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The Pharma Career Ladder · The medical rep · Step 3: Knowing the science · Lesson 8

Head-to-head or nothing

Comparing across trials is not comparing

By Ahmed El Menshawy · 20 years in pharma, from medical rep to country manager in the UAE. Founder of RepPharma. LinkedIn
Published

Two numbers from two different trials are not a comparison. They only look like one.

Industry codes require any comparison between products to be fair and based on comparable aspects. Yet I still see reps put their trial next to a competitor's trial and draw a conclusion the data cannot carry.

Why cross-trial comparisons fail:

  • Two drugs, two trials, two different groups of patients.
  • Different durations, different endpoints, different baseline severity.
  • It looks like a comparison. It is not one.
  • A head-to-head trial is different:
  • Two drugs, one trial, the same patients.
  • Same duration, same endpoint, same starting point.
  • That is a comparison a doctor can rely on.
  • The wrong sentence: "Ours lowered it more than theirs did in their trial."
  • The right sentence: "In the head-to-head trial, this was the difference, Doctor."

And when no head-to-head trial exists, the honest sentence is simply that. Specialists will catch a cross-trial claim immediately, and they remember the rep who made it.

“If there is no head-to-head trial, say so. That sentence costs you less than a lost doctor.”
Head-to-head or nothing: Comparing across trials is not comparing

Lesson 8 of 11 in Step 3: Knowing the science, with the full guide and a checklist for this week.

More lessons in step 3: Knowing the science

Lesson 1Learning the science properlyHow to study a product like a professional, not a parrotLesson 2Reading a clinical paperFour steps from the abstract to the limitationsLesson 3Relative vs absolute riskThe number that misleads doctors and reps alikeLesson 4What p < 0.05 does not meanStatistical significance in plain wordsLesson 5Number needed to treatA number a doctor can actually useLesson 6Talking about side effectsHonesty that builds trust instead of losing the callLesson 7Off-label questionsThere is only one correct answerLesson 9Guidelines are your allyPositioning your product inside the treatment guidelineLesson 10The mechanism slideWhen it helps the call and when it bores the doctorLesson 11Answering a medical question properlyEscalating to medical affairs without losing the doctor

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