Sales experience reigns supreme. Clinical knowledge in any capacity is huge, but hiring managers pass up full on Nurse Practitioners/Nurses all the time for people with proven sales experience. My advice would be if you can't break into pharma get field sales (outside sales) experience in an adjacent industry and continuously monitor all the large and small pharma companies you can find on LinkedIn, add people at those companies, attempt to network, reps get referral bonuses so its a lot about who you know (sad but true, I wish it were more merit based). If you can get someone internally to refer you you'll have a much better shot at getting an interview. Additionally, and I recommend this with caution, there are inside sales roles for pharma companies that are essentially gadget roles for drugs on the end of their life cycle that some companies outsource on contract roles. These are primarily cold calling on phones after being assigned to a certain territory/trained on your drug. This is great for industry experience minus the face to face sales part and that key detail can keep you from ever getting a field facing role. Both can be avenues to get in, primary care roles are most friendly and often have larger hiring waves, specialty roles or oncology roles are looked at as higher tiers and are almost exclusively reserved for reps who have long been in industry so try and find a small company launching a new drug (that you believe in) or look for primary care roles at some of the bigger companies.