(Photo: Hemant Mishra/Mint)
(Photo: Hemant Mishra/Mint)

Opinion | The illness plaguing India’s pharmaceutical sector

The dropping quality of medical representatives is corroding the Indian pharma industry 

Pharmaceutical distribution and sales involve an intense interaction of science and business. It needs an extensively trained skill set. The woefully inadequate number of schools for training in skills and management functions is a crying shame. Such institutes are the need of the hour for the pharma industry in the country.

There has been a significant drop in the flow of prescriptions today as the Indian pharmaceutical industry has been witnessing a decline in the overall quality of its medical representatives (MRs). This is mainly on account of lack of training and support by the industry. In today’s fast-evolving industry, a basic educational qualification for becoming a medical sales representative should be mandatory. However, a significant proportion of non-science graduates—and even undergraduates in some cases—are doing the job.

In countries such as Russia, one requires to be a medical graduate to be a pharma sales representative. In the European Union, one needs to pass stringent examinations to become an MR. Once they qualify, they need to renew their certification every three years. The authorities in India are in dire need of reforming the MR qualification processes.

Due to a high demand for MRs and a shortage of supply, there are no systematic selection criteria for candidates, and the industry recruits whoever comes its way. The industry attrition rate today is at around 20%. As a result, companies have become wary of the money spent on training MRs; the duration of training has also come down. Many companies are avoiding training altogether and putting MRs on the field for the first six months. The training process, which used to involve a good two months of rigorous coaching of concepts like anatomy, physiology, therapy, prescription generation skills etc., has now come down to a mere seven days on average.

In today’s competitive world, the time spent by an MR in a healthcare professional’s clinic is shrinking to barely a few minutes or seconds as there are more than a 20 MRs present at a time to make a visit to a healthcare professional. Further, doctors’ disposition towards an MR has changed because of the availability of the knowledge on the internet, growth of generic medicines, and transactions made by managers. The doctors, therefore, do not gain any positive outcome from this engagement. The companies are promoting freebies and gifts to doctors directly through managers.

Consequently, sales growth through the ‘prescription generation’ model—where an MR depended on a doctor and a doctor depended on an MR for generating a prescription—has significantly declined. The company management is responsible for the creation of a direct freebie-based relationship with the doctors. Unless this disposition of doctors changes, the entire concept of MRs will lose its identity.

The falling support for MRs has been adversely impacting sales. There has been a significant increase in return of old and expired pharmaceutical stocks from stockists, which for a few companies stands at 4-5% today, way higher than the accepted limit of under 1%.

In the near future, when a revised code of ethics becomes mandatory, the act of providing freebies and gifts will be subject to punishment. In such a situation, companies will have to take drastic action on repurposing the utility and relevance of MRs for the sustenance of the industry.

A lot of devices and apps have entered the market that would enhance the communication of an MR with a doctor. However, Indian pharmaceutical companies are inadequately supplying their MRs with such technologies. Multinational companies are providing their MRs with these technologies, thereby improving their productivity and relationship with doctors.

Despite the odds, even after 50 years, the MR model is still working. One should not destroy the model as MRs could be still considered as the backbone of the industry. It could modify from one-on-one to one-to-many in hospitals to one-to-a-group of patients, towards a higher order. Let us not forget that the person who works in the field is only the MR. It is the MR who would generate the prescriptions and not the manager at the hospital.

Nevertheless, in this ever-evolving pharmaceutical industry, the significance of MRs is seen coming back, at least in certain super-specialty segments. For example, the demand for MRs for super-specialty and niche segments such as osteoarthritis, stents, cardiac care, brain, kidney, liver care, operation theatre-related products and the like has gone up.

The Indian pharmaceutical industry needs to simply revive the profession to its old glory. This could be best done by limiting a freebie-based promotional campaign system to the doctors, repurposing prescription generation, and a renewed focus on the reintroduction of adequate training and technological support to MRs. Let an honest, knowledge- and relationship-based system help the profession regain its prestige and help in furthering the ethical standards of the pharmaceutical industry.

R.B. Smarta is chairman and managing director, Interlink

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