especially for professional information. We recently tested a “grab-bag” of early-stage (Phase IIIa or earlier) drug concepts with doctors. Doctors rejected some of the ideas and were accepting of some, but a full 78% of doctors told us that they would “definitely seek more information” about these drugs.
Another thing we have the opportunity to see is concept rejection by doctors. Our tests show that the foremost reason a physician rejects a drug is their assessment of inadequate efficacy. The second reason for rejection is that the product profile “shows nothing different or new” compared to existing drugs.
Is there a Silver Lining ?
Doctors need to be offered a better deal in the detailing exchange. This means that their time must be viewed as valuable, and that manufacturers need to strive to always provide new information. If you think about it, the detailer who comes in, does a psychological profile on a doctor and reminds him to prescribe Brand X to the next patient meeting a certain profile, without imparting any knowledge is not really focused on the doctor’s or the patient’s needs.
We suspect detailers would tell us that having new, relevant material is a very high bar. We agree, but it’s better than the alternative.
