In the beginnings of the pharmaceutical sales job search, a common question potential candidates ask is, “I know that doctors don’t actually place orders for your medicines, so how do you get credit for your sales?” It’s a great question that could take hours to explain, but there are a few highlights that may help answer this question for you. First, I’ll lay it out in a few steps, then I’ll expand on each of these steps.

1. The pharmaceutical rep visits the physician and gains his/her commitment to prescribe the drug (hopefully).
2. The physician follows through on this commitment (hopefully), writes a prescription, and gives it to the patient.
3. The patient takes the prescription to the pharmacy to have it filled (hopefully).
4. The pharmacy fills the prescription and enters the prescription information into a database.
5. IMS purchases the data from the pharmacy.
6. IMS resells the data to the pharmaceutical companies.
7. The pharmaceutical companies format the data and distribute it to their reps in the field.

I’m certain that you’ve noticed that many of these steps contain a “hopefully”. These help identify snags that may occur in the process. These snags may ultimately prevent you from getting credit for the sales you work so hard to acheive.

1. The pharmaceutical rep visits the physcian and gains his/her commitment to prescribe the drug.
   Luckily, in this step the hope is completely reliant on the rep. After the detail to a customer (physician, nurse practitioner, physician’s assistant), if there is an agreement on a specific patient, the rep should always close by asking for the business. 90% of the time, “business” comes in the form of writing a prescription to a particular patient. If the rep doesn’t ask for the business, there is a good chance that the doctor will not give it to him/her. If you, as the rep, don’t ask for the business you won’t get it. If you don’t get it then you’re not going to receive any credit for it, which makes the following steps irrelevant.
2. The physician follows through on this commitment, writes a prescription, and gives it to the patient.

   This is the first in a long line of steps that you really have little to do with, and, at the risk of sounding ubernegative, it only gets worse from here. No matter how good your relationship is with your customer. No matter how many times a week you’ve seen him or how many lunch meetings you’ve had discussing the patient for which you want him to use your drug, when you leave the office, it is up to him to follow through with his commitment. If he doesn’t follow through on his commitment, there will be nothing for you to get credit for.

3. The patient takes the prescription to the pharmacy to have it filled.
   The good news is, you made the sale and the doctor followed up on his commitment to write your product. The bad news is, the patient may never take it to the pharmacy. There are any number of reasons that this could happen. For medicines that treat symptomatic conditions, the most common reason a prescription doesn’t get filled is due to a lack of money. If someone can get a drug that is going to make her feel better, she will – unless she can’t afford it. For preventative or asymptomatic conditions there is a wider variety of reasons that prescriptions don’t get filled. These reasons include a lack of money, lack of agreement with the physician, apathy, losing the prescription, etc. If the pharmacy doesn’t actually give the drug to the patient, then, even though you made it, the sale wasn’t completed. Sorry, there’s no credit to be had here.
4. The pharmacy fills the prescription and enters the prescription information into a database.
   The pharmacist will always fill the prescription and will always enter it into a database (electronic or otherwise). Congratulations! No hang ups here. Even if the steps after this fail, your company’s bottom line will see a small increase.
5. IMS Health purchases the data from the pharmacy.
   Pharmaceutical intelligence giant IMS Health will gladly purchase the data from most any large pharmacy association or chain that will sell it to them. Unfortunately, not all pharmacies will sell their data to IMS. In the South, for instance, many reps complain about the fact that over 50% of their prescriptions are filled at Wal-Mart Pharmacies. If the patient has the prescription filled at a pharmacy that doesn’t sell to IMS, your company will not know who wrote the prescription and you won’t get credit for the sale.
6. IMS resells the data to pharmaceutical companies.
   There aren’t a great deal of snags in this process. Your company gives IMS a fist full of money and IMS sends them the data. The issue here is timing. Because many different pharmacies use many different databases to track their data, the information that IMS gets is often very messy. In addition, IMS collects data from thousands of pharmacies across the country. Getting all of this information takes time, and turning all of these multiple types of databases into one format takes time too. In many cases, it is three months from the time the prescription is filled to the time it shows up on your computer. The good news is, it showed up and you’re getting credit for it.
7. The pharmaceutical companies format the data and distribute it to their reps in the field.
   Your company may get the data up to three weeks before you receive it. This is a sore spot for many reps. Your company has to sift through the data, decide where it needs to go, and import it all into the company database before sending it out to managers and, ultimately, to reps. As a rep, it seems like you’re the last one to know how good or bad you did because you are the last one in line to see your data. It is absolutely imperative though that the data be in the correct format before it goes out to the reps. Making changes to sales data after the reps have already seen it is one of the worst possible things to do for company morale.

The bright side of things . . .
The light at the end of this tunnel of negativity lies in the fact that it is consistent across the board. Nearly every major company buys data from IMS so they face the same issues that your company faces. This fact seriously levels the playing field. Everyone has trouble with closing from time to time. Everyone tries to think of ways to have their customers follow through on commitments more often. Everyone tries to implement programs to take patient error or apathy out of the equation. Everyone gets the same data and everyone gets grumpy when their company doesn’t send out the data when they expected.

Hopefully, this information has cleared up any confusion you may have had about getting credit for the sales you’ve worked so hard to get. If you want to dig a bit deeper talk to an existing pharmaceutical representative or district manager about his/her point of view on this topic. Talk to a pharmacist for a different perspective. Check out the IMS Health website.

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