What’s driving a resurgence in primary care pharma representatives?

Illustration by Alex Buccheri

After flirting with remote detailing, pharma is returning to feet-on-the-ground sales to meet the complex challenges of transforming markets and changing decision makers.

Read this in the August issue of Pf Magazine. 

Not so long ago, the role of primary care sales representatives had been assigned to the scrapheap. But it seems the death of the salesman has been greatly exaggerated.

In the last year, numerous pharmaceutical companies have been steadily building up their sales forces in what appears to be a shift back to traditional face-to-face, relationship-based selling.

Specialist recruiters have attributed it to changes in the market and structure of the NHS, as well as the unwavering fact that there is no replacement for the healthcare professional-sales representative relationship.

Chris Anderson, co-founder and Commercial Director at Evolve Selection, says: “There has been an increase in GP and hospital roles compared to this time last year, and there’s certainly been a shift in the number of these types of roles being outsourced through contract sales organisations over the last year or two.

“Although multichannel roles have an important place in the pharma sales market, I believe there is no better solution to selling a product than having people on the ground meeting customers face-to-face.”



This is all in stark contrast to the bold statement made in a 2009 report from Price Waterhouse Cooper, ‘Pharma 2020: Marketing the future Which path will you take?’ which looked at shifts in sales models, hiring trends and the rise of remote detailing.

In 2006, Pfizer announced it was cutting its US sales force by 20%, the report said, and other companies soon followed suit. By October 2008, industry leaders had set out plans to axe more than 53,000 jobs, many in sales and marketing.

Looking at this data and highlighting an industry-wide move away from blockbuster primary care drugs, it declared: ‘By 2020, the role of the traditional sales representative will be largely obsolete.’

Martin Anderson, owner and Managing Director of Carrot Pharma Recruitment, said it was no secret that big pharma companies had been focussing on specialty brands in areas of unmet medical need for some time now.

“These are typically lower volume, higher value products, so therefore impact a much smaller customer base and frequently require a more sophisticated customer engagement model,” he says.

“This means that there are fewer sales people on the ground.”

At the same time, the industry has increased the use of new methods, such as remote e-detailing, as customers seek new ways to keep up to date with product and therapy area information.

Primary care arms race

Big launches in the primary care space, including direct-acting anti-coagulants, branded generics and, most recently, respiratory care, are driving a change at the coal face.

“One of the main drivers is the launch of several new respiratory products, from new brands or combinations to branded generics,” says Martin. “These are higher-volume drugs and once market access has been secured, decisions on which brand or combination therapy are to be prescribed are often made within the primary care setting.”

Even with the right approach to customer segmentation and targeting, there is an element of share of voice required, and ultimately, explains Martin, it can be something of an arms race as companies seek to gain a competitive advantage in their market.

Graham Hawthorn, Managing Director at CHASE Recruitment, agrees. “We have indeed seen a rise in demand for primary care representatives recently, driven primarily by new respiratory products coming to the UK market. It has taken much of the market by surprise,” he says.

He issued a warning against unbridled optimism, however, adding that some therapy areas, including diabetes, had actually seen a decrease in primary care representatives in recent years.

As Martin explained, recruiters are seeing fluctuations in the demand for primary care resource as the need dictates – and they expect that to continue.

Changing influencers

Changes to the structure of the NHS have also played their part in the current renaissance, explained Chris.

“It’s down to how decisions are made in the NHS and primary care is leading that,” he says. “GPs have a strong input, being an integral part of the clinical commissioning groups (CCGs), and are increasingly influential over decisions at a prescribing level.”

It’s not just doctors who have a say anymore – practice nurses are increasingly qualified to put pen to prescription pad and there has also been a shift towards GP practice-based pharmacies.

NHS England has committed £100 milllon to support this expansion even further. By 2020/21, there will be a pharmacy in 3200 surgeries across the country, according to the ‘General Practice Forward View’.

“Now you have the nurse prescribers and GP practice pharmacists, all of whom play an important part in what drugs are ultimately prescribed,” says Chris.
“Their influence has, without a doubt, become more prevalent in the last two years or so.”

Being able to call upon and network with all these influencers in a single visit places on-the-ground sales representatives at a distinct advantage to phone or e-detailers who may only ever get through to one person.

Another way in which a face-to-face appointment has an advantage over remote methods is the role representatives can play in education.

“When a device is involved, even a relatively simple inhaler, the practice nurse will need to spend time teaching the patient how to use it correctly,” says Martin. “Hence, truly account managing each practice with the appropriate capability and capacity within the field team means that the practice nurse will feel fully supported to ensure that patients are receiving optimal care. The level of support offered by the local account team can be a differentiator for the customer when deciding their own treatment strategy for long-term conditions such as asthma or COPD.”

That’s not to say remote detailing is over. Rather, it is complementary to the role of the representative, and having a mix of means to access customers is essential in the modern marketplace.

“Research has shown that even though many customers now expect to receive product and therapy specific information digitally, there is still a high percentage of people who value the interaction and the relationship with a field-based representative,” says Martin.

Nothing beats face-to-face

Multichannel roles will always have an important role to play in the pharma sales market, but Chris firmly believes there is no better way to sell a product than having people on the ground.

“A mix of several means to accessing customers is a ‘nice to have’, however, nothing beats face-to-face contact when it comes to getting necessary commitment,” he says.

Representatives of the future

Today’s primary care sales representatives do not represent a return to the past or the industry going full circle, however. They are operating in a new world, making them something of a new breed.

As well as the need for in-depth knowledge of their product, competitors and therapy area, they need to understand the drivers and influencers within their own CCG.

“It used to be about going in to see as many GPs as possible as they were the only ones who influence prescribing. It’s still about learning about products and getting out there to promote them, but it has become more commercially focused,” explains Chris, a former sales representative himself. “You have got to have account management skills to identify which customers will ultimately influence a decision on what drugs are prescribed.”

Expectations have never been higher, as the primary care sales representative role evolves along with the health service and in doing so requires an ever-larger pool of skills in order to succeed.

“One thing that continues to change is the expectation around the level of capability and knowledge that primary care representatives need to have about their products and environment and their ability to present a bespoke value proposition for each practice,” says Martin.

Strong business acumen, data analysis skills and the ability to build rapport with a whole network of decision makers are the hallmarks of the future’s successful representatives.

And that means new representatives are being drawn from a larger pool of applicants, with transferable skills that will, ultimately, benefit the entire industry.

“One of the positive side effects of the increase in primary care representatives has been the number of new-to-industry representatives who have been hired, such as graduates, commercial trainees from other sectors, and pharmacists,” concludes Graham. “This is good news for the industry as a whole as it will help, over time, to plug the talent gap that has emerged in recent years.”