HCP Access Collapsed From 60% to 45% in One Year: Why Precision Beats Volume in Field Coaching

The Collapse Nobody Planned For

Everyone in commercial leadership has felt it.

Fewer meetings. Shorter windows. Doors that used to open now stay closed.

According to Pharmaceutical Executive's conversation with Dan Rizzo, VP of Business Consulting at Veeva, the data confirms what the field already knew: "Our latest Veeva Pulse data shows HCP access reverting to low pre-pandemic levels, from 60% in 2022 to 45% today."

That's not a dip. That's a collapse.

Most companies are still reacting with the same old move: add reps, add calls, add volume. I don't think that works anymore.

Why the Door Is Closing

The causes aren't mysterious. Rizzo names them directly: "They include new health system restrictions that block access or limit meeting frequency, heightened market consolidation, growing diversity and complexity of modern medicines, and increased patient loads."

None of that reverses on its own.

Health systems aren't loosening restrictions. Consolidation isn't slowing down. Medicines aren't getting simpler, and patient loads aren't getting lighter.

Access is also uneven. Oncology, internal medicine, and psychiatry have it hardest. Which means a national average of 45% hides a much harsher reality in the specialties where the stakes are highest.

Less Access, More Competition

Here's what doesn't get enough attention.

It's not just that fewer HCPs are reachable. It's that the ones who remain reachable are guarding their time more carefully.

Pharmaphorum reports that "only 45% of HCPs globally are accessible to biopharmas compared to 60% eighteen months ago, with half restricting engagement to three or fewer companies."

The addressable pool shrank by a quarter. Half the physicians in that smaller pool have already picked their three.

Every rep in that room is competing to be one of them.

This isn't a reach problem. It's a relevance problem.

What HCPs Actually Want in the Room

If time is scarce and competition is fierce, what earns the next meeting?

ZS Associates has the answer, and it isn't what most training budgets are built around: "Our customers tell us that HCPs prefer that reps bring practice knowledge twice as much as they bring product knowledge, yet 90% of sales rep training is on the product."

HCPs want practice knowledge twice as much as product knowledge. The industry spends nine dollars out of ten on the pitch.

That gap shows up fast. Kinara, citing Bain & Company, reports that "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"

Physicians aren't rejecting pharma. They're rejecting generic pharma. MSLs bring depth. A lot of reps bring a script.

The Skill Gap Behind the Numbers

So why isn't the industry already fixing this?

Because the skill physicians want is rare, and most organizations don't measure for it.

Pharmaphorum, citing Lisa Clark, puts a number on it: "It is estimated that only 20-25% of pharma reps today have this skill."

That's roughly three out of four reps walking into a shrinking, more competitive environment without the one capability that would earn them a return visit.

Volume training doesn't fix that. You can run someone through the product deck a hundred times and it won't teach them how to read a room, pivot when a physician changes direction, or ask the question that shows they understand the practice.

Readiness Is Not Knowledge

This is where most coaching programs miss it.

Knowing the material and deploying it live, under time pressure, in front of a physician with three other companies waiting are different skills. Most training measures the first. Almost none measures the second.

Not information. Application.

What This Means for Field Coaching

If access is down a quarter in a year, if half the remaining access is locked to three companies, and if only one in four or five reps have the skill physicians actually want, then more calls isn't the answer.

Better calls are.

Coaching has to shift from checking whether a rep knows the content to observing whether they can read a conversation and adjust it in real time. Notice when a physician's question signals a shift. Interpret what that shift means for the next thirty seconds. Respond with practice-level context instead of the deck.

That's the judgment inside the conversation. It's been invisible for most of this industry's history, treated as art rather than measurable behavior.

It doesn't have to stay that way.

If access keeps shrinking and competition for the remaining minutes keeps intensifying, the organizations that figure out how to see and coach that in-the-room judgment will still be in the room a year from now.

The real question isn't whether access will keep declining. It's whether your coaching model was built for a world where reps got the benefit of the doubt, or for the one you're actually in.

Sources

Pharmaceutical Executive (Q&A with Dan Rizzo, VP Business Consulting, Veeva), https://www.pharmexec.com/view/hcp-access-drops-connected-field-engagement-dan-rizzo

pharmaphorum, https://pharmaphorum.com/sales-marketing/evolving-hcp-access-requires-new-connected-approach-build-engagement

ZS Associates, https://www.zs.com/insights/human-sales-reps-value-ai-era

Kinara (citing Bain & Company, 2024), https://kinara.co/article/beyond-the-call-evolving-the-role-of-the-modern-pharma-sales-rep/

pharmaphorum (Lisa Clark), https://pharmaphorum.com/views-and-analysis/fighting-diminishing-hcp-access