Special Delivery
by Gina Shaw
October 2007
Pharmaceutical companies are learning the importance of having well-trained, highly qualified specialty sales reps.
The recent growth in medical specialties has resulted in physicians looking for more tailored services from pharmaceutical sales companies. In Verispan’s 2005 survey of doctors entitled Specialty Reps 2005: A Preferred Force?, 52 percent of specialists reported practicing a subspecialty, compared to 46 percent just two years earlier. In fact, virtually all of the 5,300 doctors surveyed—94 percent—preferred to see pharmaceutical-specialty reps rather than general reps. This was particularly true for the oncologists who participated in the survey, all of whom expressed a desire to work only with specialty representatives.
The Value of Knowledge
The key to specialty representatives’ appeal, according to survey responses, is their in-depth knowledge about their therapeutic areas and available medications within that area. A specialty rep can shape prescribing decisions much more than a general rep—78 percent of physicians said a specialty rep’s details would have at least some impact on their prescribing decisions.
“With the new molecular entities entering the market—as opposed to the huge blockbuster drugs of the 1990s, there’s much more of a focus on specialized medicine [now], particularly in areas like diabetes, oncology and HIV—companies will probably need these types of forces more to promote to the specialty,” says Tara Hamm, a director with Verispan, in Yardley, Pa., USA. With this in mind, it’s hardly surprising that many pharmaceutical companies are adapting their workforces by focusing on the unique skills of specialty reps who can target medical experts in ways the average pharmaceutical sales representative can’t.
“General reps tend to tell the story. Specialty reps tend to ask for the story,” says Jesus Leal, vice president, infectious diseases, transplant and immunology for Novartis, in East Hanover, NJ, USA. “With a general rep, you’ll get a lot of facts from the package insert. A specialty conversation usually involves a lot more questions to the physician, such as: When do you decide to treat someone? Why one patient and not the other? What are the complicating factors when you would choose a more aggressive treatment?” he says. “They try to understand how the physician makes decisions about the patient.” For example, Leal says, Novartis previously had a campaign that focused on the level of gastric disturbance involved with one of their drugs versus a competitor’s drug. “It’s not the level of gastric distress that’s the issue, it’s what the doctor does about the gastric distress when prescribing the competitor drug,” Leal says.
Top Shelf
But as important as it is, recruiting a specialty sales force isn’t easy. These are highly trained professionals, working on complex medical issues—diseases with significant morbidity and mortality that require ongoing, hands-on management from medical specialists. And there are far fewer of these types of professionals available in the industry. “Approximately 18 percent of specialty representatives have advanced degrees, and another 5 percent possess clinical degrees,” says Rick Rosenthal, associate principal at the Lambertville, N.J., USA-based Health Strategies Group. “Among office-based primary care, roughly 5 percent have that level of education.”
The need for that level of qualifications makes the search for specialty reps longer, says Leal. “You may have to work with HR to change the job profile, and many times to change the band of employment.” According to Leal, the sales function in many pharmaceutical companies has to change in order to attract qualified candidates such as pharmacists, PAs and nurses. And with many non-specialty reps hoping to join the rarefied field of specialty sales, it can be hard to separate the wheat from the chaff. “Many representatives want out of primary care sales, and most of them can show you a great track record on paper. You have to filter through this documentation and verify what the representative really contributed,” Rosenthal says. “It’s difficult to distinguish who really drove the results, especially because many primary care reps work in teams of two to five,” he says. When evaluating a representative’s contribution to team sales performance, hiring managers should wonder about the qualifications and capabilities of each of the individuals that make up the team. “Are the sales numbers theirs, or are they riding the coattails of someone more knowledgeable, skillful and determined? Skepticism and verification are always in order here,” Rosenthal says.
Recruit and Retain
Training specialty reps also is a challenge, especially for smaller companies. “If you’re at a company with a lot of resources, you have a better chance of catering to the needs of a specialty force, but you still need management attention to make sure their unique needs are being addressed,” Rosenthal says. “In a small company, you may have a training staff of three or four people trying to figure out the needs of three specialty sales forces, developing programs and tools and calendars and budgets to address them all.”
On the other hand, because specialty representatives are so dedicated to their field—many have had experience with the disease area in which they’re working, either as a patient or with a family member—turnover is low. Leal’s 25-rep transplant team loses about one person per year, with a rep’s average tenure being over 10 years.
The best in the field aren’t looking to trade their jobs for something else, Rosenthal agrees. “It’s the product that really attracts these people. They want to work on a great therapeutic technology.” Specialty reps are involved not just in detailing the doctor about the drug, but in medical societies, patient advocacy organizations and organizations that cater to the extended treatment team, he says. “They’re not just thinking about how to beat the competitor, they’re thinking about how to help patients.”
And they’re extraordinarily good at doing both. Rosenthal’s Health Strategies Group has studied the overall effectiveness of various groups within pharmaceutical sales—office-based reps, hospital reps, regional managers, district managers and so on. “Specialty reps have an effectiveness rate of 44 percent, which is by far the highest rate of any group in pharma,” he says. “It really speaks to the profile of the person who goes into specialty detailing. They’re skilled professionals.”
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