These people need a new hobby

We haven’t quite decided which adjective best describes the current mood of pharmaceutical sales reps. Disgruntled, demoralized, unappreciated or perhaps more appropriately soon to be unemployed. Now granted we only keep in touch with reps in our wacky world but from what we can tell this lack of self-esteem extends beyond diabetes reps. Yes, as we approach the holidays management is getting ready for what has become an annual event, the purge.

Just doing a quick check of the major insulin companies Lilly (NYSE: LLY), Novo Nordisk (NYSE: NVO) and Sanofi (NYSE: SNY) the troops in the field are getting ready. They know what’s coming as management no longer cares whether they know or not. It’s hard to imagine but many of these companies are undergoing yet another restructuring perhaps because management has nothing better to do than shuffle paper.

Now to be fair this phenomenon is not unique to drug companies they are just the latest to rearrange the deck chairs on the Titanic. Devices companies, in particular glucose monitoring companies, went through this exercise a few years back. Yep after years of getting fat and happy the time came to trim the fat. Only problem was they just couldn’t trim fast enough and had to keep cutting until they hit bone. Today these companies which once employed thousands of meter maids now employ a handful of reps.

So as the drug market continues to commoditize, just as the BGM market did, it should surprise no one that these companies are trimming the fat and like the BGM companies before them they just can’t cut the cord completely which is exactly what they should be doing. While reps don’t like hearing this their function is no longer relevant and worse not tied to increasing profits.

For better or worse, and opinions vary, payors to a large extent determine the success or failure of a drug. This as we keep stating is not a battle over which drug outperforms another. No, this is a battle over formulary position and the weapons used are discounts and rebates. How else can anyone explain with a straight face that a drug like Invokana, a drug with some well-known issues, gets preferred placement over Jardiance, a drug which is clearly superior.

Over the past few days we have seen how in diabetes anyway some drug companies are embracing big data in a desperate attempt to improve sales. The general belief is that big data can crack the code and do what everyone knows needs to be done, get patients to take their meds as they are prescribed. Now it is possible big data will find the magic potion or the secret sauce but we aren’t overly optimistic. We hope we are wrong but so far big data and diabetes haven’t yielded all that much.

What everyone seems to forget is that the issues that impact therapy compliance or adherence or whatever the politically correct term is these days extend well beyond big data and won’t be solved by big data. Big data does not impact high deductible insurance plans. Big data does not motivate patients. Big data does not educate patients.

Most of all big data does not help with the fact that these patients have a chronic disease which they don’t understand and didn’t want in the first place, which requires work to manage properly.

Big data will get lots of publicity as will all these way cool whiz bang new toys and systems. Many will pontificate about how all this technology will improve outcomes, how costs will be taken out of the system. And we suppose this is possible but we aren’t optimistic but not for the reasons everyone thinks. There is no doubt big data combined with whiz bang has the potential to help that is not at issue. No, the issue is getting patients to use whiz bang which is no different than the problem whiz bang is trying to solve for; getting patients to take their meds. So round and round we go, like hamsters on a wheel going nowhere in a hurry.

Millions, more like billions are being spent on big data, whiz bang and way cool. Yet the same problem remains patients aren’t getting any better. So naturally it makes sense that these companies should restructure as if it will make difference. Listen we could care less if these companies made billions and their management teams made millions IF patients were actually getting better. However, it’s a bitter pill to swallow when patients not only aren’t getting better they are being ignored.