Some veteran observers see this new "less is more" wave as old-fashioned, a much-needed refocus on value—and even values.
"In many ways, we're going back to the vision of customer-relationship management—how to execute an effective sales mix, not
just a product detail," says Andrew Brana, a consultant of sales optimization for TNS. "What is the role of the rep? It's
always been 'Here's your detail guide, repeat this.' Now the rep is going to be a coordinator of value."
"We're going back to the future," says Mike Marquard, CEO of PDI. Marquard's first job in pharma was with Lederle, and as
the only rep in the territory, he promoted all the company's products. "Sales is transitioning from a reach-and-frequency
environment to a relationship environment."
As with all models under pilot, the specialty approach has features that make its wider application tricky, to say the least.
For one thing, the success of the physician–rep relationship depends largely on the company's actual investment in the disease—above
all, the depth of its pipeline. "The most successful specialty companies are regarded by their customers as being preeminent,
not just because of the products on the market today, but also because of the pipeline they have," says Bishop. "Specialty
customers are always—and pretty uniquely—very focused on both those attributes."
For the big pharmas buying their way into specialty disease areas with late-stage biotech products, Bishop issues a warning:
"It's very important to have a plan that's going to allow you to continue to innovate in that space, because customers can
become very demanding about your investment in that field going forward."
So while the specialty model has clearly caught Big Pharma's fancy, it's no magic bullet. "The success of the specialty model
has probably been as spotty as the mass-market model," says Luby. "Right now the specialty model is a reflection of the broader
trend, which is getting out of the arms race."
Dialing Down Primary Care
As the more daring (or desperate) drug giants dip their toes into "specialty lite," not one is forgetting the simple fact
that the majority of scripts today are written in the primary care office. Reps need to be there—just not in the same numbers.
And while downsizing is not itself a new model, the speed and other specifics with which each firm manages its cutbacks will
reveal, if nothing else, an ad hoc strategy.
In sheer numbers, how low will pharma go? PDI's Marquard predicts that over the next five years, the industry's 100,000-strong
sales force will drop into the 70,000 range. Since pharma spends about $9 billion a year to send these reps out into the field,
downsizing by that much could save nearly $3 billion annually.
That's not chump change, but it's no windfall, either, so each firm is expected to proceed with caution. As a result, many
industry observers say it could take at least a decade for pharma to unwind from its massive scale-up. "I don't think we're
going to see revolution overnight," says Nick Jones, a senior consultant in PricewaterhouseCoopers's pharma sales-and-marketing
practice. "If evolution is the case, it will be a steady and jolty decline rather than a drop off the cliff."