From the inside there might be seem to be a disctinction between these two branches of pharma selling: -
Hospital or specialty sales jobs require more intellectual horsepower than the primary care rep has. That’s why they’re paid more and get more face time with the doctors
'Industry Insider' commenting on the Pharmalot article
In my experience the jobs are essentially the same. Okay, the science might be more complex and illnesses more serious but the marketing is very simple in both cases; Freud's 'narcissism of small differences' comes to mind.