Healthy Skepticism Library item: 6286

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Laberge A.
Through the side door : Networks can gain you access to a closed hospital
Pharmaceutical Representative 2006 Jul 1
http://www.pharmrep.com/pharmrep/article/articleDetail.jsp?id=353595&pageID=1&sk=&date=

Full text: Through the side door : Networks can gain you access to a closed hospital Jul 1, 2006 By: Ananda Laberge

One of the more difficult challenges reps face in this new era of restricted pharmaceutical selling is the closed hospital. But this issue is not as daunting as one might think. There are avenues into such institutions that can increase the usage of your medicines, eliminate formulary restrictions and increase the buzz around a particular medication within the institution’s prescribing community. One way to accomplish these goals is to utilize networks that are accessible to you but that you may have overlooked.

It’s all about the network

CME coordinators. Some of the best advice I ever received was to get to know the continuing medical education coordinators at my hospitals. These individuals are constantly looking to fill their grand rounds/CME lectures with disease state talks. Most pharmaceutical companies offer unrestricted educational grants for this purpose. Although many companies have an online application process that is usually completed by the requesting institution, you can facilitate. Present potential topics and find out if certain physicians in your territory – who may already be approved speakers for your company – would be interested in presenting a disease-based, nonbranded, educational lecture. Alternatively, you can suggest a very important physician in your territory, perhaps one you know is on the pharmacy and therapeutics committee and with whom you need face-time; just be sure that this physician is not directly opposed to the medication you are promoting. This is a win-win proposition in that you are providing value to the institution and creating an opportunity for your drug to be mentioned during the talk. You can then follow up with the speaker and begin a relationship that will allow you more regular contact.

Insider tips
Hospitalists. Depending on the medications you are promoting, hospitalists can be the key to your market growth. Many of them work at several hospitals, so if you can influence them to give your drug a try at one institution, chances are they will also use it at another within your territory. These physicians are focused on decreasing their patients’ length of stay, and their compensation is tied to this metric. If you have a drug that can be promoted for a decreased length of stay (like an intravenous-equivalent oral form) or if your drug has credible data showing a faster cure rate than a competitor’s, hospitalists will be interested in this information. Additionally, if you are promoting a drug that is on formulary but usually requires a specialty consult, such as infectious disease, hospitalists can help you eliminate this enormous roadblock to your medication’s use, as many institutions exempt them from the consult restriction. Before attempting this approach, find a “champion” hospitalist (preferably one who is either on the P&T committee or a strong influencer within the hospital) who will back you up when the drug begins to gain wider use. When red flags are raised by the pharmacy or by some of the physicians who were not consulted, this hospitalist can go to bat for you on the improved efficacy and discharge rates he is achieving by using your medication.

A good way to get acquainted with this group of physicians is to find out from the discharge planners or pharmacists who the hospitalist director is and where he can be found. This individual is usually in charge of setting up weekly, monthly or quarterly meetings with his group and can provide you with access by allowing conference sponsorship. You can also go to the Philadelphia-based Society of Hospital Medicine Web site, www.hospitalmedicine.org/, to find out who the contact is for your local hospitalist society and offer to support one of its meetings.

Outside organizations or associations. In addition to sponsoring hospitalist associations, there are great benefits in sponsoring other professional organizations. Nurse practitioners and physician assistants, infection control nurses, and discharge planners are just a few examples of the many people who can help you increase the usage of your drugs within your closed institutions. You just need to give them a reason to leave the hospital so you can begin to build a relationship.

If an appropriate association doesn’t exist, you can get creative by helping organize one. Let’s say you promote an antibiotic and you realize that many of your key infectious disease doctors are working in a few of your closed hospitals. They also refuse to see any reps during clinic hours. Even when you are able to get them an invitation to an evening educational program, they generally do not attend because they want to be home with their families. One of the few ways to entice such physicians to participate is to provide an opportunity to socialize with colleagues. Network with one of the infectious disease doctors in your area and find out if she attends any local professional society meetings. If she does, you can get contact information and find out if you can sponsor an upcoming event. If not, you can suggest creating a meeting for her and her colleagues. You can then ask if she can recommend a speaker for the meeting or perhaps be one herself. This physician can then become your point-person in recruiting attendees, and you will be pleasantly surprised by the number of her peers who actually show up. You will then have solidified your connection with her and acquired an opportunity to build many more important relationships!

Volunteering. The Health Insurance Portability and Accountability Act has caused many hospitals to restrict rep access or deny them the opportunity to participate in preceptorships. One way around this challenge is to become a volunteer within your hospitals. If you go through the proper channels, many institutions will allow you to volunteer in certain departments; they may even ask you what specialty area you prefer. I have found this approach to be most successful within smaller community hospitals (75 to 150 beds). Inquire with the pharmacy first to make sure you are not breaking hospital rules. Explain that you are using this opportunity to learn more about the disease state treated by your medication and that you will not promote any of your drugs while volunteering. Do not be surprised if – like all other volunteers – you are asked to obtain a chest X-ray, as well as a few other diagnostic tests, to ensure that you are not posing an infectious disease risk. In instances where the hospital will not allow you to volunteer, HIPAA will usually be mentioned, as well as conflict-of-interest issues. Nonetheless, half of the hospitals I have approached about this have agreed, and my territory dollars within these hospitals have risen accordingly.

After volunteering just once at one of my institutions, I was able to leverage the relationships I began to build with a few key physicians, and I saw their use of my medications increase. Spending time in their clinical environment allowed me to develop a level of trust that we otherwise might not have shared. Volunteering presents a win-win situation: It is a great way to give back to the community and build new relationships with physicians and staff who are usually not accessible.

Finally, always capitalize on the openings you create to build new relationships by giving yourself a goal to obtain more information or opportunities. For example, if you are able to sponsor a hospitalist staff meeting, make an appointment before the function’s end to sponsor the next one. Strong efforts produce strong results. In the end, the only obstacle to selling in a “closed” hospital environment is you!