Studies by CMI, ZS reach conflicting conclusions.

 

Getting face time with physicians might be getting easier – or it might not, according to two recent research reports on the state of play for pharma sales reps.

Falling on the “easier” side was CMI/Compas’ 2015 Media Vitals report. In their study, CMI/Compas’ researchers found that the percentage of all physicians who refuse to see sales representatives in person had dropped from 25 percent to 19 percent in the last year. They also found that this drop occurred across a number of key specialties, with the percentage of closed doors down seven points among cardiologists, five points for dermatologists, ten points for gastroenterologists, and eight points for primary care physicians. Additionally, the CMI/Compas study found that the percentage of physicians who expect to see a greater number of sales reps in the coming year than in the previous year had increased. This, the authors say, is the first time in several years that an increase in actual access corresponded with an increase in expected future access.

“While the drop in the number of no see offices is a few percentage points, it is statistically significant and shows the first positive shift we have seen in several years across some (not all) physician specialties,” says Susan Dorfman, Ph.D., chief commercial officer, CMI/Compas. “While doctors stated for years that they prefer to receive information directly from sales representatives, access to these physicians continued to decline – with restrictions that limited (low see) and even banned (no see) rep access. A positive shift toward the reduction of no see offices is a positive sign for the value that reps can bring; even though restrictions in office visits are still prevalent. We attribute this shift to the blockbuster launch year our industry has had overall – more innovative treatment options mean more information doctors need to absorb, and one of the best ways to be introduced to that information is via sales reps. While doctors don’t have a lot of time in the day, we know from our research that they value any time they can spend learning more about how to better help their patients.”

On the other side of the question is ZS Associates’ latest AccessMonitor survey. According to ZS researchers, the percentage of prescribers that are “accessible” to pharma sales reps dropped from 51 percent in 2014 to 47 percent in 2015, and in fact has fallen every year since the survey was first launched in 2008. “Clearly, there’s some point at which access restrictions will slow down or even stop, but we’re not there yet,” says Pratap Khedkar, managing principal for pharmaceuticals and biotech at ZS.

A major factor in these growing access restrictions, ZS’ analysts believe, is consolidation among providers. This leads to more doctors working as employees subject to institutional policies, with less control over medicines they prescribe.

“After health system mergers, sales reps may no longer be able to see many of their customers,” says Malcolm Sturgis, an associate principal at ZS. “We saw mergers quickly cut off access to as many as 4 percent of local customers, on top of general restrictions physicians place on sales reps today. In fact, we found 19 out of 25 recent major mergers corresponded with additional decreases in sales rep access within one year following the merger.”

And the process of doctors transitioning to employee status through consolidation is a long way from over, which means even more shrinking access numbers in the future. “The consolidation trend is still evolving, meaning it likely has years to play out, and access restrictions will continue to grow,” Khedkar says.

Another factor in the drop in physician face time for sales reps are the policies of top-tier medical schools, which are increasingly restricting access, a behavior which their students carry along with them into the workforce. According to ZS analysts, graduates of the top 12 medical schools in the United States are more likely to restrict sales rep access throughout their careers compared to graduates of other medical school groups. While 47 percent of doctors nationwide are considered “rep-accessible,” only 36 percent from top schools are “rep-accessible.”

“With minimal exposure to sales reps during medical training and fellowship, the new generation of doctors limits in-person visits with sales reps,” Sturgis says. “We’ve watched this trend for nearly eight years and realize its implications for the industry.”

Also, the cost of access restrictions to marketers goes well beyond the loss of opportunity. According to ZS’ analysts, the pharmaceutical industry spends about $1 billion each year on “infeasible” sales calls, calls that companies plan for and staff but cannot execute. This number has changed very little over the past five years, despite all of the industry’s best efforts to economize.

“Pharma companies are optimizing the size of their sales force and their plan, but as restrictions continue, they’re always going to be a bit behind the trend,” Khedkar says. “Sales calls are so much more effective than other marketing channels that even if the odds of actually getting in to see a particular doctor aren’t in the reps’ favor, they’ve still got to try.”