Before a pharmaceutical company dispatches a sales rep to a medical practice, the marketing department learns some basic facts
about the physician: how many new prescriptions she's written, how many refills, and how much upside prescribing growth she
might generate. What the rep usually doesn't know: who else—nurse practitioners and physician assistants—prescribes medications
in the office, at a nearby clinic, or sometimes in a separate practice just down the hall. The rep could make another sales
call, but for a variety of reasons he usually does not. Physician assistants and nurse practitioners remain poorly recognized,
and therefore rarely courted by pharma. One barrier to marketing to these clinicians is simple lack of prescribing data. Information
offered for sale by the big data providers frequently excludes nurse practitioners and physician assistants. And in the pharmaceutical
industry, where there is no data, there is no marketing.
Current Prescribing Patterns
Pharmaceutical companies not only fail to market to this sector, they neglect to invite nurse practitioners and physician
assistants to meetings or to include them in plans for continuing medical education. Most practitioners must complete 100
hours of continuing education every two years. By not counting nurse practitioners and physician assistants among valued prescribers,
pharma misses the opportunity to shape the practice of these professionals.
Even when pharmaceutical companies set out to target this market, they are often uncertain how to address nurse practitioners
and physician assistants. Their practices vary dramatically in scope and orientation, which makes it difficult for sales reps
to develop consistent messages.
And in many cases, pharma's own rules get in the way of the sales force.
Reps are often charged with adhering to rigorous call schedules—many aim to see eight or 10 physicians a day—which leaves
them little time to interact with nurse practitioners and physician assistants. And at many companies, rules dictate that
reps do not receive "credit" for a sales call if they spend time detailing nurse practitioners and physician assistants.
Continuing Medical Education
In fact, pharma marketing policies regarding these medical professionals are often stricter than state laws. Manufacturers
frequently restrict reps from sampling anyone but doctors, even though laws in all 50 states and US commonwealths set conditions
under which nurse practitioners and physician assistants can accept, sign for, and dispense medication samples. So manufacturers'
own physician-only signature policies hamper reps' ability to develop relationships with other clinicians.
Whatever the difficulties, pharma is missing a good-sized market. More than 100,000 nurse practitioners and nearly 60,000
physician assistants currently practice. Just 40 years ago, nurse practitioners and physician assistants were rarely found
anywhere but rural settings, which were severely underserved by physicians, and in the military, as medics.
How often do NPs meet with pharmaceutical reps weekly?
Today, both disciplines have growing membership associations with outstanding national and regional leadership. Physician-assistant
and nurse-practitioner associations lobby Congress and work closely with state boards of medicine to advance their causes.
They have accredited training schools—collegiate and postgraduate—with rigorous admissions and graduation requirements.