Formula for success

March 1, 2002
Gwen McLean
Gwen McLean

Gwen McLean is a managing editor at Walpole, MA-based Informa Training Partners. For more information on training materials that prepare pharmaceutical sales professionals to succeed in today's marketplace, contact Informa Training Partners at (508) 668-0288 or visit Informa online at

Pharmaceutical Representative

Using clinical pharmacology to support your message.

As a pharmaceutical sales representative, you may or may not have graduated from college with a degree in health sciences. If you did, great – you're a step ahead of some of your fellow representatives. If not, you need to gain a basic understanding of the science surrounding how pharmaceuticals work.

In particular, you need to learn about clinical pharmacology – how pharmaceuticals are processed by and impact the body. Why? Because it can help you understand your product, its package insert and any clinical papers related to it. With this knowledge, you can better translate your product's characteristics into features-and-benefits statements to support your sales messages.

Clinical pharmacology covers a wide range of topics, including pharmacokinetics, pharmacodynamics, drug interactions, side effects and routes of administration. Each of these topics is fairly easy to understand on a conceptual basis. Gaining the knowledge to understand the specifics of each topic in terms of your product is more difficult. However, once you understand the specific pharmacologic characteristics of your product, you will be able to use that knowledge to support your product in discussions with your customers.

Concepts of clinical pharmacology

There are five main components of clinical pharmacology that pharmaceutical representatives need to understand to effectively demonstrate the clinical advantages of their products over competitive products.

Pharmacokinetics refers to a drug's actions as it moves through the body, including:

•Â Absorption: how the drug is received by the body.

•Â Distribution: how the drug is moved into particular tissues in the body.

•Â Metabolism: how the drug is changed so that it can be eliminated from the body.

•Â Excretion: how the drug is eliminated from the body.

Pharmacodynamics refers to a drug's ability to produce changes (both therapeutic and nontherapeutic) in the body. Under the umbrella of pharmacodynamics is a process termed "mechanism of action." This refers to how a particular drug produces its therapeutic effects. For many drugs, the precise mechanism of action is unknown. One example of a mechanism of action can be seen by looking at a drug aimed at speeding up the heart rate: A drug whose mechanism of action is to stimulate beta receptors will likely achieve the therapeutic effect of speeding up the heart rate.

Drug interactions can result when two or more drugs are taken at the same time. Interactions can also occur between drugs and different types of food or alternative therapies, including vitamins and herbal remedies.

There are several types of drug interactions, among them:

•Â Additive effect: the effect resulting from the sum of the drugs' effects (drugs involved must have similar actions).

•Â Potentiation or synergistic effect: the effect resulting when one drug enhances the effect of the other drug (drugs involved must have similar actions).

•Â Antagonistic effect: the effect resulting when the combination produces a lesser effect than either one of the drugs alone.

Some combinations of drugs can also lead to decreased or increased absorption, metabolism or excretion.

Side effects, also known as adverse reactions, are undesired responses to drugs. Some side effects are related to dosage. The most severe dose-related side effect is an overdose, in which the adverse reaction is toxic. Other side effects are related to the sensitivity of the patient. These sensitivity-based side effects, which include such responses as allergic reactions, depend on the individual taking the drug. Some side effects, however, occur just because the drug has been introduced into the body and cannot be attributed to either dosage or patient sensitivity. An example of such a side effect might be mild nausea.

Route of administration refers to how a drug enters the body. There are several routes, among them:

•Â Intravenous: injected into a vein.

•Â Inhaled: breathed in.

•Â Oral: swallowed.

•Â Intramuscular: injected into muscle tissue.

•Â Subcutaneous: injected under the skin.

It is important that you understand the concepts behind these components of clinical pharmacology before you begin to apply them in your sales calls.

Applications of clinical pharmacology

Once you understand the basic concepts of clinical pharmacology, you can go on to learn the specific pharmacologic characteristics of your products. By gaining this understanding, you will be able to apply your knowledge of clinical pharmacology during your sales calls and increase your credibility with your customers.

Applying your knowledge of pharmacokinetics can be useful in demonstrating the advantages of your product in several ways. For example, imagine you are selling a drug that has a half-life of 12 hours. This means that it takes 12 hours for half the drug to be eliminated from the body. Now imagine that your competitor's drug has a half-life of just six hours. This may mean that the competitive drug has to be taken twice as often as your drug. This is a great selling point for your drug, because it shows that it may be far more convenient to take and, as such, patients may be more likely to adhere to the regimen required for effective treatment.

You can similarly weave benefits related to the pharmacodynamic properties of your drug into your sales calls. For example, let's say your product is a dopaminergic drug used to treat patients with Parkinson's disease. Dopaminergic drugs, which aim to alleviate the movement disorders associated with Parkinson's disease, typically work by either increasing dopamine concentration in the brain or increasing neurotransmission of dopamine in the brain. For certain patients, one action may work more effectively than the other, and you may be able to strengthen your sales messages by focusing on these differences.

To use information regarding drug interactions to support your sales messages, you will need to know which drugs are most often used in combination with your drug. There are two main reasons that a patient might take additional drugs:

•Â Comprehensive treatment of the disease your drug is used to treat may require additional drugs. For example, patients suffering from AIDS take what has been termed a drug "cocktail," meaning that they take numerous drugs to treat their disease.

•Â The patient may suffer from one or more diseases other than the one your drug is used to treat. For example, a patient may suffer from both diabetes and hypertension. Thus, the patient would likely take two or more drugs simultaneously to treat both diseases.

To illustrate how you can discuss drug interactions to support your sales messages, let's say the drug you are selling is used to diminish coughing for patients with emphysema. Patients who suffer from emphysema may also be addicted to nicotine, and may thus be using a nicotine patch to suppress nicotine withdrawal symptoms while they discontinue smoking cigarettes. You need to be aware of the potential drug interactions that result from the use of nicotine patches with your drug, as well as interactions of nicotine patches with competing drugs. These differences may be the key to getting your customers to write your product instead of another.

Side effects or, more likely, the lack of side effects can be a major selling advantage for your product. For example, if you are selling a drug that is used to treat arthritis but does not cause gastrointestinal side effects, you may be offering significant advantages over competing arthritis drugs.

Routes of administration can help you differentiate your product from competitors as well. For example, if a competitive product is available only in tablet form, but yours can be swallowed in a liquid form, your product may have significant advantages for treating the elderly, some of whom find it difficult to swallow pills.

Reality is rarely so simple

When highlighting certain pharmacologic characteristics of your products during sales calls, it is important to remember that the components of pharmacology are all interconnected. If one component is restricted or impacted by some factor in some manner, others are likely affected, and so on.

For example, if the route of administration must be oral, the drug may be distributed more slowly than if it were injected. If distribution is slower, metabolism of the drug may also take longer. Now consider that a portion of patients using your drug may have liver disease. For these patients, metabolism could potentially be reduced even further. And what if these patients were taking another drug (or drugs) to treat their liver disease? It's possible that there could be some sort of drug interaction that would impact the way the drugs work and/or cause side effects that might not occur if the drugs were taken alone.

The possibilities are endless. In prescribing treatments, physicians must weigh the pharmacologic pros and cons for each of their patients. In promoting your products, you must also weigh these same pros and cons. Healthcare professionals listen to and believe in science. By using clinical pharmacology to support your sales messages, you will be letting science demonstrate your product's ability to help physicians treat their patients in the most effective way possible. PR

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