How Deep Is Your Impact?

By Malcolm Fleschner

If you’re like most pharmaceutical salespeople, you’ve probably occasionally wondered whether your efforts are having any genuine affect on doctors’ prescribing habits. It’s no idle question. Every year the pharmaceutical industry spends almost $25 billion to promote new drugs and distribute free samples to physicians. As reported in a recent article from the industry experts at EyeForPharma (, emerging research is casting a great deal of doubt on whether these promotional dollars are well spent or just, well, spent.

The article quotes Robert Jacobson, a professor of marketing at the University of Washington Business School and co-author of a recent paper published in the December issue of Management Science. In the article Jacobson suggests a variety of factors, including rising costs and government intervention, are coming together to force drug companies to reexamine traditional approaches to product marketing.

“As the cost of prescription drugs continues to escalate, increased attention is being focused on the role of pharmaceutical marketing practices as a cause of higher drug prices,” Jacobson says. “The concern that pharmaceutical marketing practices compromise physician integrity and have exacerbated increases in public health costs has prompted government actions at both the federal and state levels. The key public policy issue is the extent to which the industry’s promotional tactics lead to an increase in appropriate versus inappropriate use of drugs in a cost-effective manner.”

Jacobson’s study covered two years and investigated pharmaceutical salespeople’s impact on 74,000 physicians’ prescriptions of three popular drugs. Researchers looked specifically at how changes in the number of sales calls and free samples drove new prescription numbers.

While the effects of detailing and sampling varied among the products, the study demonstrated conclusively that at most these common marketing practices had only a modest effect on prescribing habits. Depending on the drug, researchers found that on average between 0.5 and 6.5 sales rep visits were required to generate one additional prescription. For sampling the figures were even higher, with between 6.5 and 73 additional free samples were necessary to induce each new prescription.

These results, Jacobson says, put the lie to the common perception that physicians are easy marks who fall to the persuasive powers of wily pharmaceutical salespeople. In fact, as drug reps will readily acknowledge, physicians can make for very difficult customers indeed. Salespeople’s influence is on the wane, Jacobson suggests, because physicians today have many more options about where to get information, including colleagues, scientific papers, the Internet and their own experience. These sources often are viewed as trustworthier than pharmaceutical salespeople.

“In addition, many physicians are skeptical of or hold negative attitudes toward sales representatives,” Jacobson says. “Physicians recognize that information presented is biased toward the promoted drug and unlikely to be objective or even accurate. Thus physicians often discount information received from sales representatives. Because physicians have access to alternative sources of information that are more highly regarded, it is no wonder the salesperson’s influence is minimal.”

As pharmaceutical companies assess budgets and evaluate their marketing options, future sales efforts no doubt will come under increased scrutiny. Drug companies already appear to be stepping back from the more-is-better approach to deploying sales representatives that predominated during the 1990s. It’s no exaggeration to say that Jacobson’s research, if taken to its logical conclusion, could well lead to a wholesale re-examination of the fundamental relationship between pharmaceutical sales organizations and the physicians they traditionally have targeted.