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The Missing Link: Detailing to e-Detailing
By Robert Cykiert, MD, President and Founder of

Pharmaceutical companies and medical device manufacturers spend over $20 B in marketing annually and over $12B of that goes to Detailing. Over 90,000 sales people focus on selling and providing samples to about 1 million doctors in the USA. Some focus on doctors, others focus on nurses, physician assistants, hospitals and other office staff. It's a big operation with a long and firmly rooted tradition. It may also be a hard to break habit...

Detailing has been effective for years, and budgets keep climbing despite the gut feeling Pharma executives have that the party will soon be over..."if my competition does it, I've got to keep up," so the budget keeps increasing.

ROI from detailing is not as good as alternative forms of advertising like journal ads and the newly emerging Internet sites (primarily because of the high cost of Detailing). However, Detailing efforts seem to have the most direct correlation to increase in sales, and these are metrics measured with high precision, down to a specific doctor who prescribes a specific medicine. It is hard to argue with something that works and has worked for a long time.

All this makes lots of sense because after all, doctors are the most important customers of Pharma. A single doctor who oversees hundreds or thousands of patients can make significant contributions to the bottom line of a specific medication. The numbers are available within a few weeks, and that is indisputable evidence of the value of Detailing. If it ain't broke, don't fix it, right?

The world is changing and the $12 B Detailing expense stands out like a sore thumb. Drug life cycles are shortening, competing alternatives and generics are increasing, the Feds are scrutinizing pricing, and Canada is flaunting significantly lower prices. The public drumbeat has already started, and politicians are sensing a new opportunity to get elected. Before long, laws are bound to cut into Pharma prices and profit margins. It is inevitable! The writing is on the wall, it is just a matter of time.

What to do? Pharma margins will be cut severely if politicians and the public win, and win they will, eventually. But Pharma is far from dead. The $12 B expense for Detailing stands almost as an insurance policy, as a bankroll, as a cost reduction center! It will likely be the first cost cutting target because it is so big and because current ROI is so low. Let's face it, if profits go down by $6 B due to the public squeeze, won't Pharma executives shrink the $12 B budget to retain safe margins and stabilize stock prices?

Shrinking that $12 B budget means lots of layoffs looming in Pharma, but it also presents rejuvenation opportunities. Opportunities to improve on Detailing with e-Detailing, where the Internet is leveraged, and people expenses are cut drastically. It is the ace up the sleeve of Pharma executives!

The transition from Detailing to e-Detailing has already started, but funding for e-Detailing is still meager compared to Detailing. Industry numbers suggest e-Detailing spends about $100 Million compared to $12 B for Detailing, but e-Detailing budgets are growing fast. E-Detailing growth today is likely limited by lack of evidence that it is as effective as Detailing, but it may also be limited by internal political struggles between a Goliath and a David. David will ultimately win, because the handwriting is on the wall, it is just a matter of time.

E-detailing radically cuts costs because there is no longer a need for a Detailing sales person to cover a certain number of doctors. Doctors can presumably come to a web site to get the needed information or samples or to contact someone. One person can cover hundreds or thousands of doctors, but it is a different person than the Detailing sales person. Background is different, training is different and the marketing approach is different.

E-Detailing requires imagination and new breakthroughs for creative interactivity, personalizing the information and communications, harnessing the power of computers and the Internet and creating whole new relationships with doctors. It won't happen over night, and many experiments are needed. Abundant ideas are being explored about how to create that unique blend of comfort and intimacy with doctors over the Internet, but it will take time to prove out what works and what does not. Lessons learned from Amazon, eBay and Google already suggest what seems obvious at first may not work, and what works may be more surprising than originally anticipated.

The key is to keep experimenting to find the unique blend of ideas that will attract doctors to Pharma like customers are attracted to Amazon, eBay and Google. There has to be a magnet, there has to be a reason for doctors to come, and there have to be win-win propositions for doctors and for Pharma. There has to be tasty honey for the bees to come back, because a stick won't work.

E-Detailing has yet to prove itself, and prove itself it must. The only way to do it is to keep experimenting with software, interactivity, relationship management, psychology and value propositions that will offer win-win for doctors and Pharma.

Experiments in e-Detailing abound already, but there is a missing link... How do you get doctors to taste the honey initially? Presumably, once they taste the honey, if they like the taste, they will come back, but how to invite the doctors while you are experimenting with different blends of the honey? There will be many experiments, and many blends of honey, and much time will be needed for experiments and results analysis.

The missing link is email. Over 85% of doctors already use it daily, and you don't have to bypass a receptionist. Email can be used to invite and re-invite doctors for experiments until the honey is blended so there is no longer a need for email, because the honey tastes so good, the value proposition is so compelling, the doctors will come and interact without invitation.

Why will e-Detailing save Pharma? Because a single email broadcast can go to every doctor out there in an instant--the high- prescribers, the thought leaders, the average doctor, doctors in remote areas and even the low-prescribers that Pharma wants to convert into high-prescribers. Detail people no longer need to keep visiting as often, their new role is anticipating what the doctors need and providing that over the Internet through software and automations. Detailers have a new role in e-Detailing, but there will be significantly fewer of them. That translates to significantly diminished costs that can sustain Pharma margins and stabilize stock prices as the public and political squeeze continues.

Dr. Robert Cykiert, MD is President and founder of specializes in email broadcasts to doctors, helping Pharma and ad agencies with creating and executing potent e-Detailing programs. has hundreds of clients in the USA and internationally who use our database of over 220,000 doctor email addreses, and our 80,000 medical company B2B email address database.

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