Do sales reps have the tools they need?

History has shown that in a time where sales growth is needed, the pharmaceutical industry's quick fix is to hire more sales representatives and supply them with the same message and the same tools to deliver to the same customers. For future success in a new health care environment, this can no longer be the strategy.

The successful pharmaceutical company of the future will utilize the same number of sales reps but will supply them with new tools and training programs to detail current and new customers with a different message. This new message needs to include a business component.

In research done with physicians, many doctors feel the pharmaceutical industry is deficient in understanding three key areas that can dictate tremendous change when physicians utilize certain products and services. These areas are: the impact of the shift of risk, the development and use of alternate site markets and the impact of disease management on patient outcomes.

Shift of risk

An at-risk physician is one who assumes partial or full financial responsibility for the management of a patient population. Risk is created when there is a possibility that the cost of providing contracted services will be greater than the total compensation received by the at-risk physician providing those services.

The number of at-risk physicians and physician groups in today's health care system is tremendous. This growth will continue as managed care organizations de-emphasize their role in medical management and the true medical managers - physicians, hospitals and ancillary providers - assume full or partial risk for the management of plan members.

It is crucial that sales reps know what motivates physicians' prescribing habits when they are bearing more financial risk. For instance, when risk is passed on to a physician via a capitated or case rate contract, the physician is being reimbursed a set fee on a per member per month basis or a set fee on a per patient per month basis. The at-risk customer is now concerned with total cost.

Therefore, a sales rep can no longer just cover formulary status, safety and efficacy, price and dosing. He or she needs to understand how a product or service can decrease high-cost services such as inpatient bed days, diagnostics, lab and emergency room visits. Without appropriately positioning a product or service to address these issues, the value of a sales rep's call is minimal.

Alternate site market

The alternate site market is simply defined as any service outside of the high-cost hospital setting. There are five alternate site settings that are experiencing tremendous growth: long-term care, subacute care, physician offices, surgery centers and home care.

It becomes extremely important for sales reps to identify how and when physicians, hospitals and payers are using these market segments. Sales reps should understand why and when a patient would be serviced in each of the alternate sites. And when they are in the alternate site, sales reps need to know what the drug and supply decision-making process is.

There are many dynamics that affect how a patient is treated and with what types of pharmaceutical services and products they are treated within each of the alternate sites. Key issues include reimbursement, pharmacy capabilities and key decision-makers, such as administrators, medical directors and pharmacy consultants.

It is imperative that the pharmaceutical industry place more focus on these sites of care and provide sales reps with appropriate training to allow them to position their products.

Disease management

Over the past five years, the managed care industry has been managing access to services in order to reduce cost. It is now faced with the challenge of stepping up and truly managing care. In order to effectively accomplish this much-needed goal, disease management has become popular. The key to any successful disease management program is the ability to offer a clinical extension of the physician or hospital to provide true 24-hour coverage. For this reason, most payers are looking to the home care/home infusion companies to run their disease management programs.

The payer-home-care/home-infusion relationship is a good fit because as these alternate site providers assume risk for the disease management programs, they have the capabilities to provide care coordination, oral medications, intravenous solutions and nursing. These home infusion providers are also the providers responsible for providing pharmaceuticals, supplies and high-tech nursing skills to long-term care, subacute, physician's offices, ambulatory infusion centers and ambulatory surgery centers. It is obvious that all of these components to a successful disease management program offer opportunity for any educated sales representative.

Opportunity ahead

Great opportunities remain for companies to offer tools and programs to address these changing dynamics. Every representative presenting a product to a customer needs to understand the core issues that physicians, hospitals and payers are faced with managing. If field reps do not identify how their customers are organized, how they are reimbursed for utilizing pharmaceuticals and how they are managing patients in the alternate site market, then the opportunity for significant sales growth cannot occur.

If sales reps can receive tools and products to affect those three key areas, then they will be motivated, educated and able to drive sales growth. PR