Because the pharmaceutical industry advances rapidly, there are always new products to research. Pharmaceutical sales representatives have distinct personalities. They are dominant, persuasive, and motivational.
Does this sound like you? Take our free career test to find out if pharmaceutical sales representative is one of your top career matches. A pharmaceutical sales representative may work out of a home-based office and a company car, and may be required to check in at a regional or local office. In addition to the daily physician visits, pharmaceutical sales representatives may be required to attend sales meetings, conference calls, or training sessions with the management team.
Forty-one percent of pharma reps agree that attention to detail is a key characteristic necessary to excel in their field. That discrepancy in our research was surprising and indicates that pharma sales managers should address attention to detail in their coaching sessions. The need to track, understand, and explain complex scientific information means managers should place their detailed-oriented reps on their challenging accounts.
Unfortunately, pharma sales managers may need to work a little harder to convince reps that coaching will improve their sales outcomes. Sure, pharma reps have to keep scientific and government regulation knowledge top-of-mind. But to close a deal, they need top-notch sales skills.
A harried manager may have a tendency during a one-on-one session to get right down to business. He or she might ask what happened during the most recent video call with the HCP. When the rep admits the HCP missed the meeting, the manager might respond that he or she never had those kinds of problems when selling.
Some reps will take that response as a challenge and work harder to follow up with the prospect. Other reps will pull back, feeling the manager is insensitive and impersonal. To be more effective, the manager should review the communications tips provided by the assessment results and modify his or her style.
Doing so can mean the difference between an effective and an ineffective coaching session. Doctors who ask their expert colleagues for help will also pay attention to which pharmaceuticals those experts are prescribing and often follow suit. In some markets, reps will sell to solo practitioners who need help understanding the latest research. In other markets, reps will work with doctors at academic research institutions who need no explanation about the benefits of a new medication; instead, they are concerned about insurance reimbursement and whether their patients can afford the medication.
It is important to coach reps on how to identify the right decision-maker. To make the best impression on busy physicians, reps should tailor their pitches to each practice and the kind of patients being seen.
Managers should coach them on how to succeed. To repeat: One thing pharma reps can count on is that HCPs want positive outcomes for their patients. And long video pitches? There is evidence that exposure to pharmaceutical promotion — including contact with sales representatives — has an adverse impact on prescribing habits.
Many observational studies have found an association between prescriber reliance on sales representatives and more frequent or lower quality prescribing.
See the following references for more on this topic: De Bakker et al. The more a prescriber has contact with the pharmaceutical industry, the more likely he or she is to recommend that a medicine be added to the hospital formulary or essential medicines list — even when such new medicines represent little or no therapeutic advantage over those already available and cost substantially more Chren et al. The authors of this chapter are not aware of any studies that have found an improvement in the quality of prescribing associated with exposure to sales representatives.
Tape recordings of sales representatives visiting doctors in Australia show that they frequently use five of the main types of influence techniques that have been identified by social psychologists. Roughead et al. The techniques used to influence health professionals have been discussed in Chapter 2, but the main points relating to sales representatives are reinforced here.
The relationship that develops between a sales representative and a prescriber or dispenser is often based on reciprocation. This is, in turn, based on the creation of a positive relationship between individuals Oldani, It is natural for this to create a positive response. Humans are flattered by such attention and generosity — particularly when they feel it is deserved, given how hard they work, often with what may seem like inadequate recognition.
It is normal for gifts to automatically lead to a desire to reciprocate, by providing something in return. The health professional may, for example, agree to prescribe or sell the medicine being promoted or just agree to give the representative a good hearing. Large gifts are more effective than small gifts at changing the immediate behaviours of larger numbers of people.
Small gifts, however, may be more effective at changing attitudes than large gifts. A common feature in some countries is that sales representatives offer prescribers and dispensers samples of the medicines they are promoting. The assumption is that these samples will be given to patients, particularly ones who are unable to afford them, thus saving them or the health system money.
Samples of expensive new medications are often provided, which may lead providers to prescribe these same agents to other patients. It can be difficult to change patients who receive such samples to other, less expensive alternatives once the samples are no longer available. This may result in the faster and more extensive adoption of expensive new medicines.
Some countries, such as South Africa, have banned the use of sampling altogether Republic of South Africa, Individual institutions have also done so, as reported by MacKinnon As noted earlier, some commentators suggest that providers can meet with sales representatives, but that for this to be productive and ethical, it must involve some form of critical engagement Day, It suggests asking for the data sheet or package insert approved by the medicines regulatory authority and comparing what it says with what the representative says.
It also suggests that the areas that should be questioned critically are:. In order to engage critically, one must evaluate evidence in a systematic way. Some additional material about evidence-based medicine is provided in Chapter 8. Instead of leaving the choice to individual health professionals, many institutions have tried to develop policies to govern the interaction between their staff and students and sales representatives and their employers.
An example of one such policy document is provided in Box 3 at the end of this chapter in the student activity section. In reality, however, physicians and pharmacists face a choice Doran et al. The avoidance approach is based on the view that health professionals and the pharmaceutical industry serve interests that sometimes overlap, but may also conflict.
Is it not better to use the time instead accessing independent, unbiased sources of information? A similar argument has been made in relation to continuing medical education Relman, The other option that has been discussed is to continue to see sales representatives but to try to engage critically in the process, to pose questions and assess the information provided.
Rules of engagement might include some or all of the following:. Institutions offering undergraduate and postgraduate education to health professionals such as residency or specialist training programmes have expressed concern about the potential impact of unregulated contact between their staff and students and the pharmaceutical industry Sandberg et al.
In contrast, there is evidence that prohibiting contact with representatives leads to more skeptical attitudes McCormick et al. The same can be said of pharmacists. Although there are programmes at some institutions to educate students about pharmaceutical promotion, they are still few in number Mintzes, This chapter hopes to have achieved the same aim — to have unsettled long-held views and to have provoked critical thought and debate.
Find evidence. Outline the evidence that exists for the impact of pharmaceutical representatives on professional practice e. To do this, students should break into small groups, each working with two or three of the references listed below. All of the groups should present their findings to the rest of the class. Based on the example of the university hospital policy provided see Box 3 , develop an appropriate policy for a community health clinic or an educational institution on dealing with pharmaceutical sales representatives.
The following reading materials may also be consulted:. Do drug samples influence resident prescribing behavior? A randomized trial.
American Journal of Medicine , 8 : Asundaria, P Pharma marketing — but how? Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis.
Visits from medical representatives: Fine principles, poor practice. Prescrire International , 4 18 Health industry practices that create conflicts of interest. A policy proposal for academic medical centers. Journal of the American Medical Association, 4 : Brody H The company we keep: Why physicians should refuse to see pharmaceutical representatives.
Annals of Family Medicine , 3: A controlled study of physicians who requested additions to a hospital drug formulary.
Journal of the American Medical Association , 9 Coyle SL Physician-industry relations. Part 1: Individual physicians. Annals of Internal Medicine , Dana J, Loewenstein G A social science perspective on gifts to physicians from industry. Journal of the American Medical Association , 2 Day R How to make the most of a visit from a pharmaceutical company representative. Australian Prescriber , Empirical uncertainty and moral contest: a qualitative analysis of the relationship between medical specialists and the pharmaceutical industry in Australia.
Dubois RW Health Affairs Supplement , Web exclusive: W All gifts large and small: Toward an understanding of the ethics of pharmaceutical industry gift-giving. American Journal of Bioethics , 3 3 Ethical issues concerning the relationships between medical practitioners and the pharmaceutical industry. Medical Journal of Australia , 3 Lam MD Pharmaceutical Executive Sept 1.
Lexchin J What information do physicians receive from pharmaceutical representatives? Canadian Family Physician , Interactions between doctors and pharmaceutical sales representatives. Canadian Journal of Clinical Pharmacology , 8 2 : MacKinnon NJ Use of samples as a threat to seamless health care.
American Journal of Health Systems Pharmacy , British Medical Journal , Effect of restricting contact between pharmaceutical company representatives and internal medicine residents on post training attitudes and behavior. Journal of the American Medical Association , Mintzes B
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