For decades, the pharma sales rep has been a cornerstone of the industry’s go-to-market strategy. But in an era of constant change, characterized by complex reimbursement challenges and tight scrutiny of healthcare costs, that model is rapidly eroding. 

The good news? Pharma companies aren’t shying away from these challenges. To better meet the needs of their customers and the patients they serve, they’ve embraced a spirit of innovation and experimentation. They’re evolving their sales force approach in kind. 

It’s no secret that the traditional pharma field force is under increasing pressure from rising costs and declining access to healthcare providers. While reps remain well-compensated—the median total compensation for a specialty sales representative in the U.S. is around $158,000, with senior reps often earning base salaries of $200,000 or more—their ability to engage HCPs continues to fall.

Even as provider expectations have shifted, field sales remains the single largest commercial investment for nearly every pharmaceutical company. According to a ZS report published in March, HCPs prioritize practice knowledge over product knowledge by a two-to-one margin—yet the great majority of sales training focuses on product content.

The result is a growing gap between what HCPs want and what reps are equipped to deliver. To that point, a 2024 Bain & Company study revealed that 50% of physicians want more time with medical science liaisons, while only 25% want more time with reps.

This presents a genuine paradox: The traditional model may be losing effectiveness, but it still drives enough demand to merit continued investment. That has created an uneasy stasis, one that feels increasingly unsustainable.

As a result, pharma companies might delay modernizing their sales models. And when brand performance lags, they’ll default to the tried-and-true (read: expansive rep armies) or tactical quick fixes (increases in call frequency, updated metrics for rep performance).

Those tweaks fail to take into account the structural shifts reshaping healthcare. A commercial model anchored in repetition, relationships and volume is likely out of sync with the demands of the modern-era healthcare ecosystem.

Thus pharmaceutical organizations must rethink how they sell, who does the selling and what they can be expected to deliver. To do so, companies might consider:

Looking Beyond the Usual Suspects: In the past, the ideal pharmaceutical sales candidate was defined by therapeutic area expertise, physician relationships and prior experience. Are these qualifications sufficient in today’s marketplace? Many experts believe the bar has been raised, and the ideal rep skill set has evolved in turn.

Attributes such as critical thinking, learning agility and adaptability appear to be better aligned with the needs of modern pharma organizations. They don’t need sales aces so much as they do consultants, strategic thinkers able to tackle access, cost and efficiency challenges.

Many organizations have updated job descriptions to reflect these expectations, but a disconnect still exists. Hiring decisions too often still default to outdated criteria; just because somebody won a sales award a decade ago doesn’t mean that individual will claim additional trophies in the years ahead. The industry must fundamentally rethink how it evaluates talent.

Revamping Incentive and Compensation Models: Current models reward volume-based metrics, most often the number of prescriptions written, but this approach prioritizes short-term success over long-term relationship-building. A more future-minded model would reward a representative’s ability to simplify prescribing for busy clinics and achieve broader brand objectives. Evaluations by the healthcare providers reps call upon should similarly play a greater role in performance assessment.

Linking compensation to more strategic measures would better align sales behaviors with the priorities of today’s providers and institutions. Sales compensation must reward not only what is sold, but how and to whom. This shift will enable reps to engage in a broader range of value-added activities, ones that are more meaningful to the providers with whom they engage.

Ditching the Title of “Sales Rep”—and Letting Them Cook: In all relationship-driven industries, titles matter. They shape perception, which in turn affects access. In this instance, the term “sales representative” reinforces a transactional image that no longer reflects the needs of today’s healthcare systems or the full potential of field-based personnel.

More strategic, consultative titles—”field professional,” ”pharmaceutical consultant” and “healthcare engagement partner” are among the ones that have been proposed—could bolster rep credibility and position them as true partners. But a mere title shift isn’t enough. Organizations must also expand the scope of the role and eliminate structural constraints that limit what members of a field force can deliver.

To facilitate more meaningful HCP interactions, companies should expand rep training to include workflow dynamics and access challenges. They should empower their field teams to speak to the full portfolio of approved therapies, rather than a single brand. The reimagined role would bridge commercial strategy with clinical execution, improving provider engagement and ultimately, patient outcomes.

Going Horizontal: Field teams have traditionally been organized by brand or therapeutic area. But while this vertical structure aligns with internal business units, it often fails to reflect the way care is delivered in the modern healthcare environment. It doesn’t coordinate across conditions or take into account value-based care, among other shortfalls, creating a gap between how reps engage and how providers operate.

By way of example, a company promoting a single immunology drug may send multiple representatives to the same health system. The problem? These representatives—sales reps, MSLs, reimbursement specialists and more—operate independently, creating a fragmented presence that further overwhelms already strained health systems. The vertical model thus leads to redundant outreach and inconsistent messaging.

Horizontal models, by comparison, allow companies to present a unified strategy, reduce field overlap and minimize resource waste. It’s an approach that centers on health system needs and reflects the integrated model driving care today.

So what’s next? A keener focus on value delivery, clinical relevance and data- and AI-driven solutions. That will require pharma sales reps to evolve from message carriers to solution architects. While the industry seems open to experimenting with new sales models, change cannot take hold without bold leadership and a willingness to push the envelope.

It’s a bit hyperbolic to say that the future of the pharma sales rep hangs in the balance, but the time for a meaningful evolution in the role is now. The companies willing to shake up the status quo are the ones who will come out ahead.

Tad Landowski has held senior-level sales management roles at Amgen and Novartis as well as sales and marketing positions at Galderma. He was most recently executive director, head of Tepezza sales, at Amgen.