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Are doctors more willing to see pharma sales reps now?

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flickr creative commons

The doctor will see you now.

That familiar refrain — which traditionally was directed at patients — may apply to pharmaceutical  sales reps, a new survey finds. After years of eschewing these sales teams, the percentage of doctors who refuse to meet with them fell to 19 percent this year from 25 percent in 2014.

The trend extends to most medical specialties, including cardiologists, gastroenterologists, and neurologists, as well as primary care physicians, according to CMI/Compas, a market research firm that canvassed 2,680 physicians earlier this year. The survey [2] also found that 39 percent of doctors are willing to see reps without any restrictions on office visits, up from 36 percent last year.

This appears to be a shift from recent years, when some physicians increasingly restricted sales calls or banned reps, altogether. Those moves came in response to concerns that sales reps eat up precious time and drug makers were going to excessive lengths to influence prescribing patterns, often pushing costlier medicines.

The reversal reflects a growing interest in new types of medicine that have the potential to change patient care, according to the research firm. Among oncologists, for instance, 24 percent reported plans to increase their interactions with sales reps, up from 11 percent in 2014. And only 13 percent plan to decrease interactions compared with 27 percent last year.

Over the past couple of years, a new class of cancer treatments has generated considerable optimism. Known as PD-1 inhibitors, these medications work by stimulating the body’s immune system to fight tumors and are expected to generate billions of dollars in annual sales. Already, the FDA has approved such drugs to treat melanoma and metastatic non-small cell lung cancer.

But before concluding that a sea change has truly occurred, consider that a consulting firm recently released data [3] indicating physicians are less accessible to sales reps than before. After analyzing sales calls reports filed by industry reps, ZS Associates found 47 percent of prescribers are accessible to reps this year, down from 51 percent in 2014 and 55 percent in 2013.

A key reason is consolidation among physician practices, according to Pratap Khedkar, a managing principal in the ZS pharma practice. As more physicians work for health and hospital systems, doctors typically have less autonomy in choosing medicines to prescribe. Once centralized purchasing kicks in, doctors are less likely to see reps from some companies or those who pitch certain products.

Some specialties continue to buck this trend – urologists, dermatologists, allergists and rheumatologists. Why? Many of these physicians continue to work in smaller, independent practices that are still owned by physicians. More than two-thirds of these physicians remain accessible, according to ZS.

What else may account for the varying conclusions from the firms? A spokeswoman from CMI/Compas declined to comment. But Khedkar pointed to a couple of possibilities. One is a larger sample size – ZS tracked data involving interactions involving sales reps and about 348,000 physicians, which Khedkar contends provides a more complete picture.

He also suggests that physicians have selective memories when it comes to determining which reps they plan to see. “Keep in mind that many of the reps who are not as effective or have mature products may not get to talk to the doctor at all, so doctors will not think of these reps. So the responses can be biased as a result,” he told us.

However, Khedkar does concede that one reason that physicians are willing to grant improved access is a new medicine, which requires conveying new information. And he agrees that oncology is a prime example. “We see that reps with new drugs get in more than others,” he wrote us. “But if you don’t have a distinctive new drug, it will be challenging.”