eDetailing and how it affects you

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We’ve all heard about it,but what exactly is it? And how will it impact the work of medical representatives? Dr Andree K Bates takes a detailed look at the various forms of eDetailing.

eDetailing is currently being piloted, or is at least under consideration, by many pharmaceutical companies as a way to maximize sales force time, cut costs and increase physician prescribing. But what exactly is it?

eDetailing is not a single entity but can take many different forms: from remote live discussion with a sales rep to a purely scripted interaction with a web site or an Interactive Voice Response phone line.Most eDetailing models have been tried in the US and only some models, such as some forms of Scripted eDetailing have been shown by independent studies to increase prescribing compared to traditional detailing methods. Each eDetail model differs in its popularity and applicability to specific physicians, for example, GPs are more easily accessed than specialists in Scripted eDetails.

Therefore, pharmaceutical companies need to consider their eDetailing options carefully to choose a model that will be right for their particular product, target physician group and country. Many pharmaceutical companies are simply starting a pilot with one or two models but this will not necessarily be sufficient to reach a conclusion for all cases.

The different forms of eDetailing

Virtual live eDetailing:

This is eDetailing where doctors are provided with a PC pre-loaded with the necessary software, a webcam and provided with incentives. In return for this, many models ensure doctors are obliged to contact a number of the pharma company’s sales reps a set number of times per month. In this way the timing and duration of the eDetailing session is controlled by doctor.During the eDetailing session, the physician would be able to interact with the sales representative via video and audio in real time.A variance on this approach is a system where only the sales representative is viewed, or only audio and data slides are shown, depending on the wishes of the physician.

This type of model has been associated with providing a longer interaction with the physician more cost effectively when compared to the cost and length of the traditional face-to-face call, so that the number of sales rep calls per day and the number of physician interactions are increased. However, there is no independent data on the impact of such eDetailing on the numbers of prescriptions issued.

Scripted eDetailing:

In this model the doctor views a series of interactive screens, usually through an Internet or Intranet site. There is no live interaction here but the doctor has the option to contact a rep by email or telephone.

This type of model has been shown to deliver clear, well-structured messages to physicians that is 5-10 times longer than the normal face-to-face sales rep call but at a reduced cost.

Participating physicians especially like the convenience of the 24 hours a day, seven days a week availability of this model. Unlike the other models, some forms of scripted eDetailing have been found in independent studies to show actual increases in prescribing of the drug featured in the eDetail – that can be directly attributable to the eDetailing done, whether that is via the internet or via IVR.

eDetailing through a portal for doctors:

This option is quite visible in the UK at the moment thanks to the profile enjoyed by GP portals such as Doctors.net.uk and OnMedica.net and detaildirect. com.These portals offer access to ready-made communities of doctors and can be used to deliver broad, sponsorship marketing messages or more product-specific ones more like traditional detailing. Potentially, physician portals can provide access to hard-to-reach physicians (e.g. specialists) though, for most portals, the number of physicians who actively use that portal is usually significantly less than the official membership list. Portals can usually provide online statistics that give insight into where physicians spend their time and hence an insight into their web habits and interests.

“There is no doubt that detailing directly to the doctor serves an important purpose. Physicians want and need information from the sales representatives – but on their own time terms”

However, these are not necessarily straightforward to interpret. For instance, there is no easy way to know whether the reason a physician spent 10 minutes looking at a web page was because he was interested or because he was bored and took a break to do something else whilst the web page was open! There is little evidence of the actual impact of portal-based eDetailing on the number of prescriptions issued.

The eDetailing story so far

Many European pharmaceutical companies are still piloting eDetailing and eDetailing solution vendors are still emerging in Europe, so the history of the eDetailing story is largely US based. In the US,‘Pure’ eDetailing companies such as Lathian systems are well established, with most of the top 20 pharmaceutical companies signed up as clients. Many other marketing service companies are also offering an eDetailing package.

In the US, all of the top 20 pharmaceutical companies have some involvement or investment with eDetailing.A number of eDetailing companies have strategic alliances with physician portals, giving potential access to large numbers of professionals. Aside from overall development of the internet in everyday life, there are three direct drivers behind the growth of eDetailing:

• falling effectiveness and increasing costs of sales representatives
• increasingly busy doctors with little time to see reps
• high connectivity and acceptance of the Internet by physicians. 

Detailing via sales representatives accounts for the lion’s share of sales and marketing spend, around 45% of the total.The last decade has seen substantial growth in the use of sales representatives as the marketplace becomes increasingly crowded with similar products and the length of market exclusivity of new innovative products falls.The top 40 pharmaceutical companies in the US now employ an estimated 80,000 sales reps, a doubling since 1996, though the increase in prescribing in this period has risen by only 15%. Some studies suggest that 40% of sales reps’ calls are cancelled or rescheduled and over 80% of conversations between reps and physicians last not much more than two minutes.

In the UK, studies suggest that 30% of GPs no longer see sales reps from pharmaceutical companies. Physicians, both in Europe and the US, are acknowledged to be highly time pressured and encouraged to see as many patients as possible. The conclusion is that there is a lack of sufficient time for the physicians to meet with sales reps. Consequently, pharmaceutical companies’ very significant expenditure in traditional detailing is not yielding the desired returns.With a constantly increasing number of drugs to sell, the sales force’s efficiency is dramatically decreasing through no fault of its own.

There is no doubt that detailing directly to the doctor serves an important purpose. Physicians want and need information from the sales representatives – but on their own time terms. eDetailing can potentially provide physicians with a more convenient means of getting the information they want at a time that suits them.

Where are we now?
Examples of success and uptake

To date, studies indicate a good level of acceptance from physicians and positive results for the pharmaceutical company reps.

One study showed 39% of physicians after partaking in a 10 minute eDetail session requested to see a rep and 70% asked for samples. Another showed that after the implementation of an eDetailing programme the product’s market share increased by 10% (against a control group of 3%) which was meaningful as each percentage point equalled $40 million in sales.

A study by Lathian found that doctors participating in two eDetailing sessions increased brand prescribing by 51% more than could be expected by seasonal variance, and a group participating in one eDetail increased brand prescribing by over 19% more than could be expected by seasonal variance.

How does the representative fit in? Is it a threat or a support?

One pharma company in the UK measured impact on Rx in four groups who were matched on a variety of variables:

1) practices with no rep or eDetailing
2) practices with only reps
3) practices with only eDetailing
4) practices with a combination of rep and eDetailing.

The fourth group (the combination of rep and eDetailing) was found to be 71% above the baseline group (not seeing either reps nor eDetails) and 39% above the groups where rep detailing was done in isolation.This shows that eDetailing, when done properly, can be a valuable tool to assist sales reps in gaining better Rx results for their territories and, in turn, better recognition for their efforts.

The future

At present, the main emphasis of an eDetailing programme is to directly and quickly increase prescription rates, rather than cut costs or build branding relationships online. However, in the future we expect that it may be used to measure brand loyalty.

Studies have shown that doctors are rational prescribers early in the life cycle of a brand, then they become heavily emotional prescribers, and then they become more rational prescribers again late in the life cycle – presumably due to the entrance of new competitors demanding a rational approach. However, given that branding can effect emotional prescribing by physicians, and an eDetailing programme can reinforce the brand, this branding component could become part of the eDetailing equation.

Dr. Andree K Bates Eularis