Over The Counter Selling

Most commercials for medications end with the tagline: Ask your doctor or pharmacist if [insert drug name] is right for you.

Naturally, patients ask their doctors for advice about medications but, as the commercials suggest, pharmacists also regularly receive such inquiries. Yet these days pharmacists are often all but ignored by many pharmaceutical sales reps. Asked about this set of circumstances, Melissa Schlaifer, director of pharmacy affairs for the Academy of Managed Care Pharmacy (www.amcp.org) in Alexandria, VA, suggests a couple of theories.

First, she says, is that a number of pharmaceutical chains restrict drug reps’ access to pharmacists. Second is the assumption that pharmacists have lost much of their influence over patients. “To an extent this is a true assumption,” she adds. “Community pharmacists do not have the decision-making authority they used to have to determine what medication is going to be used. For that reason they may be somewhat ignored by reps.”

Schlaifer suggests that despite these concerns, sales representatives nevertheless can provide community pharmacists with helpful information, particularly about new drugs that become available.

“Pharmacists are the people who get all the questions,” she says. “Whether they can answer the questions to the level required by patients or customers might determine whether or not the patient takes that medication.” Questions cover a variety of issues, including the desire for more information on the latest studies, such as the one about Crestor that suggests it might not be a safe drug. Pharmacists might have to rely on just what they’ve read in the newspapers, so there could be information that the representative could share with them that they wouldn’t otherwise have. Again, such information might influence whether the customer takes the medication.

This example points to another area where pharmacists do wield potential influence over patient behavior: compliance. This is a key issue for many pharmaceutical sales organizations. Schlaifer points out that a well-informed pharmacist also can act as the go-between for patients who are struggling with a certain medication.

“This is happening as more and more pharmacists take on medication therapy management-type roles,” she notes. “A pharmacist observing that a patient is having trouble adhering to a four-times-a-day therapy might be able to recommend a new once-a-day therapy that might help the patient with medication adherence. The pharmacist is always in the position to call a physician and recommend something like that.”

Schlaifer adds that while it’s unlikely a pharmacist would make a formulary decision based on the friendliness or forthrightness of a drug representative, the information salespeople provide can give pharmacists a new perspective on a treatment option they might not have considered otherwise. She adds, however, that as well-trained professionals pharmacists are pretty quick to see through some drug reps’ more transparent sales efforts.

“It’s pretty easy for pharmacists to figure out which reps are telling them what they think they want to hear and instead of all the facts,” she says. “Pharmacists have a pretty deep knowledge of medication and what is true and what isn’t. They know which reps are just giving the pat answer they’re supposed to give because it’s the only answer they know and when they’re really delivering quality information. I think pharmacists can dig through that pretty quickly.”

So what do pharmacists want from the relationship with pharmaceutical representatives? Schlaifer says it comes down to two main issues: respect and accessibility. “Pharmacists are busy – they really don’t have time to chit chat for no good reason,” she explains. “They want someone who respects their time – or the lack thereof. Don’t show up on a Monday at 9 a.m. or 5 p.m. and don’t show up on a Friday at 5 p.m. No one has the time to talk to you then.

“From the pharmacists’ point of view, they want to know who their representative is and have enough of an established relationship that when they have a question about a product or an issue they can pick up the phone and call the representative. They don’t necessarily need you the day you walk into their store, but there will be a time when they need some information or guidance on a drug. They might hear that a certain company has a patient compliance booklet they want, for example, and they’ll get in touch with you to get it.”