Pharmaguy's Insights Into Drug Industry News
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Pharmaguy's Insights Into Drug Industry News
Pharmaguy curates and provides insights into selected drug industry news and issues.
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HexaBlockbusters! Sales of Each of the 9 Best-Selling Prescription Drugs in 2016 Topped $6 Billion.

One primary reason behind the continued increase of prescription drug costs is the greater number of specialty drugs that have been introduced by biopharmaceutical companies. These specialty drugs are used to treat complex or rare chronic conditions. Many of them are biologics, which are drugs derived from living cells.

The flip side of the rising costs of prescription drugs is that some drugmakers are making a lot of money. Here are the nine best-selling prescription drugs of 2016, all of which generated sales of more than $6 billion.

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Study: Restricting #Pharma Sales Rep Access to Doctors Cuts Prescriptions for Promoted Drugs. Duh!

Study: Restricting #Pharma Sales Rep Access to Doctors Cuts Prescriptions for Promoted Drugs. Duh! | Pharmaguy's Insights Into Drug Industry News |

Restricting drug company access to doctors at academic medical centers resulted in a substantial reduction in the number of prescriptions that the physicians wrote for drugs touted by the pharmaceutical industry, a new study found.

The University of Pittsburgh School of Medicine was among 19 academic medical centers in five states that were examined in the study, which appeared in the latest issue of the Journal of the American Medical Association. The institutions represented nearly 35 percent of all prescriptions written in 2015.

The study is the latest to challenge direct pharmaceutical sales calls to doctors — a practice called detailing, which sometimes includes gifts and meals — to encourage the use of products that are often more expensive than generics and other treatment options. In the past, drug company representatives have touted new uses for existing drugs for Alzheimer’s disease, for instance, which have harmed patients.

For example, in cases involving the antipsychotic drugs Risperdal and Invega, Johnson & Johnson in 2013 agreed to pay the government $2.2 billion to settle claims that pharmaceutical representatives promoted the medications for patients with confusion or dementia, despite evidence the medications increased the risk of stoke and other problems in the elderly.

Pharmaceutical companies earned more than $60 billion for the eight detailed drugs that were part of the study while generic drugs are on average 80 percent to 85 percent less expensive than branded drugs. Eight drug classes were part of the JAMA study, including medications to lower lipids, control gastroesophageal reflux disease, treat diabetes and others.

“It’s amazing how little it takes to influence how somebody thinks about something,” said George Loewenstein, one of the study’s authors and a professor of economics and psychology at Carnegie Mellon University. “The study really supports the need for more academic medical centers to adopt stronger policies.”

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Big Pharma Sales Dominated by Products That are Over 10 Years Old!

Big Pharma Sales Dominated by Products That are Over 10 Years Old! | Pharmaguy's Insights Into Drug Industry News |

Biopharma’s never-ending challenge of refreshing pipelines is today a tale of three companies, all of which have ageing product lines that are vulnerable to generic competition.

On the one side are Sanofi  and Lilly, which have turned largely to their in-house laboratories to refill pipelines in the hopes that billions of dollars a year in R&D spending will help them replace products that are at least 10 years old. On the other side is  Roche , which has outspent both on R&D, and at the same time has spent far more than the others to buy companies for their promising developmental assets (see graph above).

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Woman Pharma Sales Rep Income Still Lags Behind That of Men

Woman Pharma Sales Rep Income Still Lags Behind That of Men | Pharmaguy's Insights Into Drug Industry News |

According to the report by medical job board, U.S. professionals selling pharmaceuticals had a higher base pay than some – almost $91,000 on average – but with bonuses, total salary was just over $122,000.


Medical devices sales reps: Base Pay = $88,000 and total pay with bonuses = $148,000


Biotechnology sales reps: = $108,000 and total pay with bonuses = $165,000


Women earned on average just under $124,000, around 20% less than their male colleagues. Authors said that women were more likely to work in pharma, with its higher base salaries and lower commissions.


However they are also less likely to report having higher paying job titles such as sales management or sales director/VP.


Women make up just 14% of respondents with these job titles.

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Are More Physicians Willing (& Able) to See Pharma Sales Reps? Yes. No. Maybe.

Are More Physicians Willing (& Able) to See Pharma Sales Reps? Yes. No. Maybe. | Pharmaguy's Insights Into Drug Industry News |

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. This according to a CMI/Compas survey of 2,680 physicians.

The Survey also found that 39 percent of doctors are willing to see reps without any restrictions on office visits, up from 36 percent last year.

But before concluding that a sea change has truly occurred, consider that a consulting firm recently released data 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. ZS tracked data involving interactions involving sales reps and about 348,000 physicians.

Pharma Guy's insight:

For many years, the ZS data has been cited to support the argument that pharma companies should be investing more in non-personal marketing (i.e., via the Internet and eDetailing) to reach the increasingly elusive "no-see" doctors. 

The chart shown in this post comes from ZS Associates. Note that "Accessible" means that docs are reached by more than 70% of sales reps and "Severely Access Restricted" means reached by 30% of reps or less.

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Sales Reps Are Dead to #pharma: Are eDetails the answer?

Sales Reps Are Dead to #pharma: Are eDetails the answer? | Pharmaguy's Insights Into Drug Industry News |
32% of physicians said they cannot talk to reps, compared to 27% last year.

eDetails the answer?

A Cegedim Strategic Data (CSD) promotion audit with doctors has found spending on outreach to healthcare professionals through digital channels rose 40% worldwide in 2012.

In the US, e-detailing (one-on-one), email and e-meetings (group sessions) accounted for $534 million in promotional spending for full year 2011, and rose to $879 million for full year 2012—an increase of 65% year over year.  E-detailing grew 73.9% from 2011 to 2012.

Pharma Guy's insight:

A long time ago, I wrote: "Are Sales Reps Necessary?" It's still a relevant question today, it seems.

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Even Though There Are Fewer Sales Reps, More Physicians Deny Rep Access

Even Though There Are Fewer Sales Reps, More Physicians Deny Rep Access | Pharmaguy's Insights Into Drug Industry News |

According to the spring 2014 AccessMonitor™ report from global sales and marketing consulting firm ZS Associates, pharmaceutical access to physicians continues to decline. Only 51% of physicians/prescribers now allow access to sales reps, down from 55% in 2013.

The decline in access continues despite the downsizing of the pharma sales force by one-third since 2008. But, the downsizing has actually helped pharma deliver better sales calls.

How? Read the original post to find out.

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Former Lilly President Says Stories of Demise of Sales Reps are “Greatly Exaggerated”

Former Lilly President Says Stories of Demise of Sales Reps are “Greatly Exaggerated” | Pharmaguy's Insights Into Drug Industry News |

Ever wish you could pick the brain of a pharma insider who not only has deep knowledge of the pharmaceutical industry, but also has their pulse on Washington?


That was exactly what Matt Wallach, co-founder and president of Veeva, did during his company’s annual Veeva Summit held in Philadelphia earlier this week when he interviewed pharmaceutical and healthcare industry expert Alex Azar in a fireside-type chat in front of more than 1,300 attendees.


Azar, who most recently served as president of Lilly USA before leaving in January to pursue other professional opportunities, also has extensive experience in the public health sector, having served first as general counsel of the U.S. Department of Health & Human Services, before becoming deputy secretary under Mike Leavitt.


Here are some brief snippets of what he had to say about the future of the sales representative:


“Stories about the death of the sales rep are greatly exaggerated,” said Azar.


He believes that in many instances the sales rep position is still the highest ROI tactic for many brands.


“As a corporate leader, there is nothing like when a sales rep goes on vacation and you get a call from the doctor’s office asking, ‘what happened to our rep?’” he said. “These people are intimately involved in helping physicians with caring for their patients.”


The problem, Azar says, can be access.


“Access [to doctors] is getting worse, but it’s not as bad as some suggest, especially if you are an established pharmaceutical company,” he said.


Azar relayed an example of how when he was with Lilly, the company created a suite of interactions to test how influential they could be at reaching physicians that categorically were considered “white space”—those that were never called on by a rep.


Over a period of six months, Lilly engaged the physician in a variety of touch points—peer-to-peer videos, direct mail, email, etc. He said the company was able to convert 18% of those who never saw a rep from its bottom tier to its top tier of advocacy.


“That tells me it can work, but I don’t think it can replace the rep,” Azar said.


When it comes to account management, he says the sales rep position plays a huge part.


“Sales reps don’t just do short sales,” he said. “They build relationships over the long term and add value over time.”


Further Reading:


  • LinkedIn: “Benefits and Risks of Limiting Pharma Sales Rep Access to Physicians”:
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New, Pricey Biotech Cholesterol Drugs Aren't Selling.

New, Pricey Biotech Cholesterol Drugs Aren't Selling. | Pharmaguy's Insights Into Drug Industry News |

It looked like a surefire way to make billions.


A year ago, two new drugs that used a novel mechanism to drive down cholesterol levels came on the market, and were promptly crowned as blockbusters in waiting. Analysts estimated sales at more than $3 billion a year.


But the two drugs have been commercial flops, in part due to a complicated reimbursement system that has frustrated doctors, confused patients, and left the biotech industry worried about the implications for other high-priced drugs in the pipeline.


“These launches so far are close to, if not the biggest, wastes of development and commercial investment in recent industry history,” said Geoffrey Porges, a biotech analyst at Leerink.


The companies behind the drugs — Amgen and the partnership of Sanofi and Regeneron — are spending hundreds of millions to promote their products but have reaped a mere fraction of that in revenue. “You don’t need to be in finance to know that that’s not a sustainable business proposition,” Porges said.


The problem boils down to doctors who are reluctant to write prescriptions, insurers who are unwilling to pay for them, and drug companies that have failed to understand a fast-changing marketplace.


Docs won’t prescribe pricey new cholesterol meds unless they lower heart risks.


The failures could send a chill through the still-booming biotech business, which relies on the idea that the risky, expensive process of developing new drugs can one day pay off big.


Cardiologists say the drugs could save lives. An estimated 15 percent of the roughly 74 million Americans with high cholesterol have alarmingly high LDL levels despite taking other drugs. Many would be candidates for the new treatments.


[But cardiologists may be biased. See my insights.]


And yet the new therapies have only been prescribed about 120,000 times, according to data from QuintilesIMS, grossing just above $150 million combined in the past year.

Pharma Guy's insight:

Dr. Robert Eckel, former American Heart Association (AHA) president and co-author of certain cholesterol-related AHA guidelines, received nearly $33K in industry payments in 2014. Over $14K came from drug maker Sanofi Aventis.. Express Scripts’ Chief Medical Officer Dr. Steve Miller wrote in July 2015 that the company’s new cholesterol-lowering drug, Praluent, and other “PCSK9-inhibitors” like it, could cost U.S. payers and patients more than $100 billion per year if not managed properly. More here:

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Opdivo Puts BMS Way Ahead in Revenue Generated by New Drug Sales

Opdivo Puts BMS Way Ahead in Revenue Generated by New Drug Sales | Pharmaguy's Insights Into Drug Industry News |

When it comes to measuring success in the world of pharma, one closely watched gauge is the amount of revenue a drugmaker generates from new medicines. The figure can serve as a proxy for growth potential and give investors an indication of how productive a company's research pipeline is, or how fruitful an acquisition turned out to be.


Case in point: A Bloomberg Intelligence analysis of drugs approved since 2010 would appear at first glance to show Bristol-Myers Squibb as the clear winner. No other large pharmaceutical company had a higher proportion of sales from new drugs in the second quarter, and it wasn't even close. Newer drugs accounted for 42 percent of Bristol-Myers' revenue in the period, while runner-up Novo Nordisk managed just 24 percent. By 2020, analysts expect these new Bristol-Myers drugs to account for an industry leading 64 percent of its revenue.


But numbers alone don't tell the whole story. Bristol-Myers gets substantially more sales from recently approved medicines than any other company, but the majority of the revenue comes from just two drugs (one of those is Opdivo).

Pharma Guy's insight:

But does Opdivo work? Read “BMS: Thank Opdivo Trial Participants by Pulling Ads from TV - It Doesn't Work!”;

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DUIPs (Docs Under the Influence of #Pharma) Prescribe Opioids - Sales Reps Arrested

DUIPs (Docs Under the Influence of #Pharma) Prescribe Opioids - Sales Reps Arrested | Pharmaguy's Insights Into Drug Industry News |

The former district manager at Insys Therapeutics was irate. Several doctors were not prescribing enough of the company’s Subsys painkiller, which contains fentanyl, a powerful and addictive opioid.


So the manager, Jonathan Roper, wrote his sales team a pointed email, saying that “we invest a lot of time, money, blood, sweat, and tears on ‘our guys,’ ” — a reference to doctors who were paid to speak to other physicians about the medicine. “We hire only the best of the best to be a part of our speaker bureau and dropping script counts is what we get in return? This is a slap in the face to all of you and is a good indication as to why NONE of you are climbing in the rankings this quarter.”


Last Thursday, Roper and a former Insys sales rep named Fernando Serrano were arrested and charged with violating federal kickback laws. They allegedly ran a scheme between October 2013 and June 2015 in which doctors were paid thousands of dollars to participate in “sham educational programs” designed to boost Subsys prescriptions, according to Preet Bharara, the federal attorney for New York. The email from Roper two years ago was part of the indictment.


The arrests come amid intensifying controversy over the abuse and misuse of prescription painkillers and the extent to which these are appropriately prescribed. Federal health officials recently released new guidelines urging doctors to restrict their prescribing and some lawmakers want to pressure the Chinese government to toughen its laws to stop the illicit export to the United States.


This is not the first time that Insys has been named in connection with illegal activities designed to boost prescriptions for Subsys, which was approved in 2012 to treat cancer pain and generated nearly $330 million in sales last year (see here).


For instance, the company arranged “social gatherings at high-end restaurants in Manhattan” that were supposed to involve teaching doctors about Subsys but did not really involve any education. Doctors were enlisted to speak at these events, but often “lacked an appropriate audience of health care professionals,” according to the indictment. To make them appear legitimate, sign-in sheets were sometimes forged by adding names of doctors who did not attend.


Serrano and other reps received bonuses based, in large part, on the volume of Subsys prescriptions written by the doctors they were assigned to work with, according to the indictment. Serrano received a $70,000 bonus in the first quarter of 2014, which was the eighth-largest bonus among Insys reps at the time. In the fourth quarter of 2013, his bonus was about $100,000, the fifth-largest among Insys reps.

Pharma Guy's insight:

Is it any wonder that “Pharma Speaker Dinners are Popular with Docs”?; 

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Pharma Sales Calls to Individual Physicians Soon to Be Equivalent to Making Best "Buggy Whips" in Town

Pharma Sales Calls to Individual Physicians Soon to Be Equivalent to Making Best "Buggy Whips" in Town | Pharmaguy's Insights Into Drug Industry News |

The work of every brand manager, sales rep, medical science liaison, marketing researcher, meeting planner, and medical affairs person consists of this one central task: driving the behavior of physicians and other professionals who are legally empowered to prescribe medications.

The change currently taking place is that all of this effort to sway physicians will soon become a contemporary version of making the best buggy whips in town.  Individual physicians will no longer remain the major decision makers about which medications to use and when to use them.  That role will be taken over by payers, provider networks and integrated provider-payers.

Marketing to individual physicians in this age of managed markets will be as unproductive and wasteful as a finance manager or accountant who performs all her arithmetic functions with a paper and pencil. 

Pharmaceutical marketing and sales will continue to exist, but as a business-to-business (BTB) function instead of the mass operation that now prevails.  That means most of the jobs currently dedicated to influencing physicians' behavior will disappear.  The descriptions of those few remaining positions, and the skills of people needed to fill them, will be vastly different from those of current employees.

Pharma Guy's insight:

Interesting factoid: sales reps outnumber marketing researchers by a factor of more than a hundred to one.

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The lost art of #pharma selling - samples, sales aids & copy what others do

The lost art of #pharma selling - samples, sales aids & copy what others do | Pharmaguy's Insights Into Drug Industry News |

First let me be clear what I mean by selling. I'm talking about a discussion that leads to the identification of needs and the proposal, and hopefully subsequent agreement, of product the rep is selling as a potential means of addressing these needs. This was a time when reps joining a company could expect their first six to eight weeks to consist of enduring the, generously described as functional, three star hotel nearest to their company's head office, where they would spend their time learning to sell their company's three main brands. And to those of you reading this who are under the age of forty, yes that was six to eight weeks, not the six to eight days that would seem like “a long time off the road for training” these days.

Now if you're in that sub-forty age bracket you're probably wondering at this point what on earth could a training course agenda have possibly consisted of to fill up six to eight weeks of a reps time. Well believe me when the invite arrived on my doorstep twenty-something years ago I too wondered the same thing and I'm sure did most of my 'Initial training course' alumni did too.

However, I can tell you that the time flew by and I'm pretty sure we all learned quite a bit about how to sell pharmaceutical brands. So let's look at how the eight weeks broke down. The first four weeks focused on the disease and the product. None of the distance learning we see nowadays, rather proper face-to-face teaching delivered by people that had made it their craft to both understand and be able to teach representatives with a variety of backgrounds, about diseases, their diagnosis and treatment and how, where and why their company's brand was of benefit. Three brands covered across four weeks, the culmination of which was a written and verbal exam to test understanding.


Here are some basic tactics you must master to practice the art of pharma selling (source: Basics of Sales Rep Watching):

  1. If there are other reps in the office, wait your turn just as if you were at a deli counter at the local Acme super market;
  2. Before entering the back office, the sales rep ahead of you must leave the back office;
  3. Ask the receptionist if it's OK to drop off your samples in the sample room;
  4. After dropping off your samples, wait in the hallway until you can accost the doctor;
  5. Get the doctor's signature and leave.
Pharma Guy's insight:

A funny thing happened on my way to being PharmaGuy -- I started out working in a pharma sales training company where I developed computer-based training (CBT) programs at a time when most sales reps did not have laptop (notebooks not invented yet) computers.

I remember sales training programs that started out with the basic biology of the disease treated by the product -- that was pretty intense. We had medical writers working on the content, which went on and on for pages!

When the Internet came along and all sales reps had computer that could access the Net, I suggested that the biology portion of the CBT provide links to trusted disease information that was already on the Internet. But that idea did not fly.

In those days, most new sales reps majored in biology in college. These days, most reps seem to have majored in cheerleading: read: Sexy Reps Sell Rx Drugs

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