Losing ground?

Place: OPD at a leading hospital, Time: 5 pm. As the patients move in and out of the doctor’s cabin, a group of four men sit huddled together with heavy brochures of a leading pharma MNC. They discuss with each other while anxiously waiting for his personal assistant to let them in for a meeting as they hope of making their elevator pitch, rehearsed and prepared for that very moment. This is just one slice out of the daily grind of a Medical Representative (MR), who to a large extent is a pharma company’s most on-ground person when it comes to sales.

The front salesman

With as high as 98 per cent of the staff hired at entry level in a pharma company consisting of MRs, they form a large chunk of the field force that is deployed. Just like the pawn in a game of chess, their responsibility is to be at the frontline, interacting with the doctors, who play a key role in doling out prescriptions, on which drugs from pharma firms if there consistently, could send cash registers ringing. However, it is not as easy as it sounds.

“These are changing times the industry is going through. Companies need to come out of their marketing myopia and look at the business in a larger perspective, shifting their focus from selling to healthcare.” Ashish Dutt COO, BioQuest Solutions

“There are roughly 26,000 pharma companies and 7.5 lakh doctors, However, companies may direct MRs to target only 25 per cent of these physicians who might be seeing the maximum number of patients (and hence more prescriptions) or maybe even opinion makers (even though they may not be prescribing),” chips in Ashish Dutt, Chief Operating Officer, BioQuest Solutions. And if you thought, less physicians would make the going easier, let us first understand the job profile.

Typically, as the name suggests, an MR is the sales representative of a pharma company and is required to ensure that doctors have his company’s drug brands topmost on their recall. With branded generics forming a considerable part of prescriptions, this is the single-most important task but also the most difficult with majority of the companies selling the same molecule but under different brands as high as 50-60. Since there is no novel research or new facts that he can share with the physician, price points can be critical to pique the interest. The selling can be more on the consultative side should he represent an innovator company. He could share new studies and research papers, even discuss these along with the drug side effects if any, efficacy etc. Setting targets for territories and managing the supply chain by ensuring that the nearby chemist shops are well stocked are others.

“70 per cent of those hired are science graduates and the rest from a non-science background. Some MNCs may also hire MBAs or engineering graduates depending on the profile in question.” Thammaiah BN Director, Kelly Scientific Resources & Kelly IT Resources

“Competitive intelligence though is the key,” adds Dutt. Knowing if a doctor has shifted from brand X to Y, elucidating how the drug is different from its peers in clinical trials, even dispensing information on competitors. “Up to 70 per cent of those hired are science graduates and the rest from a non-science background. Some MNCs may also hire MBAs or engineering graduates or those with specific qualifications depending on the profile in question. But typically, most companies into branded generics are looking at sales competency,” enumerates Thammaiah BN, Director, Kelly Scientific Resources & Kelly IT Resources. Most of them may spend upto five years before becoming a manager and may even specialise in a drug division, for instance cardiovascular, diabetes etc, he adds.

Then and now

“With most information being available on the Internet for the doctor, shorter training programme or on the job training in some cases and targets being the only focus, the MR visit becomes a mere formality instead of a serious discussion.” Timothy EJ Started his career with Pfizer as an MR in 1984

Inspired by his elder brother, an MR himself, Timothy EJ, began his career at Pfizer in 1984 at a salary which was higher than what a bank officer commanded those days.“ I was quite impressed with the way he carried himself; neatly ironed clothes with a tie and at times a coat. The fact that he was rubbing shoulders with the respectable doctors’ community was only part of the motivation. Not to mention the generous extra pocket money he always shelled out for my college outings (which I later learnt was because of the allowances in addition to salary and incentives he earned).” He worked under Sam Varkey, his Sales Director, who himself joined the company as an MR in 1960. That is how most top management started out. Of course MBAs were not a rage back then.

Today MRs earn Rs 2 to 3.5 lakhs annually depending on the company that employs them. Incentive as a component of the CTC can be as low as 15 per cent or even be twice as much as the salary itself, adds Thammaiah. Attrition levels hover between 12 to 13 per cent, and while this may not be a cause for concern, one would closely need to watch the numbers because the pressure seems to be building up. 30 years back there were only two or three competitor brands as compared to 50-60 brands of the same generic name. The doctors’ time is also at a premium with most of them cutting down on the time for MRs to as less as once a week seeing only five MRs or even less. While most may have their elevator pitch handy, getting a physicians interest is a tough ball game. And that is only the tip of the iceberg.

“With most information being available on the Internet for the doctor, shorter training programme or on the job training in some cases and targets being the only focus, the MR visit has become a mere formality instead of a serious discussion. The respectful relationship building with knowledge and skills driving business of yore is missing,” laments EJ. Better training, at least for a month, followed by regular on-the-job coaching by the managers and frequent evaluation during the quarterly review meets was the norm earlier, he adds. Lack of rigourous training and overnight results makes it tough. The growing focus on incentives leads to trading (less convincing but more enticing for the doctor and chemist) rather than building business through knowledge and skill, which might explain the short duration most MRs spend in companies.

Technology to the rescue?

In 1980s with no Internet access, limited access to journals and less flourishing private practices, the dependence of doctors on MRs was high. But today, there is a deluge of information on the net and hence what the MR might need to dispense now has to be exclusive and unique. But that also spells opportunity. He could use direct mail, voice mail, web, iPads, smart phone applications, etc. rather than the routine face-to-face meeting at a clinic to step up the communication. This also translates into flexibility in plans when the need arises. While earlier any query handling or information required would take time, today the entire document can be downloaded and passed to client.

His own development can be strengthened through e-learning platforms, CRMs can be used for better planning and making more effective calls, suggests EJ. However, the key is perseverance and willingness to spend time for his own development and the willingness of the organisation to do the same. “This will ensure that he does not remain a trader but scientifically engages the doctors and makes himself a valuable asset to the organisation,” he says. And then, there are companies which are exploring unique marketing solutions given budget restraints and focus on higher engagement. BioQuest’s deTab solution (iPad detailing) is one such tool which has enhanced field force engagement for pharma companies.

Exhorts Dutt, “These are changing times the industry is going through. Companies need to come out of marketing myopia and look at the businesses in a larger perspective, shifting their focus from selling to healthcare.” In a case study, the solution helped a pharma company target more than 25 per cent of the physician population by effectively engaging them and building their interest while collecting data simultaneously. Does this signal the end of the road for an MR? Maybe not. But something needs to be done to help regain the lost lustre of the profession. EJ recounts an incident during his days as an MR where his discussion with a leading GP in a small town got a little lengthier and an impatient patient barged in. Knowing it was not a serious situation, the doctor got up and told the patient, “I am able to treat better because of people like the gentleman sitting here. He updates me with the latest information on the drugs and other medical products. You should be thankful to him.”

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