The current role of the pharmaceutical industry's sales and marketing workforce will be replaced by a new model over the next ten years as the industry shifts from a mass-market to a target-market approach to increase revenue, according to a new report published by PricewaterhouseCoopers (PwC).

Today's army of sales representatives, the billions of dollars in free drug samples, the millions spent on TV advertising and aggressive marketing to doctors and patients will no longer be practical as the industry shifts its focus from pushing pills to demonstrating through products and services that it can promote health, improve quality of life and reduce healthcare costs, the report said.

According to PwC, the pharma industry's sales force of the future will be dramatically smaller, more agile and require new skills, including an education in science or health, greater understanding of specific complex diseases and the ability to negotiate with powerful payers and medical specialists. Its focus will no longer be just selling products, but better managing of health outcomes through a full complement of health management services, including health screenings, compliance programmes and nutritional advice.

In its paper, Pharma 2020: Marketing the future, PricewaterhouseCoopers outlines a range of dynamics leading to a new marketing and sales system. "For years, pharmaceutical companies have decided what their products were worth and priced them accordingly, investing little effort in understanding the payer's perspective or what the market was willing to buy. With healthcare costs rising, payers including governments and private insurers are becoming the ultimate arbiters of pricing and value, reimbursement and prescribing decisions. There will have to be a stronger link between marketing and R&D. Pharma companies will start thinking about product pricing earlier in the development phase, commercially de-risking their portfolios in phase two by terminating any drug candidate that looks unlikely to generate commercial demand," the agency said.

The often contentious relationship and competing agendas that have long existed among pharma companies, payers and providers will end as pay for performance and comparative effectiveness analysis force them to work together for the common goal of improving health outcomes for the patient and demonstrate value for the money. The current blockbuster model was designed to promote mass-market treatment of common diseases such as hypertension, diabetes, high cholesterol to primary care physicians. Sixty-five percent of these drugs are now sold generically in the US and 70 per cent in Central and Eastern Europe. In the next ten years, only drugs considered truly innovative will be financially rewarded with a premium price. Pharma companies that choose to focus on specialised medicines will gradually shift their product mix to include more biologics and medicines that are targeted to specific and more complex disease states. In addition, it's no longer solely about the product, the report said.

Specialised drugs are significantly more expensive, in some cases costing thousands for a single dosage or treatment. The global market for specialised medicines, which accounted for 44 per cent of worldwide prescription drug spending in 2008, could be twice the size of the current market for all prescription drugs by 2020, according to PwC.

The FDA and other leading regulatory agencies are exploring various new methods for assessing, approving and monitoring innovative medicines. While a single global regulatory body is unlikely, global regulatory harmony will make simultaneously multi-country launches routine. By 2020, the launch of a new drug will become much more incremental. The big bang, big budget, blockbuster launch will be replaced by a process in which clinical outcomes information is continuously disseminated in a series of much smaller waves. New medicines will be launched with 'live licenses', conditional on further in-life testing to substantiate their safety and efficacy in larger/different populations, the report said.