More from Genentech's McCracken on the Future of Pharmaceutical Sales

(MoneyWatch)  Last week I wrote that Pfizer's (PFE) move into ultra-orphan diseases is bad news for pharmaceutical sales reps, because the handful of doctors who treat such conditions can be reached with a small sales force.

Several readers wrote in asking for more context on comments made by Joe McCracken, vice president of business development at Genentech (DNA). At a recent conference, McCracken questioned how much longer pharma will pay sales reps to bring coffee and donuts into clinics. He also predicted that the future pharma sales model will be less focused on detailing more focused on running call centers to help patients with reimbursement.

Those comments were made during a panel on commercialization at the BioPharm America conference, held in San Francisco last September. The panel discussed, among other things, whether or not pharma has transformed from marketing for the masses to expensive drugs for niche indications.

McCracken said he expects the market to become much more payer-focused in the next five or six years, with FDA approval considered "just one step in the process" rather than the finish line. Sure there will be opportunities to get approval of improved primary care products, but those products will face price constraints. Success will hinge on not just approval, but demonstration of value.

McCracken also predicted that pharmaceutical sales will become much more regulated. He noted that most drug companies are using a commercial model that was established 20, 30, 40 years ago -- which is when he questioned the coffee-and-donuts approach and predicted the rise of reimbursement support.

Panelist Gwen Melincoff, senior vice president of business development at Shire (SHPGY), provided further evidence that orphan diseases are no good for salespeople. She noted that Shire's gastrointestinal division has 120 reps in the U.S., while the orphan drug division gets by just fine with 10 reps. "Expensive drugs for small populations ?€" that's Shire's business model," she said.