Narrowing physician access puts pharma in a bind


Oncologists have a reputation to maintain — and according to the latest report from ZS Associates, when it comes to fortifying against pharmaceutical sales representatives, the specialty remains characteristically hardboiled for the second year in a row.

The report consulted 200 different pharmaceutical sales teams within the United States regarding their access to and negotiations with approximately 325,000 physicians and other providers. What analysts soon discovered was that oncologists were considerably more rigorous with setting pharma restrictions and sticking to them than the 20 other common medical specialties, a pattern that began to take shape in the previous years’ studies.   

"Today, the average rep can see an oncologist only seven or eight times per year — and even the best reps visit oncologists just once per month," said Ganesh Vedarajan, principal and leader of the oncology and specialty therapeutics practice at ZS Associates, in a prepared statement. "Access has continued to decline due to an increased number of oncology reps trying to reach the doctors and an increasing number of doctors joining institutions that severely restrict rep access."

These results seem to highlight an evolving trend toward medication marketing restrictions for healthcare. According to ZS Associate data dating all the way back to 2008, oncology may be at the helm of the narrowing access gateway, but it certainly isn’t the only specialty with such a prerogative — 45 percent of prescribers across care realms placed increased restrictions on rep access this year, compared to the 35 percent the year before and the 23 percent in 2008. 

This is especially the case for academic institutions and major cancer centers.

"Access has historically been challenging in academic institutions, so it's no surprise these places remain restrictive," Vedarajan said. "However, in recent years, we've seen a similar decrease in access to large group practices as they attempt to improve efficiencies and streamline their business models. In the same vein, parts of Texas, Georgia and Florida also have high access restrictions."

Key statistics from the report were as follows:

All information and data courtesy of ZS Associates. Presentation by PhysBizTech.

  • Teams of sales reps carrying at least one new product are able to call on oncologists 33 percent more frequently than reps without new products (10.4 times per year compared to 7.8 times per year). However, this window closes quickly – after six months, teams with a new product are only able to call on oncologists 5 percent more frequently than reps not carrying launch products.
  • Oncology reps with three or more products are able to visit physicians an average of 10 times per year. But those carrying just one or two products only see physicians an average of seven times per year. On average, a rep carrying three or more products is twice as likely to have access to even the most restrictive oncologists (26 percent vs. 13 percent for reps carrying one or two products).
  • Access to physicians has declined consistently since the first AccessMonitor survey in 2008. In 2013, only 55 percent of prescribers were deemed “accessible,” compared with 65 percent of prescribers one year ago, and 77 percent in 2008.
  • The decline in access has made it difficult for companies to maintain high call frequencies. A scant few physicians allow the industry’s best representatives to call on them more than 24 times a year — a mere 2 percent of primary-care physicians and 13 percent of specialists allow representatives to visit that frequently.

"Many companies are building systematic ways to identify the drivers of positive customer experience, train the field organization to customize their local engagement approach and integrate digital approaches, inside sales and other channels to enable the field organization to engage with customers based on their unique preferences," commented Jon Roffman, associate principal with ZS Associates, from the sales perspective in a news release.

Find a copy of the full report here.