Some pharma sales representatives are shifting to a more supportive role in the face of industry consolidation, dry pipelines, FDA scrutiny and physician schedules, representatives say. "Increasing physician satisfaction, it turns out, is a much better way to promote a pharmaceutical agent than simply telling them to write more prescriptions or what the benefits [are]," said David Ricks, president of Eli Lilly & Co.'s global business unit. Nonetheless, many doctors refuse to see drug reps, often because they have no time or have had unpleasant experiences with reps, says Chris Wright of ZS Associates.

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