The downside: No company cars, much more actual work, a lot more late nights, and you'll spend a decent amount of time putting out fires or struggling with clinician availability. Home health patients need to be seen within a couple of days of discharge and you won't always have the staff. A lot more playing politics and a hell of a lot more competitive.
The upside: much more actual work (pharma is mind-numbingly boring in comparison), way more freedom, a lot more actual control over your own numbers, how hard/smart you work will directly affect how well you do, as opposed to pharma where it rarely makes a difference. You get to interact with patients and families, and you learn a hell of a lot more about actual, in-the-trenches health care.
I spent six years in pharma, and while it was the easiet part-time job I ever had (I don't think I ever was in the field before 10am and never home after 5), I was bored out of my mind. Doctors don't want to hear about the same drugs for years on end and I didn't want to talk about them. It became nothing more than signature chasing, sample-dropping and box checking. I was a caterer with drugs.
I've been in home health for almost a year and while at times it's frustrating and stressful, I actually enjoy what I do. I feel vindicated and rewarded when I see my first referral from a customer I'd been working on for months. My bonus structure is fixed (not dependent on rankings) and can be very lucrative when everything hits on all cylinders.