Ok, so from what I’m gathering our ol’ buddies
Post# of 148170
(A good, but underappreciated candy bar by the way)
They got the contract with us, some old office furniture, a few filing cabinets, and Shkreli’s old safe where he kept the Wu-Tang Album. Maybe even a few unused coffee mugs with the Cytodyn logo, given as a peace offering during contract negotiations a few years ago.
Not ideal. But maybe not that big of a deal.
When a pharma company is planning on marketing (selling) a drug upon approval (or acquisition) there are numerous ways they can go about “forming” their team.
The big companies have multiple divisions already out selling that may or may not overlap with each other in terms of what drugs they promote. There are typically anywhere from one to three products in each rep’s “bag”. They’ll have a primary drug that makes them their most potential money and takes up the majority of their time, a second line product that gets…you guessed it…second billing in terms of time and money. Last would be the third line product that only gets truly addressed at specific offices or when you have enough time to get to it.
There will often be overlapping of teams and possibly divisions. The Respiratory team may have a COPD drug as their first line, a blood pressure drug as their second, and a sleep aid as their third. Meanwhile the Neuro team may have a Parkinson’s drug first line, COPD second, and a different third line product. Back when I sold for Sanofi-Aventis there were something like 18 reps in my general geography that shared some level of responsibility for promoting Ambien CR when it was released. Ridiculous. But also a great example of how to extend patent life. Ambien, then Ambien XR, then Ambien CR, and then far down the road generics can finally compete.
Getting back on track…
Unless it’s a bit smaller or hyper-focused on only one disease state, like diabetes, there is usually a primary care team, a specialty team, and a hospital team. Essentially you’re a product expert talking to a doctor who may use it, which if you break it down is exactly what’s happening in each of those categories, but pharma usually separates them and treats them differently. It’s a promotion to go from primary care to specialty, for instance.
A mid to large sized company like that can often absorb an acquired drug and shift their rep’s responsibilities around to ensure they have enough people focused on it. All that takes is a realignment call with the organization and a few weeks of homestudy and training to get up to speed. But they’ll often hire more people as well, because the amount of reps focused on certain drugs is a formula they’ve mastered and they likely weren’t sitting on enough unused capacity to launch a big drug with their existing force.
When they do this they can hire directly, but many companies choose to hire through a contracting company like Ventiv or Publicis Touchpoint. This was becoming very popular in the early 2000’s and is still popular today. These companies specialize in hiring what is often a large number of sales reps on behalf of their client. And they can do it quickly, as well. They manage the HR, pay, training, etc. At some point the company can decide to hire these folks in, keep the contract in place, or end the contract. It’s popular because someone else goes through all the hassle, and if things don’t work out you aren’t on the hook for all the unemployment and severance costs.
For a drug like Leronlimab there will be heavy promotion in “specialties” like Infectious Disease (HIV), Oncology, Hospitals (ER, ICU, etc.), but there will also be many primary care doctors who get into the mix for certain conditions once it’s approved. Any small, but focused specialty company could handle it for a single disease state. Any mid to large sized company can also easily handle it. A three member organization can’t.
Which is part of why I’d bet the agreement with Vyera 2: Electric Boogaloo never hits the streets. We’ll have bigger and better partners, or opportunities to partner, and they’ll be able to buy their way out of it. Or Cytodyn will find a reason to end the contract before the BLA is approved and get a new, better partner in place for commercialization.
But let’s assume this agreement does make it through the approval of LL for HIV and they need to begin marketing it, I’d bet they do it with the help of a contract team like one from Ventiv or Publicis. There’s no easy way to quickly ramp up from such a small organization to become an effective sales team without help.
Years ago the pharmaceutical industry shrunk considerably. Right around the time of the housing crisis. There were something like 95,000 pharma reps across the US in the 2000’s and now there are reportedly only around 81,000. That’s a lot of talent waiting to get back in. I made it through a good bit of downsizing before the 4th or 5th one caught me. I never got back in, though I tried. Multiple times I was able to get to the final two or three candidates but would lose out to someone with highly specific experience for the products being marketed. I’ve long since moved on to other things but I’m certain that’s still the case. One time I walked out of my interview with a guy who couldn't have been less enthused to meet with me. As I walked out I met the woman walking in for the next time slot. She was one of the most beautiful women I'd seen out in the wilds of Michigan. I told her I'd just interviewed, then told her about the oddball question at the end so it wouldn't catch her off guard before leaving. You wouldn't be surprised to learn that she got the job.
Vyera 2 (Electric Boogaloo) will no doubt have the ability to find seasoned and talented reps. They’ll have their share of partner organizations to help contract the salesforce. None of that part really worries me. My concerns are strictly from a strategic perspective.
We have to start making smart moves. We can’t afford another Amarex-style partnership. Are the people involved with these two terribly named pharma companies competent enough to make strategic decisions? Are we going to have to wait for 6-12 months of poor commercialization efforts before realizing we made a bad choice? Where is that Wu-Tang album Shkreli bought? Can I have it or stream it somewhere? You know, I always thought U-God would be a better solo artist. I mean, he had a couple bangers along the way but it was mostly terrible stuff. I don’t think the RZA produced much of it, which probably didn’t help...
Shit, where was I?
Oh, yes, I was about to wrap it all up.
I was watching the new Gordon Ramsay cooking show Next Level (or something) last night. In it there are three teams competing who are each mentored by a chef like Ramsay. They compete on various levels of a cooking stage. The bottom level is the worst. You get the last pick of the ingredients and have to make do. Your pans are old and beat up. There might not be the right utensils. The next level up is a solid kitchen with just about everything you need, but they pick ingredients second. The top level, of course, is the Rolls Royce of kitchens. Needless to say, with the first pick of ingredients and the best tools at their disposal, the top level team won the first challenge. I suspect that trend will continue more often than not, barring some Respert-level chefs kicking ass in subpar kitchens of course, because nothing stops greatness. #Humblebrag #HotelFilets
All of this is a long way of saying that I don’t worry about this weird-ass partner being able to find good people to promote our drug if that’s what it comes down to. But I am concerned that there have been a lot of choices that turned out to be poor ones, and it’s about high time we stop actively signing up to work from the shittiest kitchen.
I’d urge Nader and the board to consider the intangibles a deal with the right partner could bring and not just maximize how much we make on paper. Friends in high FDA places, the size and experience to enroll large trials quickly, media stories/sources we can’t seem to get on our own, and the CEO isn’t in jail are among the ones that come to mind quickly.
So please, for the love of god, partner with a big dog for NASH.
Lamenting the hours until wine time,
Daytime Respert