Wednesday, March 13, 2013

Hot Drug Reps and Smooth Operators Going After "Buckets of Money"


"Sales representatives still pay 115 million visits to 340,000 doctors each year, and some companies and reps have kept up the old, aggressive tactics. Doctors still complain about receiving inappropriate pitches from particular firms, and many hold the pharmaceutical industry and its marketing practices in low esteem. Earlier this year, 23% of 680,000 doctors surveyed by market research firm SK&A said they refused to even see drug reps."

 (Paul Christ, "Drug Reps See Their World Changing,"
KnowThis Blog Postings, January 13 2012)

Paul Christ says in years past, the sales tactics of pharmaceutical reps were considerably less aggressive than salespeople in other industries, who are primarily involved in getting prospects to make purchase decisions (i.e., order getters).

However, over the last decade this changed as drug companies were finding they had fewer new products to sell while also facing more competition. This led companies to increase the size of their sales force and train them to use more convincing selling approaches when discussing products with doctors.

According to Christ, the world of the pharmaceutical rep may be inching back to the earlier soft-peddling days.
Drug Representatives - Information To Consider
* It is very rare for reps to have any science background prior to becoming a drug rep. A drug sale has much more to do with establishing personal relationships than it does with understanding the latest science.

     One working Pfizer rep confessed, "You have to be like a chameleon. You have to blend in to every situation. You have doctors who are big sports fans; you have doctors who could care less about any sport. They’ve never played a sport, they’re more into science and more into research and stuff. You have to blend yourself to be able to have conversations and communicate with all kinds of different kinds of people."

* While it is a bonus to have a scientifically educated representative, it is far from a primary recruitment criterion. Youth is a much higher criterion for the sales position.

* Most reps are taught a modicum of science pertinent to their product. They learn the basics of the disease their product is intended to treat but still lack a significant scientific education to place their knowledge into context. 

    In 2007, AstraZeneca fired a sales executive Mike Zubillaga after his interview in an internal company newsletter went public. In the interview, Mr. Zubillaga offered the following advice to his sales reps when they visited a doctor:

    “There is a big bucket of money sitting in every office. Every time you go in, you reach your hand in the bucket and grab a handful. The more times you are in, the more money goes in your pocket. Every time you make a call, you are looking to make more money.”
    The remarks became especially infuriating when it was revealed that Zubillaga and his sales staff dealt exclusively with cancer medication.

* Drug reps need sales skills more than an understanding of science and medicine, so drug companies teach their reps only what they want them to know. Thus, reps become...

     More passionate salesmen since they only learn the most favorable side of the picture.  Reps memorize facts and statistics to support market-tested positive perceptions of their products.
    Easier targets for accepting a skewed perspective; one where a product is presented in the best possible light while the company shines a spotlight on the shortcoming of our competitors’ products. Reps memorize negative facts and statistics about their competitors.

    Skilled tacticians in rebutting the negative medical experience of the concerned physician with positive data from the company that addresses their concern. Here is an example:

    ‘Doctor, that may be you’re experience but the data, drawn from a much larger population, suggests otherwise …’

     An equally typical tactic is to rebut the negative data a concerned physician may have with positive anecdotes of their colleagues’ experiences and how their vicarious understanding should outweigh the concerns that the data may cause.

    ‘Sure, doctor, the paper may suggest that the side-effect commonly occurs, but how often have you seen it with your patients?’ The use of these tactics is not mutually exclusive.

* One study that reviewed promotional materials distributed by drug companies judged 35 percent of those materials to be lacking in fair balance. This finding is consistent with the results of a study of drug ads in medical journals, which found that 40 percent of reviewed advertisements lacked fair balance.If drug promotion serves an educational function, the industry can certainly do better.

   A rep from Parke-Davis told a Congressional committee in 2008 that a senior marketing executive once said: "I want you out there every day selling Neurotonin. Neurotonin is more profitable than Accupril, so we need to focus on Neurotonin. Pain management, now that's money…. I don't want to see a single patient coming off Neurotonin before they've been up to at least 4,800 milligrams a day. I don't want to hear that safety crap, either."

   A rep cited a senior sales executive at the company who told him:

  "I want you out there every day selling Neurotonin. Neurotonin is more profitable than Accupril, so we need to focus on Neurotonin. Pain management, now that's money…. I don't want to see a single patient coming off Neurotonin before they've been up to at least 4,800 milligrams a day. I don't want to hear that safety crap, either."

  The problem is that Neurotonin was only approved for use in seizure patients at the time but the sales staff was pushing doctors to prescribe it for everything from migraines to bi-polar disorder. In 2004, the company was ordered to pay $430 million in fines for their marketing practices of the drug, which many felt was an ineffective slap on the wrist considering the company’s proceeds from the medication exceeded $3 billion.
* The most qualified candidates for drug rep positions are attractive and well-spoken. And, of course, persuasiveness, enthusiasm and charisma are necessary to overcome the natural misgivings of physicians. Thus companies may prefer...
     Certain ethnicities to make the rep distinct among other reps or to provide them with a cultural advantage in connecting with their clients.

    Male reps who are persuasive and likable.

    Female reps who are attractive with physical appeal. A former drug rep testified before Congress that “pharmaceutical companies hire former cheerleaders and ex-models to wine and dine doctors, exaggerate the drug’s benefits and underplay their side-effects.”

   Which is why pharmaceutical companies are systematically recruiting from cheerleading squads — even spawning a cheerleading employment firm. Read all about it:

  So, congratulations to these Spirited Sales Candidates on their success in landing new sales positions this year:
Jennifer- Novartis
Brandy- Novartis
Angela- Novartis
Brandi- Novartis
Chelley- Novartis
Emily- Novartis
Lindsey- Novartis
Kristen- Novartis
Jackie- Novartis
Mindi- Novartis
Shermin- Novartis
Alesha- Sciele
Tim- Sciele

Jenn C.- Sciele
Jenn M.- Sciele
Kristy- Sciele
Kimberly- Bayer
Alyana- Bayer
Christina- Sciele
Lauren- Sciele
Sarah- Sciele
Darcy- Sciele
Elizabeth- Sciele

Susannah- Boeringer Ingleheim
Kris- Boeringer Ingleheim
Catherine- Boeringer Ingleheim
Stephanie- ADP
Monica- ADP

Tawnya: Years As An Eagle Cheerleader: Rookie
College: University of Buffalo
Major/Degree: Communication, Marketing and French
Career/Profession: Pharmaceutical Sales

* Among the more dubious ‘unofficial’ lessons a new rep learns are:

     How to manipulate an expense report to exceed the spending limit for important clients,
     How to exceed spending limits for important clients by using friendships and personal gifts,
     How to use free samples to leverage sales,
     How to use friendship to foster an implied "quid pro quo" relationship,
     How best to handle the importance of sexual tension,
     How to maneuver themselves to becoming a necessity to an office or clinic.

* A very common if informal part of training is learning to classify your clients’ personalities into categories defined by psychological tests such as Myers-Briggs.

* Financial rewards help drug reps rationalize the many ethically dubious situations they routinely encountered in my work.

    Seasoned drug reps can make six figures if they’re really good; good at schmoozing with physicians; or in the case of female reps, being easy on the eyes.

    Starting salary isn’t too bad either. If you happen to land a job as a drug rep with a major drug company you can expect to start out with a base salary of about $50,000. That’s around the same as the average starting salary of a Ph.D. college biology professor (public universities, although salaries do vary).

    Drug reps also get a company car with auto insurance. They’re also eligible for quarterly and annual bonuses along with lavish vacations if they meet sales targets. One rep interviewed recently said, "I would say there’s $20,000 added onto your salary that you don’t see that you get in just perks, that come with the job."

   To help achieve their sales quotas, they are provided with a large annual expense account to buy the loyalty of physicians in the form of gifts, vacations, five-star dinner seminars and other perks.

   When reps hold “educational meetings” they’re usually in fine dining restaurants with physicians free to order as much food and drinks as they wish. Drug companies spare no expense when it comes to wining and dining physicians. After all, physicians ultimately control up to 100% of drug company revenues.
   An assertion that sales representatives may be an important “channel of information” runs contrary to a recent study documenting an 11 percent rate of inaccurate statements made by drug reps during lunch conferences.

* Drug reps do not visit every doctor in their territory - they only visit the ones that are most likely to give them a good return on their investment of time, money, food, gifts, samples and friendship.

   Reps call these doctors “No Sees.” Cracking a No See is a genuine achievement, the pharmaceutical equivalent of a home run or a windmill dunk.

* In their PLoS Medicine report, Ahari and Adriane Fugh-Berman, an associate professor in the department of physiology and biophysics at Georgetown University Medical Center, even put together this chart of the specific tactics used to manipulate physicians.

 (Click to Enlarge.)


1. Paul Christ, "Drug Reps See Their World Changing," KnowThis Blog Postings, January 13 2012

2. "Confessions Of A Drug Rep,", Stathis, December 29 2009

3. "Interview with a Pfizer Pharmaceutical Rep,"

4. M.G. Ziegler, P. Lew, and B.C. Singer, “The Accuracy of Drug Information from Pharmaceutical Sales Representatives,” Journal of the American Medical Association 273, no. 16 (1995): 1296–1298.
D. Stryer and L.A. Bero, “Characteristics of Materials Distributed by Drug Companies: An Evaluation of Appropriateness,” Journal of General Internal Medicine 11, no. 10 (1996): 575–583.

5. M.S. Wilkes, B.H. Doblin, and M.F. Shapiro, “Pharmaceutical Advertisements in Leading Medical Journals: Experts’ Assessments,” Annals of Internal Medicine 116, no. 11 (1992): 912–919.

6. "25 Shocking Facts About the Pharmaceutical Industry" March 27 2008.

7. Cary Byrd, "Introducing … the All-Pharma Cheerleading Squad!"

8. "Why Are Drug Reps Hot?", May 15 2010 

No comments: