Kimberly Corbitt doesn’t have anything against pharmaceutical sales reps. She used to be one.
But she believes that the $15 billion the industry spends annually sending them to doctors’ offices is an ineffective and inefficient system that has helped fuel astronomical hikes in drug prices and widespread public mistrust of the pharmaceutical industry.
What consumers, health care providers and the drug industry needs, she says, is a web-based interface that merges information about drugs, their side effects and benefits with coverage and copay information so that doctors and patients can sit down together and quickly find out not only what drugs best fit their individual needs, but also which ones are covered by their insurance, and by how much.
Corbitt has spent the last few years working to develop such a system to replace the bloated and outdated pharmaceutical representative sales model. And its potential as a game-changing solution to help healthcare providers and patients navigate the vast and constantly evolving world of pharmaceuticals has grabbed the attention of some major players in the global healthcare industry.
Her company, Xpress, based in Santa Fe, was one of just 12 from more than 200 applicants accepted into the second class of a digital healthcare incubator recently launched by the Texas Medical Center in Houston, which is the world’s largest medical center. Thanks to contacts made during that four-month program at the TMCx Innovation Institute, Xpress is now working with two key partners on pilot projects to bring the platform to market.
Although she can’t yet name names, one partner is among the most globally recognized names in the healthcare field, Corbitt says. Another is a pharmaceutical giant.
It all came about, she explains, during lunch a few years ago, with a friend who is still a pharmaceutical sales rep. Corbitt had left her position as a rep several years prior and had since built a successful regional healthcare business, Santa Lucia, that provides services to people with developmental disabilities.
“She was bitching about her job, as most reps do,” she recalled. “I had owned my own business long enough that I could see how operating in different ways can change things. I had achieved some success. I had built my first company, Santa Lucia, into a $6 million business with 180 employees, and was feeling heady and like I could do whatever I wanted.”
Building off a running joke in the pharmaceutical sales industry that reps are “wearing the brown suits, like they are UPS drivers,” just dropping off packages, she started thinking about how to develop a better way for drug companies to deliver samples and information to doctors without annoying sales calls.
The first iteration of Xpress focused on building a UPS-style team to drop off drug samples and quickly gather a little information on tablets about doctors’ needs, which could then be forwarded to a sales rep for follow up.
But after testing the system with more than 600 providers, Corbitt said she realized doctors needed and wanted more. Because while they know about drugs, and they know what type of insurance their patients have, they don’t necessarily have information on their patients’ prescription coverage, which usually falls under a separate insurance plan. Many also don’t like sales calls, period, no matter how short. In fact, she notes, some big health providers now ban reps from their buildings.
“The model of reps going out to buy doctors lunch to get them to sell their drugs isn’t working anymore,” said Erik Halvorsen, director of the TMC Innovation Institute.
Dr. Kelly Wirfel, an endocrinologist in Houston who serves on the company’s board, agrees, adding, “Xpress takes the drug rep interruption out of the clinic and replaces it with targeted information customized to her patients.”
The goal of the Xpress platform is to provide a so-called ‘middleware’ solution that takes information about all the drugs on the market—including their benefits, side effects and costs, as well as the coverage rules of insurance companies and clinical trials—and integrates it into one searchable screen that makes it easy for doctors to pull that up next to their patients’ records to find the drugs that best fit their health needs and budget. It also shows when resources are available from drug companies to help patients whose insurance won’t cover costly drugs they might need.
“When your doctor is getting ready to write you a prescription for an antibiotic, or for birth control or migraines, they can click and up will pop the drugs available specifically to you – the drugs your insurance will cover and what they cost under your specific prescription plan,” Corbitt explained. “There’s no more guessing.”
“Your doctor can say, ‘I really like this one for you, but it’s going to cost $60 a month, and you’re going to be on it for a year. Let me see if I can get a couple of alternatives or see if the manufacturer provides a discount’,” she added. “[The doctor] doesn’t have to talk to a sales rep, doesn’t have to go [the company’s] web site, and doesn’t write you a prescription for something that’s not covered or is too costly.”
The platform, she said, will prevent patients from getting to the pharmacy only to discover they can’t afford a drug, which forces a call to their doctor’s office, which then might have to spend hours researching alternatives. It will also prevent an even worse scenario: the patient walking away without a needed medication, and then ending up in the emergency room.
“Drug adherence is a significant problem,” Corbitt explained. “Part of the value of Xpress is to help mitigate that by identifying drugs that people can afford, and getting their buy-in at the outset, so they’re more likely to stick to the regimen.”
“It is hard to get good information about what medications are out there and how they compare,” explained Halvorsen of TMC. “I think there is a real desire for access to that information by consumers. Similarly for doctors. It’s not that doctors don’t know the drugs, but they need one site where they can find information,” including more detailed reports on how patients fared in clinical trials of new drugs.
He said the platform offers potential as a “conduit to get that information directly to consumers and doctors in a low-cost way.”
Corbitt is strengthening that conduit by bridging alliances with existing databases and pharmaceutical and insurance companies to give her access to their data. Basic information on insurance coverage and drugs is available in the public domain, but taking that from its varying formats and integrating it into a searchable database does make building the system more difficult and time-consuming.
But she believes it’s a challenge that’s well worth the effort, and notes that the pharmaceutical industry itself is a motivated constituent.
“Pharma spends $15 billion a year sending sales reps to doctors’ offices,” she said. “By contrast, they only spend $3 billion a year on those stupid TV commercials. That’s five times what they spend on ads, and over half of the doctors won’t even see [the reps.]”
She pointed to a recent study that shows that 68 percent of pharmaceutical representatives don’t believe the current sales model is working.
“They are spending huge amounts of money and getting minimal results,” she added. “They are excited to learn about alternatives that doctors will actually use.”