Product is going to sit regardless. RAMs should go, not because they're not doing anything; but, because there is nothing for them to do. Consider the number of RAMs there are, versus the number of IVs being submitted per region. Too many RAMs! Other, more successful, companies operate with a third of the support.
This drug was doomed before it even launched. First, it was priced too high. Second, the territory goals were not properly established. Third, executive management grossly underestimated the specialty's experience with injectible Buy & Bill drugs. And, last.....they overestimated how readily physicians would be willing to abandon the very thing for which they went to medical school - surgery, for the chance to use XIAFLEX.
Don't get me wrong.....XIAFLEX is a good product. It does exactly what it is marketed to do. But, how you start off, will have a lot to do with how you finish.
HUBRIS KILLS!!!!!!!