S&R Blog

Why Pharma Is Pushing Its Drug Pushers Out

New day. Same story.


The pharmaceutical industry is going through a transformation — not only has it been consolidating with mega-mergers like the one between Merck (MRK) and Schering-Plough, but it’s facing a major patent cliff as the revenues from the blockbuster drugs of the 1990s fall prey to generic competition.

Yet, these larger changes have led to shifts in other parts of the industry, too. Since Big Pharma can no longer rely on new blockbuster drugs to pad their top line, these companies now have to transform how they do business to include the biotech model of finding drugs for diseases with smaller patient populations. This also means a major overhaul of how the industry sells its product to the masses.

Pharmaceutical sales reps will be the first to tell you that the industry is scaling down. Once plentiful — there were more than 100,000 reps in 2005 — the drug sales rep is quickly becoming part of the past. A recent report by Deloitte proclaimed to the industry to change its sales models or bust.

An article in the Indianapolis Star this week shows just how much sales rep are despised by the very doctors they’re supposed to woo. Doctors have been pushing for sales reps to make appointments and cut down their pitch time. In some cases, doctors are asking to ban their presence altogether (one in four doctors now refuses to meet with reps, according to the Deloitte report).

But doctors’ dislike of this incredibly aggressive and confident class of individuals isn’t the only reason that the sales rep is becoming extinct. Doctors are no longer the key decision makers when it comes to what drugs are being prescribed. That decision now rests heavily with consumers (who are highly affected by direct-to-consumer advertising), and even more so with insurers who are the primary payers for the often over-priced drugs being pushed by the pharma companies.

Pharmaceutical companies aren’t blind to the problem. The past year has been a bloodbath for pharmaceutical peddlers. AstraZeneca (AZN) said in 2007 that it would cut 7,600 people by 2013; it later upped that number to 15,000. The company didn’t say where those jobs would come from, but the sales force was offered the buyout first. Sepracor, wholly-owned subsidiary of Japan’s Dainippon Sumitomo Pharma, reduced its number by 530 in 2009, bringing its sales force to 1,325 people. King Pharmaceuticals (KG) eliminated 380 field sales positions last year, bringing its total number of reps down to 720 and Sanofi-Aventis (SNY) cut 750 people from its sales roster.

Jump to 2010: Pfizer (PFE) cut 556 sales reps as part of its broader layoffs due to its merger with Wyeth last year. Earlier in the month, Merck eliminated 400 positions from the Schering-Plough headquarters in New Jersey with a majority coming from the sales team. This is on top of the 1,000 sales reps that Schering laid off in 2008 before its merge.

So how will the new pharmaceutical sales landscape look?

It’s likely that insurance companies are going to be playing an even bigger role in which prescriptions become the drugs of choice. Meanwhile, Big Pharma will likely look to outsourced sales rep to educate those same insurance companies. As a plus for doctors, their knowledge will likely have to come more from medical journals and other non-biased sources.

“Pharma’s challenges require a detailed understanding of each stakeholder’s role and contribution to value,” says W. Scott Evangelista, principal at Deloitte. “By better understanding every stakeholder’s unique needs and motivators, a pharma company would be better equipped to improve its internal capabilities — e.g., knowledge, skills, tools — to interact more effectively with each constituent.”


What do physicians really think about Big Pharma?

According to Dr. Candida Fink’s latest blog post on PsychCentral, not highly. In what clearly wasn’t a good year for pharma in terms of reputation, Dr. Fink highlights why she will “no longer see any drug reps.”

I didn’t want to hear from them, and I haven’t since. I avoid lectures and meetings that drug companies sponsor, and I use no drug company pens or notepads. The longer I avoid direct contact with drug company reps, the better I feel about it. The further removed I am from these things the more I realize I was getting a lot of my information about medications from company reps who had vested interests in my using their product. I realized that I don’t need samples, because the companies give samples only of their newest products, and those don’t have the research or track records that the older products have. Furthermore, the older products are now available as generics, which ultimately save my patients far more money than they save by taking a few free samples and then paying for the priciest, newest product.

Obviously, this is the opinion of one physician, but the points Dr. Fink brings up about her disdain for pharmaceutical marketing tactics have been echoed more than once lately. So if not from pharma companies, where would physicians get their information about products? According to Dr. Fink,”That isn’t to say I don’t keep informed and try new products that are appropriate for certain patients, but I do so based on research and my patients’ needs, not who bought me lunch last week.”

Samples, proper medical education, and other informative materials should be needed to help improve patient outcomes. But physicians seem to be turning their heads the other way.  If pharma doesn’t heal the wounds and restore the trust with physicians, credibility will be the least of its problems. What do you think?

Read Dr. Fink’s post here.

Will the Mac Tablet revolutionize EMRs?
January 7, 2010, 9:48 pm
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After a lull of about 6 months the Mac Tablet buzz has started to heat up again with Apple announcing its release for March. Like the iPhone before it, the medical community has started to hail the Mac Tablet as a revolutionary healthcare device, most notably for electronic medical records (EMRs). Ease-of-use has been a primary barrier to EMR adoption, so Apple – known for intuitive design and usability – would be welcomed by physicians.

The EMR possibilities for the Mac Tablet  have been covered in depth through an article at Softwareadvice.

“The Ultimate EMR User Interface
An Apple tablet would be the ultimate UI for electronic medical records. With a touch-screen display like the iPhone, using the EMR during an encounter would be simplified. For example, selecting an evaluation and management (E&M) code could be as easy as “dialing in” the code with a swipe of a finger…”

But are EMRs really making life for physicians easier? And will the Mac Tablet help? This video begs to differ.

The top 10 health stories of 2009 (according to Harvard)

Via: Healthcare IT News

Swine flu, health reform and restrictions on industry gifts to doctors are among the top 10 health stories identified by the Harvard Health Letter in its annual list.

The Harvard University publication develops a top 10 list each year with help from doctors on its editorial board.

Among the top stories of 2009 is the national effort to curb healthcare costs via reform legislation, mandated coverage and tighter regulation of health insurers. “Chances are that legislation, if it does become law, won’t do nearly enough to control costs,” the list’s authors said.

Healthcare organizations faced additional challenges this year as a result of the H1N1 flu pandemic. “Measured public health response” and “plenty of information” helped keep the pandemic in perspective, the editors said, and despite the oncoming flu season, they expect that H1N1 will likely remain manageable.

The Harvard Health Letter‘s full list of top 2009 health stories is as follows:

  • H1N1 flu
  • Healthcare reform
  • Screening tests
  • An alternative to warfarin?
  • New findings about “good” and “bad” body fat
  • Restrictions on industry gifts to doctors (TRANSPARENCY)
  • MicroRNA-based treatment
  • Changes in blood sugar goals for patients in intensive care
  • Testing for C-reactive protein
  • Social networks as conduits for health and disease

What about Pfizer? They must be on the ‘pharma’ list.

Check out the Wall Street Journal’s top 10 here.

78 percent of US interested in mobile healthcare solutions
October 19, 2009, 3:57 pm
Filed under: mobile | Tags: , , , , , ,

Attention healthcare industry! Mobile healthcare solutions will be a reality sooner than you think. And we aren’t talking about just blood pressure monitoring apps, but full-blown health services.

According to a new study conducted by wireless industry association CTIA with Harris Interactive, a vast majority of the US (78%) is interested in mobile health solutions and 15 percent of the U.S. is extremely or very interested in learning more about mHealth.

The study used a combination of two online studies of U.S. adults (5,563) and physicians (115 general practitioners and 129 specialists) to gauge their interest in mHealth service options.  Survey respondents felt that access to mHealth would allow for more home-based care (68%), make medical care easier to obtain (51%), and give patients more freedom and choice (51%). More highlights are below.

mHealth Today

mHealth Appeal

mHealth Appeal

Read the full report here.

New study reveals 77.5% of physicians use social media professionally

This blog is full of information about social media, including SmartPhone apps, Twitter, and others, and S&R decided to take this topic to the physicians to find out their thoughts on social media.

The S&R Communications Group Social Media Survey was conducted on July 20, 2009, via SermoTM, an online community for physicians. The purpose of this survey was to gather information about the personal and professional use of social media by physicians. The survey was administered to 102 physicians and was directed at physicians in the specialty areas of family medicine, internal medicine, pediatrics, and psychiatry. The survey contained 18 questions on various topics that ranged from basic demographics to use of specific social media sites.

One of the most important pieces of information gathered with this survey was not a surprise: Some physicians do use social media professionally.

Who uses it?

Of the 79 respondents (77.5%) who reported using social media professionally, 72.2% were 25 to 35 years in age. (The other 27.8% were 36 to 55. No one over the age of 55 participated in this survey.)

How do they use it?

Like any other tactical tool, social media will not be effective for every physician or every situation. The majority of respondents reported using social media to connect with physicians within their specialty (87.3%), to connect with physicians outside of their specialty (64.6%), to connect with colleagues they trained with (54.4%), to connect with medical school alumni (53.2%), and to connect with key opinion leaders (21.5%).

Interestingly, only 2.5% reported using social media to connect with patients, which suggests that physicians do not see social media as a viable means of communicating with patients. Why is this?

Perhaps the answer lies in the benefits respondents see in or their reasons for using social media professionally. Because the majority of physicians see social media as a means of gaining professional information, it is reasonable to expect that very few respondents would use social media as a means of communicating with patients. Plus, respondents, even those who reported not using social media professionally, reported that the 2 largest downsides to using social media professionally were issues of privacy (69.6%) and legal concerns (52%). Other downsides included concerns over credibility, time requirements, the impersonal nature of social media, and incongruence with their ideals of being professional.

At the moment, physicians must be careful about interacting with patients via social media. However, social media presents the opportunity to satisfy the demand for more immediate information and to correct mistakes quickly. Doctors already use non–face-to-face methods like letters, phone calls, etc. It may only be a matter of time before social media falls into this same category.

What can we learn from this survey?

As the world of pharmaceutical advertising is changing, we have to change with it. This survey confirms what we already knew: Social media will play an important part in pharmaceutical advertising. This survey indicates that social media is a source for information for physicians, so we know that we have the opportunity to create a place where we can build relationships with physicians while rapidly providing education, information, and the ability to interact with KOLs and other physicians.

In fact, more than 50% of respondents reported that they would be in favor of additional social media designed for better professional interaction with patients and other healthcare professionals.

As they always have, physicians are turning to their colleagues for information, and you have a responsibility to your product to participate in this conversation and ensure that accurate, factual, and complete information is being presented to the physicians who are seeking out that information.

Contact Wayne Dunlap (wayned@srcomgroup.com) for a full report.

No longer a fantasy. Healthcare enters the realm of augmented reality.
September 1, 2009, 5:49 pm
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With the advent of mobile augmented reality apps and developers like Layar, what was once just a pipe dream in the minds of marketers just a few months ago is now a wide open canvas for innovation.  Recently, we discussed how healthcare could benefit immensely from the new augmented reality technology that was being developed for Android and the iPhone. And it looks like that day has arrived, according to a new interview Mobile Health News had with the developers of  Layar about new healthcare aps being developed for their augmented reality platform. Some of the key exchanges are below.

Are there any healthcare or related Layars currently available?

In the beginning, we launched in Holland and one of our original launch partners was Zekur.nl, which is a local healthcare provider. They have a specific health insurance offering, which is only available over the Internet and it is cheap because they only contract out their healthcare services to specific providers. So you can only go to “that” chiropractor and not the other one. In order to facilitate this and give their patients insights into which provider they can go to — they built one of the first Layars with us to point people to where they can go. This company is also very young so they needed the marketing push this platform would give them. The various healthcare providers covered by their insurance are what you can find [if you toggle] their Layar. That’s one of the first healthcare use cases.

Secondly, we have a general hospital Layar in Japan that enables users to point their phone in any direction and it shows them on their camera screen the closest hospitals or emergency rooms in that direction. This is like a healthcare directory service. Also, in Japan and in Holland there is a Layar that allows users to find the nearest AED, [which is an “automated external defibrillator” — a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation.] These are machines in public places that people can use on people who have heart attacks.

OK, I can see that service as being potentially useful — what’s next? Beyond just finding things through your mobile camera — how else can this platform better health or wellbeing? What other opportunities do you see?

Well, you know that I am a cancer survivor, right? So for me that is a good subject always and I know the Livestrong Foundation has a new campaign where you can make what’s called a Dedication Page. I made a Dedication Page for my wife, who was great to me and I express that through my Dedication Page. It is a great way to really capture that and to make other people aware of what people do in that circumstance. Those pages also include location information, so that could make a great Layar, where you could go to a Livestrong Dedication Layar and see, literally, how much “cancer” is all around you. I mean that in a good way — the Layar could make people aware of how much of an impact something like cancer has. Maybe as a part of that Layar you could make a donation or send flowers to someone, but really just to raise awareness and help people lend support, this Layar would be very effective. I didn’t know how much there was out there before I got sick. It’s good to put that information out there because for those who have it can know that they are not alone. I have emailed them, but I haven’t heard back yet.

Another way is for an epidemic type thing, which it may or may not be true for the H1N1, but you could use Layar to pinpoint where cases of [the H1N1 swine flue have been diagnosed], those may be areas that you might want to avoid.

One of the biggest challenges, especially in healthcare, is knowing where to go once you are in the hospital. This is more of a future application — we are not doing this yet — but say, you have an appointment with your specialist: Those are very expensive appointments so you need to make sure people know how to get there. Layar could point you to which door you should take to get you to the place you need to be in. This is not possible now, but I see it as a common use case for the future.

Read the full interview here.