Pharma is in the spotlight again, but not for the right reasons. In a recent post on the Denialism blog, Mark Hoofnagle discusses John Oliver’s “Last Week Tonight” report about the influence of sales reps in the pharma industry. So what’s going on here?
I’m curious why pharma as an industry has become such a convenient whipping boy? In his post, Hoofnagle suggests that sales and marketing should be restricted in the pharmaceutical industry. He asserts that we should outright ban drug reps, and at the very least outlaw rep-provided lunch for the staff, because he thinks it's too influential.
Are people seriously suggesting that pharma is the one industry in which we should ban sales and marketing? Even setting aside the notion that sales reps have historically been an important conduit for new therapy information for busy physicians, how does an industry thrive and grow and provide a pipeline of innovation if it doesn't have a sales and marketing engine?
The Influence of a Pizza
Lunch has become the lightning rod for the critics. But let’s be frank, when pharma sales reps bring in food to a doctor’s office, it’s not gourmet food — it’s usually pizza or sandwiches. And the food usually goes to the office staff as a courtesy for sitting through a rep’s short sales presentation. Physicians are usually too busy to listen to a sales pitch. But regardless, I honestly can’t imagine that a physician who has been through four years of college, four years of medical school and three to seven years of residency and who has taken the Hippocratic oath is going to prescribe the wrong product for a patient because a rep brought in pizza for the office. Physicians deserve a bit more respect.
Doctors frankly don't have the time to see reps, and with more than 50% of doctors now working as employees rather than as partners or sole proprietors, many of them aren’t allowed to see reps anyway. Which is why pharma has laid off half the reps they had even five years ago. I don’t see contact with pharma reps as the dangerous issue that’s being portrayed in the media.
Sales & Marketing Evolution
Much of what’s being profiled about pharma sales practices in the media is outdated. Many of the clips of sales reps from John Oliver’s HBO show were several years old. The flagrant practices that catch the most attention — boondoggles with reps taking doctors on cruises — are long gone. The role of reps has evolved.
Previously, the job of the sales reps was to deliver an approved “sales verbatim” message to a doctor. Now they have become account executives, engaging with doctors on a different level. Reps are asking, “How can we help you?” They’re not just pushing brands or pills, an approach much more in tune with the practice of consumer-centric marketing.
Just last week, I heard a story of a physician who rarely interacted with reps. As she walked through the lunch room, a rep called out, “Hi, doctor. I’m not here to talk about drugs, I’m here to talk about services I can offer you for your patients.”
The physician spun around and said, “Okay, what have you got?” They spent a few minutes talking about programs to help patients, not about drugs. That’s the new world of the pharma sales rep. The staff meal had nothing to do with it.
The Real Issue
The real issue hidden in this debate is trust and transparency. When we put our trust in a doctor’s expertise, we want to know that any recommendations are completely impartial and not unduly influenced by a third party. We want to be certain that our physician is working exclusively in our best interest.
This is why there is a PhRMA Code already in place limiting the monetary value of what a pharma company can give to a doctor. Currently, sales reps can’t provide more than $100 worth of medically relevant goods or services to a physician per year, including items such as an anatomical model for educating patients. And any time a doctor receives anything of value, whether a medical textbook or a latte, it is posted to a federal website. Sales reps aren’t buying doctors $200 steak dinners.
We can trust our doctor.
There are many important healthcare issues that need healthy debate today, such as access, pricing, outcomes vs. fee for services, etc., but whipping the pharmaceutical sales rep isn’t one of them. It’s an unnecessary distraction.