SELLING PHARMACEUTICALS in a managed care environment presents unique challenges, because two distinct entities exert enormous influence on a patient's decision to purchase and use a pharmaceutical product. The first and most obvious influence is the physician. The second influence is the organization or individual that pays for the prescription.
To maximize sales in a managed care environment, pharmaceutical representatives must have a solid understanding of three concepts:
Who is ultimately paying for pharmaceuticals.
How these payers exert influence over the sale of a pharmaceutical product.
How to leverage the payers' influence to maximize a product's sales.
It may be instinctive to simply say that pharmaceuticals are paid for by managed care organizations like health maintenance organizations or by employers. However, pharmaceutical reimbursement cannot be described by such simple statements. Two interrelated concepts — opportunity costs and insurance risk — better define the true payer of pharmaceuticals.
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