Fixing the rep-physician relationship
Physicians are the most important component in pharmaceutical sales. They write the prescriptions that determine which drugs will be used by patients. And, in a time when sales force cuts are greatly reducing the number of touches between companies and physicians, pharmaceutical companies are scrambling to find new ways to increase their reach and efficiency.
Contraction has dominated sales force news over the past few years, a trend that has recently been accentuated by the economic turmoil. A study conducted by Cutting Edge Information indicates that this trend shows no signs of changing in the near future. Industry analysts predict a continued reduction of sales representatives over the next few years, quantifying the decline to approximate 75,000 total sales representatives in 2012. Figure 1 shows the sales reps count through the years since 1970.
Close to 83,000 (estimates) pharmaceutical sales representatives currently operate in the United States, all striving for invaluable face time with the physicians who have the power to prescribe their drugs. This number is expected to go down to 75,000 by 2012. In addition to the scarcity brought on by the competition among diverse brands for physicians time, PhRMA and OIG guidelines regulating sales representatives activities have further limited representatives access to physicians. When representatives do gain face time with physicians, the competitive environment forces them to maximize their influence and information delivery in an ever-shortening window of time.
Also, while the new guidelines and regulations have ended the arms race between pharmaceutical companies, they do not address the ever-growing issue of physician dissatisfaction. Many publications and articles published over the last several years indicate that physicians are dissatisfied with the sales representatives exchanges. These surveys reveal a few key issues with the current model:
-An average of 78% of physicians would like to see a greater quality in the information provided to them
-Physicians want to see more educated, trained, and experienced sales reps during office visits
-The majority of physicians would like to see a shift from the old sales model
-Physicians would like be visited by higher quality sales representatives
Between the physicians pushback and pharmaceutical companies that want to maintain healthy ROIs, sales reps are caught between a rock and a hard place.
In its study, Cutting Edge Information conducted interviews with top sales executives, regional and district managers and sales representatives, who all pointed to reduced physician access as the major challenge facing sales forces today. When sales representatives do score meetings with physicians, time is severely limited; survey respondents indicated an average 4.4 minutes with a physician for primary care representatives, and 8 minutes for specialty representatives (Figure 2). In an era when even patients, as paying customers, are struggling for more time with their physicians, pharmaceutical sales forces need to restructure themselves and rethink their strategies in an attempt to increase their efficacy.
Enhancing Sales Representative Relationships with Physician through Expanded Scientific Knowledge
Most companies have seen reductions of personnel on all fronts, but mostly in field sales representatives forces. This reduction has resulted in a streamlined sales force that emphasizes the quality of physician-representative interactions over the quantity of calls a representative makes.
Todays sales reps must ascend beyond just the traditional sales pitch and quick sample drops as it does not work with physicians anymore. By expanding their scientific knowledge and increasing their knowledge in doctors business issues, sales reps will gain more quality time with their clients. The best reps provide solutions to the business problems their customers face and have an understanding of the business to provide valuable solutions. Sales forces that do not put their customers first and that are unable to find ways to eliminate current inefficiencies will be left sitting in waiting room after waiting room as competitors reps gracefully waltz through the door to meet with their targets.
Maximizing the Return on Investment
The annual cost per sales rep has shown little change over the past few years. As Figures 3 and 4 show, cost per detail and overall employer costs, sales reps are fairly high company investments. With cost per detail varying from $204 to $330 depending on type of physician called on and if samples were dropped, each visit carries a high premium. From the corporate perspective, employers bear an average cost of $165,556 for primary care reps, while specialty reps cost an average of $228,273 annually (average compensations provided as references). The results might surprise some as with pharma companies recent cost-cutting efforts; some might expect a decrease in cost per rep numbers. However, pharma leaders still see their sales forces as the best marketing piece their organizations have to offer and treat them as such. Companies will not skimp on sales force compensation, nor the materials and equipment with which they arm reps. 
But, when pods of representatives are calling on physicians, it is difficult to discern which representatives are making an impact on physicians and which representatives are ineffective. And the fact that sales reps are high-level investments means companies need to ensure their access to clients and ensure that this access if of highest quality. The latest technology, free samples or fancy scientific flyers will not open physicians doors nor gain more visit time. Only a relevant scientific and clinical exchange will ensure a robust quality conversation and strengthen the rep-doctor relationships. The key solution is to empower sales reps with more scientific and clinical knowledge through training.
Making the Most of Face Time with Physicians
Once a sales representative succeeds at meeting with a physician, time together is limited and invaluable. 
Figure 5 shows the factors that influence quality exchanges with physicians. In attempting to differentiate themselves from the traditional hard sellers, sales forces have to move toward consultative selling techniques. That is, they have to spend more time educating physicians about the clinical and scientific data surrounding their brands and less time pushing an actual prescribing pitch.
Companies that engage in consultative selling train their sales representatives to speak competently in scientific terms. An executive at one participating company who adopted and applied this approach claimed that this sales technique drastically increases face time with a physician, with some representatives seeing the traditional 60 to 90 second window extended by several minutes. Figure 6 presents a typical detail profile and the cost related to this activity. Based on these calculations, the top 10 companies incur an average $380m loss in productivity through worthless face time with physicians.
Significant productivity gains can be achieved when combining a reduction of wasted time and increased visit duration. For instance, reducing wasted time by 30 seconds translates into productivity gains of close to $100m, based on the average number of details conducted per year. Cost per detail will certainly increase when reps score additional minutes with their client, but the gains in quality of relationships and investment will offset the expense and will benefit the company as a whole. 
To date, no studies or surveys have truly addressed these issues in a recognized format that tracks the benefits of scientific and clinical training.
A collaborative effort between Cutting Edge Information and BioPath Consulting proposes to conduct a prospective study that directly measures the effects of scientific and clinical training and education on physician satisfaction, as well as ROI and various other factors. With CEIs benchmarking expertise and BioPaths expertise in scientific and clinical training and education, the Sales Force Training Impact Study is poised to be both groundbreaking and eye-opening.
We currently are in the process of selecting pharmaceutical companies to participate in this study. If you would like the opportunity to discuss the details of this article or the prospective study and how your participation will be of great benefit to your company, please feel free to contact yanis_saradjian@cuttingedgeinfo.com or alexis.kertsburg@biopathconsulting.com.
Access complimentary study summary here: http://www.cuttingedgeinfo.com/reinventing-sales-forces/