An important link

December 1, 2002
Paul Pinsonault
Paul Pinsonault

Paul Pinsonault is president of Flanders, NJ-based Pinsonault Associates L.L.C., a managed care training and information company for the pharmaceutical industry. He can be reached at (800) 372-9009 or by e-mail at paul@pinsonault.com.

Pharmaceutical Representative

The value of calling on the retail pharmacist.

Until recently, pharmaceutical sales efforts have been directed almost exclusively at the prescribing physician. However, with the advent of managed care, it is very clear that influencing physicians' prescribing behavior is simply not enough to guarantee greater utilization of your company's product. Oftentimes, managed care organizations override a product the physician prescribed for a patient and replace it with another at the point of sale, thus overturning all of your sales efforts in the doctor's office.

Therefore, your sales efforts today should also be directed to retail pharmacists, because many prescribing changes using therapeutic and generic substitutions are being made behind the pharmacy counter. This change has given more decision-making responsibility to pharmacists, who are becoming an ever more important link in the pharmaceutical sales chain.

Today's retail pharmacists wear many hats and have numerous responsibilities. They work closely with physicians, managed care organizations, patients, and numerous clinical and business personnel at their corporate headquarters who direct their activities. Pharmacists talk to physicians about the appropriateness of drugs for different patients, including potential drug interactions and adverse events. They interact with MCOs by phone, fax and computer transmission, determining whether or not certain prescribed medications are covered for payment by the health plans, or if other drugs may be preferred by the MCOs. Pharmacists are also the critical patient interface, since they will distribute the product and provide counseling to the patient. This makes the pharmacist a good barometer for the reception of your product across all customer segments. Remember that the pharmacist also has the ability to override health plan and pharmacy benefit management drug substitution policies in favor of your brand, so calling on the retail pharmacist should always be considered a critical part of your weekly call plan. Let's take a look at how to maximize your efforts when selling to the retail pharmacist.

Target high-volume pharmacies

Health plans and pharmacy benefit management companies usually have drug purchasing contracts in place with high-volume retail pharmacy chains and co-ops that are responsible for dispensing pharmaceutical products at the consumer level. The health plans and PBMs are often able to negotiate volume discounts with these drug retailers based upon the high number of prescriptions they collectively dispense on behalf of the health plan or its PBM. For this reason, you should put time and effort into establishing relationships with pharmacists in busy retail outlets, because this is where most prescriptions are filled. Find out where the busiest pharmacies are located throughout your territory by asking physicians and their office staff members which pharmacies their patients seem to use the most or which ones seem to generate the highest prescription volume. This will put you on the right track for targeting the pharmacies that can make the biggest impact on your products' sales and market share.

The first call

As a rule, retail pharmacists tend to be overworked and have a limited amount of time to see sales representatives. In fact, most work overtime during store hours on a regular basis and must come in early before opening or stay late after closing just to keep pace with the flow of prescriptions that must be filled during the average workweek. Being aware of the time constraints of the typical community pharmacist, it is imperative that you do effective pre-call planning so that your face-to-face time is well-spent. Be certain to have copies of the latest clinical studies and Food and Drug Administration prescribing information sheets for your products as leave-behinds, along with appropriate patient education materials, as the pharmacist should be detailed the same way you would a physician. Pens, writing tablets and other company-approved reminder items are also good to leave behind, but clinical papers and marketing pieces that outline the safety, efficacy and benefits of your products should always be of highest importance.

When calling on a pharmacy for the first time, the first thing you need to do is gather basic information about the store's operating schedule to ensure that your future visits are pleasant, productive and convenient for all who will be participating in the product discussions. The five most important things you'll want to find out initially are:


•Â The best day(s) of the week to call.


•Â The best time(s) of day to call.


•Â Whether or not appointments are required.


•Â What type of information the pharmacy staff needs most.


•Â What the pharmacy staff expects of you and your company.

In addition, be sure to introduce yourself to the head pharmacist and to include him or her in discussions on every call, as this individual keeps a finger on the pulse of the entire pharmacy operation. Moreover, the head pharmacist is often the primary resource for physicians who call and seek expert advice on pharmaceutical products and therapeutic recommendations. It is critical to make the head pharmacist an advocate of your brands; as the physician's most trusted source of information on pharmaceutical products, he or she can effectively promote the use of your products versus those of your competitors during discussions with healthcare professionals each day.

Provide product information

By being a valuable drug information resource for pharmacists, you help them to do their job better by serving their patients more effectively. Treat the pharmacy call exactly as you would a physician call. Present the features and benefits of your product so pharmacists can recommend your brand when it is an appropriate drug therapy. Alert them to any new labeling changes or indications for your product, share new studies as well as any company-approved support materials you may have, and explain to them how your product compares favorably with the competition. Whenever possible, show how your product can reduce the total cost of care by eliminating the need for additional office visits, lab work, tests and other expensive healthcare services, and support these claims with pharmacoeconomic outcomes studies if they are available. When calling on pharmacists, treat them as sophisticated healthcare professionals and partners in providing appropriate drug therapy for the hundreds of patients who come through their doors each day.

Present managed care information

It is important to share information on your drug's formulary status with pharmacists, especially when your product has been added to a health plan's formulary for the first time. Pharmacists may not be aware of this change, or that your product may have a lower co-pay than the competition. Also let pharmacists know when your product has achieved preferred status with major health plans, since the pharmacy may need to stock more of it to meet increased demand. By bringing your product to pharmacists' attention when it is preferred on formulary, you increase the chance that they will suggest your product to physicians when they make therapeutic recommendations and product substitutions. This is an important step in a pull-through program and will help reinforce formulary compliance while increasing your products' sales and market share.

Pharmacists are also open to receiving patient education materials so they can counsel customers on the value of your products. If you have programs in place to support the use of your drugs, or if disease state management programs are available, make sure pharmacists are aware of them so they can supply them to appropriate patients. When you are able to secure time with the head pharmacist and the pharmacy staff, schedule in-service breakfasts or luncheons where you can provide in-depth information about your products. By providing these added benefits, you will help increase patient compliance and help pharmacists perform their jobs more effectively.

Continuing education accredited programs are another resource you may provide for pharmacists. Pharmacists must earn a certain amount of CE credits every year to maintain their professional licenses, so capitalize on the value of these programs whenever they are offered by your company.

Gather product information

One of the most important functions of your relationship with pharmacists is to gather information and learn more about your territory. Pharmacists can provide valuable information on the movement of your product, including:


•Â Which dosage strengths are being utilized most.


•Â Which dosage schedule is being written most frequently.


•Â Other products being commonly co-prescribed with your product.


•Â Trends in off-label utilization.


•Â Patient demand, feedback and compliance.


•Â Physicians' comments regarding the product's usage within their practice.

Pharmacists can also provide you with important feedback as to what the competition is doing from a marketing perspective, what their sales message is, and what impact other brands are making within your territory. This information will allow you to adjust your physician presentations accordingly and thus sell more effectively.

Gather managed care information

Pharmacists work with all types of formulary information from national, regional and local MCOs when adjudicating claims. They have access to claims adjudication information such as whether a product is on formulary, if any National Drug Code blocks are in place and what the co-payment amounts may be. Equally important, pharmacists know of the drug substitution policies that are in effect at various MCOs and the impact they have on your product. All of this information and more is readily available to pharmacists via their computer connection to MCO networks. Once you have established a relationship with the key pharmacists throughout your territory, they can become a resource to supply you with this information.

It is important to remember that you should only request managed care information from a pharmacist whom you have built a good business relationship with first, because managed care information may be sensitive. It can also be time-consuming for a busy pharmacist to gather this data on your product and its competitors, so you should only make this request after you have established a good business relationship with a pharmacist. Always be sure you are prepared before making the request. Consider handwriting or typing your request prior to the call. Then, offer to leave your request with the pharmacist and pick it up at the end of the workday or the following business day. In high-volume pharmacies where pharmacists are extremely busy, this technique may be very helpful, and also makes it easier for them to look for the information.

Above all, remember that pharmacists are an increasingly valuable resource for you, and their influence should never be underestimated. A well-planned call at a busy retail store builds mutually beneficial relationships that allow you to help retail pharmacy providers keep physicians and patients informed on the safety and benefits of your products. In return, pharmacists can supply you with timely information about competing products, as well as first-hand feedback from both the doctors who prescribe your brands and the patients who use them. Your ability to sell retail pharmacists on the safety, efficacy and benefits of your products can help convert these individuals into powerful advocates who will recommend your brands to dozens of physicians they speak with each day regarding the most appropriate therapy options for their patients. So take time to properly prepare before sales calls to retail pharmacists, as the successful business relationships you build with them can dramatically improve your products' sales and market share. PR

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