Mr. Rolodex Stallion sir...I still don't get how a specialty rep is different than a primary care rep? You said, "Specialty is not defined by who you call on rather by what drug you sell." I want to know...if both reps sell pharmaceuticals or drugs, what's the difference...seriously? What are you saying??
I'm really confused. Are you saying that cancer *agents* are more special or more important than drugs for the heart, brain, gut, pancreas, other organs etc? Therefore, oncologists are more special than family medical docs? Are oncology medical specialists more intelligent and harder working than their primary care physician counterparts? Do oncology specialists give better care than primary care generalists and therefore are more special?
Or are you saying that oncology reps know their product's actions, side effects, tolerability, efficacy,etc etc better than their primary care rep counterparts? Or maybe you're saying that specialty reps need more clinical knowledge, more patient focus, a better understanding of managed care issues, or maybe a better understanding of their target market than primary care reps? And primary care reps don't need to be bothered knowing any of this? Or is the main reason you feel specialty reps are more special is because the medicines they sell come at a higher price per treatment than plain ole primary care medicines? Oh wait, do specialty reps have a higher business acumen than primary care reps? And primary care reps do not need to know messaging, the reason behind the message or the business decision behind the message to sell to primary care docs?
Lastly, what is the difference between a mass market pharma company and a great biotech? Whew--lots of questions!Please enlighten me. Thanks in advance!
ETA--last time I checked..psychologists don't prescribe..
First I do think the Rolodex Stallion smack is pretty funny so kudos to for having a sense of humor. Secondly please excuse any grammatical and spelling errors has I had a lot to say and my editing might not be the best on a Friday after a long week. So even though you were being sarcastic here are some replies to your questions.
To your first point I am not saying cancer agents are more “special” or more “important” (both subjective terms btw), what I am saying is the knowledge base a rep needs to work in this area is more involved and at a much higher and in-depth level. I’ll give you an example: If you sell a PPI to a GI you need to know about GERD and the other PPI’s in the space but you do not need to know, nor are you expected to know, about other GI disease not related to PPI’s like Crohn’s disease or HCV/HBV or NAFLD. Likewise if you sell a lipid lowering agent to a Cardiologist you need to know the other agents and some basic anatomy and disease state, but you will not be having conversations about valve ablations, defib implants, and interventional techniques, etc.
In oncology even if you only sell a lung drug you need to have solid understanding of most of the other tumor types, solid and liquid, and the hundreds of drugs used in treating all cancers. If all you know is lung ca and the treatments used in that space and the oncologist is trying to draw a treatment parallel to CRC and you can’t follow the conversation you credibility is shot and you are done. You need to have a very strong working knowledge of every class of agents and all the surgical/interventional/radiological/diagnostic imagining components involved in a variety of cancers. Within your own drug you have to be a somewhat expert of many bodily systems that your drug may have a negative affect on. Cardio toxicities, tumor lysis, neurotoxicitys, pulmonary events, thrombocytopenia, bowl perforation to name only a few. With those AE’s you better be well versed on cardiology, pulmonology, nephrology, hematopoiesis, and neurology. Misrepresent the severity of any of those AE’s to your doc or nurses, and it occurs, you are done. Go to the NCCN website and look at the treatment guidelines. To be a respected oncology rep you better have a clear understanding of most of those treatment algorithms and at the very least the larger tumor types. It can take years to have a high level of understanding so you can have a remotely intelligent conversation with a KOL on a tumor type. Understanding your products, its competitors, and the tumor type will take you a year, and that’s without learning any other tumor type or class of drugs. Pretty sure you can pick up the beta, ACE, antibiotic, statin, PPI, etc markets with a few weeks of home study and two weeks at the home office training…
To your point about AE’s/Efficacy/Clinical Knowledge:
Sure every rep needs to know their stuff, what I will say is the stakes are lot higher in life and death TA’s. The AE’s for most oncologics are intense and can be life threating, not to mention the efficacy of a cancer therapy IMHO is more “important” that the efficacy of a PPI or a beta blocker or statin where you can switch to other drugs in the class with very little concern. If you don’t like Prilosec you can move to Previcid. If you have nausea on one SSRI you can switch to another SSRI. If you get a rash on one antibiotic you can switch to another. Sure there are the rare cases of fatal AE’s from PC drugs but it is not an everyday occurrence. In oncology there usually isn’t drug B to go to so understanding the nuances of dosing preventative and supportive measure, combo options, adjuvant, neo adjuvant options, and off label data and articles that most oncologists won’t be fully aware of, are critical and unlike any other TA’s. A big part of our jobs is in servicing the infusion nurses. You would think that the doc or the senior nurses would do this but they do not – they simple do not have the time. They call us in and we teach the new nurses how do mix, administer and monitor patients. Also when you look into the NCCN guidelines you will see where the opportunity is to sell. There is a plethora of gray area in the guidelines which is where an oncology rep sells. Trying to convince an oncologist to use your drug versus another drug with a higher category rating in the algorithm is very challenging and you better know you stuff inside and out. Sorry I do believe this is more clinically challenging to get a doc to switch from Lipitor to Crestor. This isn’t switching a beta blocker or an ace inhibitor, this is trying to keep someone alive and not die in the infusion chair form a reaction or their tumor in a week or two. We don’t message in oncology, like you do in PC. The good reps have very consultative conversations many times about things not related to the drugs we sell per se. It may be building MDT’s, or working on a building a tumor board in the community. It’s not reach, frequency, messaging, sampling, and dinner programs which is what 95% of PC is. Look I’ve done both and I know what both jobs are. Can you say the same? I’ll be the first to say that in the commodity/PC/Mass Market or whatever you want to call it you “sell” a lot more and harder than we do in oncology. We are more like liaisons for the company and the product and sometimes for the disease state. We manage accounts, KOL’s and academic institutions more so then we “sell”. Think of most oncology reps as the MSL, the hospital rep, the community/clinic rep, the reimbursement specialist, and the nurse educator. In rarer tumor types we are truly the educators to the physicans. Sure they can look up stuff on the internet and they can call their collegues but they still call use to inservice them and their staff especially before the first treatment, and many times we can provide information not found on the web or from their colleagues. We wear a lot of hats that can take years to master hence why you so seldom see a PC rep go to oncology. Even at the big pharma oncology companies like Pfizer, Novartis, BMS, and GSK recognize this as they promote less than 5% from within due to this steep learning curve.
Better business acumen? I wouldn’t say that. I would say that based on being in a far more involved selling process you gain things form that experience that cannot be gained another way. The buy in bill model, in patient vs out patient, etc, MDT’s and who is driving the cases, are all things that are very hard to obtain selling PC, PO drugs picked up at Walgreens.
The difference between mass market and a great biotech:
Mass Market: products aimed for the primary care and general practice physicians, many times in commoditized, me too markets, where a key marketing tactic is the use of samples. Mass market drug companies many times grossly over manage and micro manage their reps and have a long list of processes, policies and procedures to insure employee compliance. Compensation is benched marked to other mass market companies and is usually much lower that their biotech counterparts of equal years of experience. There tends to be no or very small equity in the companies in the form of stock options, grants, and espp, and generally the perks are at a much lower level. Things such as vacation days, company car choices or car allowance reimbursement, meeting sites, and presidents club trips. You will train with archaic methods like role playing, scripts and “messaging”.
Great Biotech: products are generally novel and innovative with a focus on meeting an unmet medical need in a very serious and/or life threating disease state. Reps are generally very experience both in the industry and the therapeutic area in which they work. Because the sales forces are tenured you tend not to see the same processes, policies and procedures seen in big pharma/mass market companies. Generally but not exclusively you see very little micromanagement and a high degree of autonomy at the rep level. Field ride a longs at a maximum are limited to one customer visit a quarter generally with a KOL and not for the purpose of evaluating the rep but rather to work on a larger issue with a KOL. There is no call reporting system or metric of “calls per day” nor is there a management by metric or objective. Performance in generally based in units sold. Annual compensation can reach $200K plus at the rep level and the average is approx.. $175K. Equity in the company is common and can have a positive financially impact in the form of options, grants, espp, and MPP’s. Perks like higher end company cars like Volvo SUV’s or Saab’s or Jeep Grand Cherokees are common but for the most part great biotech offer a lucrative car allowance of $700-$800 a month plus 51 cents per mile. On average a car allowance affords the reps with extra $8000 to $9000K a year plus $15K to $20K in mileage.
Yup you got me… I spelled psychiatrist wrong and my spell check flipped it to psychologists…my apologies.
I hope this is helpful.
, but thanks for asking.
