Education Trumps Regulation

New research points to the power of a highly educated sales force, supporting the case for a voluntary educational standard
Mar 01, 2008


James E. Dutton
The SafeRx Act, legislation that requires licensure of pharmaceutical sales representatives in Washington, DC, is the latest in what looks to be a long line of efforts to regulate interactions between industry sales reps and physicians. Legislators in Maine, New Hampshire, and Vermont also are eyeing the relationship, proposing legislation that would further restrict pharmaceutical sales-and-marketing activities.

This movement is increasingly organized and has what appears to be a growing number of supporters. No Free Lunch, a not-for-profit organization of healthcare providers, recently made headlines by urging medical students to resist the free pizza offered by drug companies. A health system in Duluth, MN, reported ridding its offices of 20 shopping carts of promotional items from pharmaceutical representatives and shipping them off to Africa. The Massachusetts Prescription Reform Coalition—a newly formed alliance that includes the AARP, the American Heart and Stroke Associations, as well as insurers such as BlueCross BlueShield of Massachusetts and Neighborhood Health Plan—announced its intention to work to eliminate the "inappropriate marketing practices" it says are driving up the cost of healthcare. The Prescription Project, an effort funded by the Pew Charitable Trust, has similar goals.

Some groups advocate eliminating the pharmaceutical sales call altogether, and stories abound of healthcare systems that have banned or severely restricted sales representative visits to physicians—not to mention individual physicians who have decided they will no longer see reps in their offices or clinics. These and other efforts create the impression that more and more of today's practicing physicians and other providers see no value in any aspect of the pharmaceutical industry's marketing efforts and want nothing to do with sales representatives. But is that perception accurate? Do physicians really want to do away with the sales call by pharmaceutical representatives?


Docs to Reps: You Oughta Know
To find out, CMR Institute decided to go to the source—physicians and industry representatives—and ask them about their experiences. What we found is that most physicians we surveyed do value sales representatives—if they are well informed, have something new to say, and have a well-rounded body of knowledge that goes beyond the specific attributes of the products they sell. Based on our preliminary research, CMR concluded that more education, not regulation, is the key to improving perceptions of the pharmaceutical industry and, most importantly, adding value to the quality of patient care.

Asking the Questions

CMR Institute conducted a series of focus groups with primary care physicians and specialists across the country, as well as a quantitative online survey, in which doctors were asked what qualities were most important in a sales representative. When asked, fewer than 10 percent said they do not see sales representatives.


Rep Education: A Cost/Benefit Analysis
Our research suggests that physicians do value pharmaceutical representatives whose knowledge goes well beyond familiarity with a particular product. Yet, bringing representatives to a knowledge level where they are confidently conversant in all these areas requires a real commitment from pharmaceutical companies and their sales teams.

A standard already exists in Europe: Sales representatives have to meet strict corporate-responsibility standards set forth by the European Federation of Pharmaceutical Industries and Associations (EFPIA). EFPIA—the voice of 2,100 research-based European pharmaceutical companies—is committed to patient care and quality-of-life issues, with strong emphasis on research and development of new medicines. Its Codes of Practice, which all representatives must follow, regulate marketing tactics and require sales representatives to have "adequate training and sufficient scientific knowledge."