Pharma industry personnel frequently speak of HCPs, presumably because there are more types of healthcare professionals than physicians. This is generally good. A lot of players are involved in the system. But in speaking with most marketers, when they expand the HCP description beyond physicians they seem to get all the way to Physician’s Assistants (PAs) and Nurse Practitioners (NPs). This was driven home when I mentioned to a marketer the importance of getting to the nurses within a practice. The response was “Oh, yeah, we have lists and call plans for NPs and PAs.” Great, but that’s not what I meant!

During my time in the field, I learned that to get things done in a practice I usually needed to find the nurse. Most of the time, the lead nurse was the best informed—and also the most influential. I paid close attention to these folks and usually made sure that my first stop was with the nurse!

Recently at a conference on co-pay cards, a discussion focused on delivering the cards to physicians, even though the one physician on the program said that he had no idea whether the drugs he prescribed came with cards or even if his patients needed them (he was a specialist, not a PCP). The audience heard that but still asked him about his program design preferences and then discussed the optimal number of cards to leave with a physician. I later spoke with the doc and asked if he thought his nurses knew about the cards. We had a lively conversation about how his nurses took care of all of that and would even suggest changes to prescriptions for patients who could benefit from using the cards. Co-pay cards are not part of his world, but a very important part of his practice—and the nurses take care of it. Please think about that last sentence!

Good sales reps know nurses are critical sources of information and support, but they are seldom considered an important target. Very few marketers understand a nurse’s role and take advantage of the opportunities for patient service. Over the past few years, one firm, Johnson & Johnson, realized that when trying to get oncologists to prescribe Procrit for chemotherapy-induced anemia, the physicians didn’t respond to their messages. But the nurses did—they saw the need through the patient’s eyes. It is a broad generalization that physicians treat diseases and nurses treat patients. A nurse once put it this way: “Doctors want to cure and nurses want to heal.” If your product has significant quality of life benefits, or your service items are specifically geared toward the patient (compliance, convenience or economy), then your plan needs to focus on the nurse, before the physician.

Nurse practitioners generally aren’t the same as nurses—they practice more like physicians. Do not confuse them—you will be disappointed. If your co-pay card, sample program or patient education program isn’t living up to your expectations, ask yourself if you are taking the message to the right HCP, because nurses and physicians address and treat different kinds of problems and issues.

My favorite admonition is to ask yourself two questions about your product:

  • What problem does my product solve that is not solved by other products?
  • Who owns that problem?

These questions are important. The answer to the first identifies your value proposition and the answer to the second identifies your target. Problems belonging to physicians require tests to diagnose, asymptomatic diseases and those requiring complex treatment modalities. Your solutions must be marketed and communicated to the physician (or PA/NP). If you solve a patient problem, such as burdensome symptoms or disorders that affect quality of life or lifestyle (including economics) you can use DTC—but do not forget the nurse. Nurses think about those aspects of the patient’s life. The nurse knows.


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