The evolution of the pharmaceutical sales representative

With the advent of the millennium, it is natural that people would think back over their pasts as well as look forward to their futures. This fact led me to realize that in July 2000, I will be starting my 28th year in pharmaceutical sales. Almost every person I know, whether in my company or in others, has been a sales representative for less than 10 years, and during that time many have already worked for several different companies.

The pharmaceutical industry as they know it has been dominated in recent years by large company mergers, periods of downsizing and subsequent re-hiring, managed care formularies, generics, billion dollar drugs, media advertising and chain store pharmacies on almost every comer. More and more representatives have computers. Everyone has constantly updated lists of targeted physicians along with daily contact quotas. Thirty-second details in hallways, sample closets and laboratories are the norm. And how often do we hear the receptionist ask us, "Do you want to check samples?" or the doctor ask, "Do you want me to sign?"

Today's new pharmaceutical representatives might be interested to know that their jobs would have been far different if they had begun their careers in 1973 as I did with Parke-Davis. At that time, there were approximately 40 major, well-established drug companies, along with a few additional smaller ones. Each company had one tenured representative in a territory, and all of us carried a catalog with an extensive list of products, each with multiple sizes, dosage forms and strengths. Because of all these diverse product lines, and because we were responsible for every business opportunity in our respective areas, it was not uncommon for us to call on clinics, pharmacies, hospitals, nursing homes, veterinarians, public health facilities, military bases and even prisons (complete with psychiatric wards) on a regular basis.

One of the biggest differences between then and now is that I spent 50% of my time in retail selling, particularly to pharmacies. Back then, each drug store ordered directly from almost every manufacturer. There were also many more independent pharmacies. It was my responsibility to take inventory of their stock on hand, call in orders, write up outdated merchandise and even resolve order errors and credit problems. At various times of the year I would sell vitamin deals, antibiotic specials and promote our lines of rubbing alcohol, hydrogen peroxide and cough syrups. Likewise in hospitals I took orders, wrote up returns and sold vial, ampoule and injectable offers.

Our extensive product lines also meant that we called on a wider range of physician specialties. Due to the diversity of our product line, I was trained in multiple anatomical areas, which has served me well to the present day. There were also many fewer doctors then, and even fewer of them in group practices. They tended to work longer hours, saw more patients, and almost all of them had Saturday hours.

The companies' emphasis was on the quality of our calls rather than the quantity. We probably averaged about five doctors per day due to the time we spent in the retail sector. We also spent more quality time in front of the physician, typically sitting across a desk in his or her office. A five- to 10-minute presentation was normal, but it was not uncommon to be able to talk with physicians for up to 15 minutes. But at the same time, the doctors were not being called on by six or more representatives per day like they are today. Physicians typically saw two or three. You didn't go into the office asking to "check samples." You asked to "speak with the doctor," then sat and waited until you were called back. Sometimes you waited quite a while until she or he was ready to see you. I even had several doctors who saw representatives in the same order as their patients. If you walked into the waiting room, and there were ten people there, you would be the eleventh person seen. No company-sponsored lunches were required, and after-hours programs were rare. Back then, we were able to develop and maintain personal relationships with the physicians we regularly called on.

In the late 70s and early 80s, however, business relationships with pharmacies and physicians began to change. In order to cut costs and reduce inventories, hospitals started buying through large contract purchasing groups, and pharmacies began buying almost exclusively through wholesalers. Pharmaceutical companies in turn started developing consumer product divisions and started selling over-the-counter products through independent distributors.

At about this time, generics started to become more widespread, while many old, established prescription products went over the counter, notably Benadryl Capsules, Benylin Cough Syrup and Afrin Nasal Spray.

It's my sense that medicine itself started to move from an art to a science. Advances in research and development led to the release of innovative pharmaceutical products such as lipid lowering agents, anti-hypertensive drugs like calcium channel blockers and ace inhibitors, along with a wide array of new antibiotics and anti-inflammatory agents. Increasing numbers of hugely successful drugs in more and more therapeutic classes led companies to create new divisions or additional spin-off companies. Overnight, we had legions of specialty reps, mirror reps, contract reps and part-time flex reps.

Have the changes that have occurred in the job description of a pharmaceutical representative been for the better or for the worse? It depends. Our day is not as varied. We have fewer products in our portfolios to promote per representative. Physicians are certainly harder to see, and we have much less quality time with them. Our presentations tend to be much shorter and less comprehensive. Managed care formularies often tie our hands and limit our ability to market our products. But at the same time, today's medications are more innovative and cutting-edge - and more exciting to sell.

There have been several constants over the past 27 years that have contributed to my success and that of my colleagues. Our responsibility has always been to influence the prescribing habits of the physician. This requires us to target the right physician with the right frequency. As a result, product knowledge, communication skills and organizational ability are of paramount importance. Last but not least is enthusiasm. Success comes from getting the physician as excited about the benefits of our products as we are. I once had a manager who maintained that "sales is the transference of enthusiasm." That, I suppose, is the most significant constant of all. PR