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

Relative vs absolute risk

The number that misleads doctors and reps alike

By Ahmed El Menshawy · 20 years in pharma, from medical rep to country manager in the UAE. Founder of RepPharma. LinkedIn
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The same trial result can be told as a big number or a small one. Good doctors always ask which one you are showing them.

Relative risk reduction tells you how much the risk fell compared with the control group. Absolute risk reduction tells you how many patients in every hundred actually avoided the event. Both are true. Only one of them sounds exciting.

A simple worked example, not from any trial:

  • Risk falls from 2 in 100 to 1 in 100.
  • Relative: "50% lower."
  • Absolute: 1 fewer patient in every 100.

Same result. Very different impression.

  • The rule I give every rep:
  • Never show a relative reduction on its own.
  • Put the absolute number beside it.
  • Show the absolute number first.

A specialist who hears only the relative figure assumes you are hiding the other one. Often he is right. The rep who offers both is the rep he starts to trust with data.

“Give the doctor the absolute number before he has to ask for it.”
Relative vs absolute risk: The number that misleads doctors and reps alike

Lesson 3 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 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 8Head-to-head or nothingComparing across trials is not comparingLesson 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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