E-detailing Evolves

E-detailing is currently being piloted, or is at least under consideration, by many pharmaceutical companies as a way to maximize sales force time, cut costs, and increase interaction with physicians. E-detailing is not a single entity, but can take many different forms, from remote live discussion with a sales rep to a purely scripted interaction with a website, or in some cases, an interactive voice-response phone line. Most e-detailing models are being tried in the US now, with each model differing in popularity and applicability among specific medical specialties; for example, primary care physicians are more easily accessed than specialists with scripted e-detailing.

The various forms

With virtual live e-detailing—a model seldom used anymore—physicians are provided with a computer that is pre-loaded with the necessary software, a webcam, and incentives. In return for which, doctors are obliged to contact the respective pharmaceutical company’s sales representatives a set number of times per month. With this approach, the timing and duration of the e-detailing session is controlled by the physician. During the e-detailing session, the physician is able to interact with the sales representative via video and audio in real time. A variant of this approach is an e-detail in which only the sales representative is viewed or only audio and data slides are shown, depending on the wishes of the physician. This type of model has been associated with providing a longer interaction with the physician—which is more cost-effective when compared to the cost and length of the traditional face-to-face call—allowing for more sales representative calls per day and an increased number of physician interactions.

As any busy physician knows, time is precious. So, when virtual live e-detailing came on the scene, many physicians were happy to participate, as the advantages outweighed the disadvantages—the time of the call was on the physician’s terms (calls were usually scheduled at the physician’s convenience with little notice, with direct calls to live, virtual representatives able to be made at any time up to midnight). In addition, it saved canceled representative visits, as calls were scheduled at the moment the physician wanted them, rather than in advance. Such calls also meant physicians didn’t have to take time out of their busy day to see a sales representative. For most physicians, the most convenient times to participate in this form of e-detailing were in the morning (before clinics opened), during lunch, and around 9:00pm. All was well for virtual live e-detailing, until more pharmaceutical companies began using this approach and physicians who had signed up for it were required to make calls to all the pharmaceutical sales representatives signed up to the system at some time throughout each month. This daunting task caused many physicians to withdraw from virtual live e-detailing. Partially fi lling the void left by virtual live e-detailing is scripted e-detailing, in which the physician views a series of interactive screens, usually through an Internet or Intranet site. With no live interaction, the physician has the option to contact a representative by e-mail or telephone but is not required to do so. This model has been shown to deliver clear, well-structured messages that are fi ve-to-10 times longer than the normal face-toface sales representative call, but at a reduced cost and on the physician’s terms. Participating physicians especially like the convenience of the anytime availability of this model.

Another option for e-detailing takes advantage of portals that offer access to ready-made communities of physicians and can be used to deliver broad, sponsorship marketing messages or more product-specific ones, like traditional detailing. Potentially, physician portals can provide access to hard-to-reach physicians (eg, specialists); although, for most portals, the number of physicians who actively use that portal is usually signifi cantly less than the offi cial membership lists. Portals can usually provide online statistics that give insight into where physicians spend their time and hence, an insight into their Web habits and interests. However, these are not necessarily easy to interpret. For instance, there is no easy way to know whether the reason a physician spent 10 minutes looking at a Web page was because he was interested or because he was bored and took a break to do something else while the page was open.

The story so far

“Pure” e-detailing companies, such as Lathian Systems, are well established, with most of the top 20 pharmaceutical companies signed up as clients. Many other marketing service companies also off er an e-detailing package. In the US, all of the top 20 pharmaceutical companies have some involvement or investment in e-detailing. A number of e-detailing companies have a strategic alliance with physician portals, giving them potential access to large numbers of professionals. Aside from overall development of the Internet in everyday life, there are three direct drivers behind the growth of e-detailing:

• Falling effectiveness and increasing costs of sales representatives
• Increasingly busy physicians with little time to see representatives
• High connectivity and acceptance of the

Internet by physicians

Detailing via sales representatives accounts for the lion’s share of pharmaceutical sales and marketing spending, representing about 45% of the total, according to a 2002 personal communication with W.R. Hambrecht . The last decade saw substantial growth in the use of sales representatives, as the marketplace became increasingly crowded with similar products. Th e length of market exclusivity of new innovative products has fallen, and due to increasing cost pressures, we are starting to see the number of sales representatives decrease in all the major companies. With a lack of suffi cient time for physicians to meet with sales representatives, thus causing a signifi cant proportion of sales calls to be cancelled by the physician, pharmaceutical companies’ significant expenditure in traditional detailing is not yielding the desired returns. With a constantly increasing number of drugs to sell, the sales forces’ efficiency is dramatically decreasing through no fault of their own.

There is no doubt that detailing directly to physicians serves an important purpose in disseminating information about pharmaceutical products, such as new clinical data. And although physicians do want and need information from the sales representatives, they want it on their own terms. E-detailing can potentially provide physicians with a more convenient means of getting the information they want at a time that suits them; in fact, the majority of primary care physicians are most likely to use e-detailing outside the normal office hours.

Where are we now?

To date, studies indicate a good level of acceptance from physicians and positive results for the pharmaceutical company representatives. One study showed 39% of physicians, after partaking in a 10-minute e-detailing session, requested to see a representative, and 70% asked for samples. A more recent study found similar figures. It showed that 46% requested to see a rep and 67% asked for samples. The pros and cons from the primary care physician’s viewpoint can be seen in the Table above.

The Future

Physicians, for the most part, value the social interaction and information they get from meeting sales representatives; after all, a representative may be the only healthy person they meet all day. However, when you’re pressed for time, the last thing you want is a long list of representatives to see. There still exists a role for the sales representative who knocks on offi ce doors, but in moderation. E-detailing frees up valuable time and still allows physicians to stay up to date with the latest information that a representative would have brought them.

Dr. Bates is the president of Eularis, a pharmaceutical analytics fi rm headquartered in New York City that offers sophisticated analytics that provide data-driven insight into the fi nancial impact of current corporate and marketing decisions.