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ccording to Michelle O’Connor, senior VP,learning strategy and innovation, at CMRInstitute, clinicians have reported that themost useful interaction is one with a high-

ly educated representative who brings a broadunderstanding of the healthcare continuum to thetable and who delivers information that benefitspatient outcomes.

“Evidence-based medicine information givessales reps the opportunity to provide data basedon research that clinicians value as opposed to amarketing message,” she says. “Physicians tell usagain and again that this is what they value most.”

Mark Sales, global practice leader, stakeholdermanagement, at TNS Healthcare, says pharmaceu-tical companies have begun a dramatic transitionfrom product-centric sales models to physician-centric service models.

“More than 90% of companies now say theyare adopting service models, expanding their focusfrom measuring internal sales processes to moti-vating external sales drivers: the physicians writingprescriptions and the stakeholders influencingthem,” he says. “As service models evolve, theindustry is moving toward patient-centricapproaches, in which physicians and the industrypartner to advance patient care and improve treat-ment outcomes. Evidence-based medicine will bean important tool in ensuring reps can form thatkind of strong partnership with their physician cus-tomers in helping them optimize patient care.” (Formore information on creating successful servicemodels, please turn to page 44.)

THE EVIDENCE FOR EVIDENCE-BASED SELLING

Recent studies reveal that physicians want andneed to have more valuable clinical informationcoming from pharmaceutical companies. In a 2008

Sermo study sponsored by Publicis Selling Solu-tions Inc., with physicians from a wide variety ofdifferent specialties, 85% of respondents wanted“more” or “significantly more” higher-quality repre-sentatives, defined as more highly trained, “special-ty type” representatives. Fully 87% of respondentswanted “more” or “significantly more” use of clini-cal studies and evidence-based medicine in theirdiscussions with sales representatives. Surveyedphysicians preferred clinical studies to “glossybrochures” and evidence-based medicine-orient-ed discussions versus promotional details.

Another study, conducted annually by theHealth Strategies Group, shows that only 40% ofphysicians said they were satisfied with the infor-mation that reps shared during product discus-sions and only 30% were satisfied with the sup-porting materials that sales reps used.

“These figures are not positive indicators,” saysRick Rosenthal, principal and practice leader, salesforce effectiveness, Health Strategies Group. “Partic-ularly since we know that visual aids and clinicalreprints that support what sales reps say in the officeare important predictors of prescribing changes.”

Mr. Rosenthal says now, more than ever, salesreps should be able to speak more clinically to thedoctors who desire this type of discussion.

Solvay recently studied the results of syndicatedreports from physician focus groups to determinehow its sales reps can better fill physicians’ needs. Theoverriding conclusion was that doctors like the inter-change with reps and appreciate the services theybring, but they have limited time for the interaction,says Kevin Guthrie, VP sales, Solvay Pharmaceuticals.

“Sales reps need to bring physicians relevant,up-to-date, good, sound clinical information,” hesays. “As a result, our reps have found that if theyprovide good information, they get more facetime with the physician. But, if the information pro-vided is just a repeat of the last five visits to the

Gaining Power ThroughEvidence-Based Selling

by Robin Robinson

SPECIAL FEATURE VIEW ON SALES

office, they won’t get any of the physician’s time.” Mr. Rosenthal says physicians report that they

want to see reprints, professional journals, consen-sus statements from medical societies, and otherinformation of this type.

“Physicians’ underlying concern is around bias,”

Sales reps need an edge to get face time with the physicians these days.The way to their schedule calendar is through evidence-based medicine, our experts say.

Studies show that not only does adding evidence-based medicine information to the sales call

increase the value of the sales rep’s role, evidence-based medicine data

can also help drive physician prescribing behavior.

A

Sales reps and marketers mustadapt to a new playing field—one in which highly technical informationis readily accessible to both physiciansand savvy patient populations.

Robert NorrisComplete Healthcare Communication

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he says. “Physicians may hear from one rep thattheir drug is better than another and when thatscenario is repeated over and over again, categoryby category, soon they start to wonder who is giv-ing the most truthful and accurate information.”

Richie Bavasso, president of Exploria SPS, saysbecause of the advent of alternate channels forthe physician to find and review unbiased andcomparative data on therapies, the sales-rep chan-

nel has become less valued and important. “If pharma companies want to improve the

value of their reps and strengthen this channel inthe eye of the physician, they must provide salesreps with the tools to participate in discussions thatpresent the appropriate therapy for a patient pop-ulation,” he advises. “This means it is just as impor-tant for sales reps to inform physicians when not touse their brand as it is when to use the product.”

Ms. O’Connor says building trust is key in asuccessful clinician and rep interaction.

“To maintain credibility with clinicians it is imper-ative that evidence-based medicine or any type ofclinical-trial results are presented in an unbiased andfactual way,” she says. “Physicians don’t want to heara sales rep criticize a competitive product.”

Craig Sponseller, M.D., executive VP and chief

medical officer at Vox Medica, agrees that trust isparamount to rebuilding the value propositionbetween sales reps and physicians.

“We need to help re-establish the reps’ valuefor this new era, as they are our industry’s frontline,” Dr. Sponseller says. “It starts with rethinkingthe salesforce strategy, rebranding the reps, andtraining them to deliver on their brand promise,not just that of the products they sell.”

Dr. Sponseller says there are three driving fac-tors to making a sales rep essential in today’s envi-ronment: access, credibility, and success. (To learnmore about these interrelated factors to improvethe value proposition, please turn to page 46.)

TRAINING REPS IN EVIDENCE-BASED MEDICINE

Integrating evidence-based medicine into a salesstrategy requires reps to understand the impact ofdata on clinical decision-making, key research find-ings and evaluations, and the validity of trial results.

Training reps on evidence-based medicine ismore important than ever in a downtrodden econ-omy, says Paul Mignon, chief operating officer of

SPECIAL FEATUREVIEW ON SALES

Clinicians tell us the most usefulinteraction is one with a highlyeducated rep who has a broadunderstanding of the healthcare continuum.

THOUGHT LEADERS

�RICHIE A. BAVASSO. President, Exploria SPS, which offers sales per-formance solutions for tablet PCs and other mobile technology to the phar-maceutical and medical-device industries. For more information, visit exploriasps.com.

� KEVIN GUTHRIE. VP, Sales, Solvay Pharmaceuticals Inc., a research-driven group of companies that constitute the global pharmaceutical business of the Solvay Group, which seeks to fulfill carefully selected, unmet medical needs in the therapeutic areas of neuroscience, cardiometabolic, influenza vaccines, gastroenterology, and men’s and women’s health. For more information, visit solvaypharmaceuticals.com.

�DON HRIBEK. VP Sales, EMD Serono, which specializes in several therapeutic areas, including reproductive health, neurology, and metabolicendocrinology. For more information, visit emdserono.com.

�PAUL MIGNON. Chief Operating Officer, inVentiv Commercial; President, inVentiv Selling Solutions, a segment of inVentiv Health that provides outsourced product commercialization programs, recruiting, professional development and training, and regulatory compliance services; andsalesforce automation/data analysis, as well as planning and analytics, and otherservices. For more information, visit inventivhealth.com.

�CELESTE MOSBY. VP, Life Sciences, Wilson Learning Worldwide, aprovider of human performance improvement solutions for Global 2000,

Fortune 500, and emerging organizations worldwide. For more information, visitwilsonlearning.com.

�ROBERT A. NORRIS. President and Founder, Complete Healthcare Communications Inc., which focuses solely on the art and discipline of strategicpublication planning. For more information, visit chcinc.com.

�MICHELLE O’CONNOR. Senior VP, Learning Strategy and Innovation,CMR Institute, a not-for-profit, 501(c)3, independent educational organization thatprovides advanced education and professional certification and sets national stan-dards for pharmaceutical representatives and managers. For more information, visit cmrinstitute.org.

�RICK ROSENTHAL. Principal and Practice Leader, Sales Force Effectiveness, Health Strategies Group, a leading consulting firm that provides mar-ket intelligence and research to pharmaceutical and biotechnology professionals. For more information, visit healthstrategies.com.

�MARK SALES. Global Practice Leader, Stakeholder Management, TNSHealthcare, A Kantar Health Company, which provides globally consistent solutions and custom advisory services to support product introductions; brand,treatment, and sales-performance optimization; and professional and DTC promotional tracking. For more information, visit tnsglobal.com/healthcare.

�CRAIG SPONSELLER, M.D. Executive VP and Chief Medical Officer,Vox Medica Inc., an independent healthcare communications company. For moreinformation, visit voxmedica.com.

Physicians need more information than ever before about the latest innovationsand best courses of treatment and protocols, and they are looking to sales representatives toprovide this information.

Don HribekEMD Serono

Michelle O’Connor CMR Institute

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inVentiv Commercial and president of inVentiv Sell-ing Solutions. Trained in how to best use evidence-based medicine, reps will bring more value to thephysician and gain more access as a result.

“Because so many physicians are programmedto think that a rep is going to repeat a marketingmessage, they shut down,” Mr. Mignon says. “Once

Solvay began training its sales reps in evidence-based selling four years ago. The module used pro-vides sales professionals with the foundation tofully understand clinical study data.

“We explain study design, we talk aboutreport structure and background on statisticalanalysis and statistical significance, we help pinpointkey findings and establish the terminology to beused in the review of the articles we provide tothem,” Mr. Guthrie explains.

Mr. Guthrie says the training includes workingin partnership with several other departments inthe company.

“We have great relationships with the medicalservices group, the regulatory and marketinggroups, and the sales and training departments,”he says. “This helps us to be proactive in identify-ing therapeutically relevant information as itcomes to market and we can discern if it fits pro-motional opportunities, or if it should be usedstrictly for educational purposes for sales reps, orif it fits better with medical affairs.”

Don Hribek, VP of sales at EMD Serono, rec-

sales reps start using evidence-based medicine,there will be an evolution in how physicians thinkabout reps; they will believe that reps can bringinformation that is worthwhile.”

Mr. Mignon says there also needs to be an evo-lution in how sales reps are trained.

“Historically, companies trained their sales peo-ple to be experts in their own products; now, salesreps need to be experts in all products and thediseases,” he says. “Doctors diagnose disease, but awell-trained rep is a better facilitator of the appro-priate products for the physician to use.”

Mr. Guthrie says his salesforce teams alreadyhave reaped the benefits from this change in focus.

“Anecdotally, we have witnessed that whensales reps bring new landmark data to physicians,they tend to get extended time with them,” hesays. “For many physicians who normally won’t seeus, when we tell them we have new and impor-tant data, they often make appointments with us.”

Richie BavassoExploria SPS

Often there is a disconnect — repsbelieve they are using evidence-based data intheir discussions with physicians,but physiciansthink the data are limited, controlled, andbiased.

SPECIAL FEATURE VIEW ON SALES

Insights From the InsidersPHARMAVOICE ASKED EXPERTS IN THE SALES REP TRAINING AND DEVELOPMENT ARENA TO IDENTIFY TO WHAT DEGREE WILL KNOWLEDGE OF EVIDENCE-BASED MEDICINE (EBM) BECOME A NECESSARY TOOL FOR THE SALES REP OF THE FUTURE AND WHY.

The Evidence is ClearEvidence-based medicine will

be an extremely important toolfor reps. A TNS study of morethan 1,500 primary-care physi-cians found that doctors rated“strong scientific/clinical evidence

to support the product” as the second-most impor-tant criterion for assessing the value of a meeting witha rep. This ties with the related attributes of “commu-nicating product information clearly and comprehen-sively” and “acknowledging weakness and limitationsof the product.” It is clear that doctors are looking forreps who can credibly deliver evidence-based infor-mation to demonstrate a product’s treatment value.

Mark SalesGlobal Practice Leader, Stakeholder ManagementTNS HealthcareFor more information, please turn to page 44.

A New Type ofTraining

Training sales representa-tives to deliver a fluent yetpowerful message will enablemore effective connectionswith targeted customers and

trigger responses that warrant more engaging reac-tions from physicians.

Ultimately, physicians want to be able to makeclinically relevant treatment decisions based ontrusted clinical data. Therefore, they want to consid-er sales representatives as trusted advisors and val-ued resources who can partner with them in get-ting this important information.

Celeste MosbyVP, Life SciencesWilson Learning WorldwideFor more information, please turn to page 48.

A Foundation of Trust EBM will be a critical tool, a tape

measure of sorts, to mark off the dis-tance sales reps can travel with eachrespective HCP on the path of indi-vidual practice challenges and com-munity nuances. At the core lies the

understanding and appropriate implementation of EBMand how it can help guide clinical judgments and decisionsdirected to our most paramount customer, the patient.Therefore, future reps will need to be rooted in theessentials of EBM, while masterful of the balance betweenthe science of medicine and the art of medicine. Fromthis, a foundation of trust can be built by credibly assimi-lating the very fabric of EBM into the services they pro-vide to ensure success through the eyes of the HCP.

Craig Sponseller, M.D.Executive VP/Chief Medical Officer Vox Medica Inc.For more information, please turn to page 46.

Paul Mignon inVentiv

Once sales reps start using evidence-based medicine data, there will bean evolution in how physicians thinkof reps.

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ommends that evidence-based medicine informa-tion is best communicated in a face-to-face envi-ronment, which means special training.

“Just sending out an article with a fact sheet isnot enough to verify that all of the sales represen-tatives will deliver the message effectively and in-line with the label,” he says. “Training workshopsneed to be conducted to effectively roll out thistype of information.”

Mr. Rosenthal adds that evidence-based train-ing needs to be an ongoing endeavor and not aone-time shot.

An overlooked opportunity is listening andlearning from the physicians’ feedback regardingthe data presented, he says.

“Many times, reps lock into the idea that cus-tomers are only there to be persuaded, but physi-cians have years of training and experience andthey can be a great source of information and canprovide feedback to help sales reps do their jobsbetter,” Mr. Rosenthal says.

One of the critical steps in training is to teachsales representatives how to pull pertinent infor-mation out of clinical papers and to help themcommunicate this information in the best way tothe physician, says Celeste Mosby, VP, Life Sciences,of Wilson Learning Worldwide.

“It is important to align the technical skills ofunderstanding evidence-based medicine to theskills of communicating this information,” she says.

Ms. Mosby says the conversations that sales rep-resentatives will now need to have will be morecomplicated than writing one prescription for suc-cess; it will take a shift in go-to-market strategy.

“Sales representatives will serve as captains ofa very integrated service team,” she says. “The waythis service team is rewarded should not just beindividual; incentives, rewards, and recognition ofthe team’s productivity and success must also bethe focus of sustaining this new service model.”(For more information on the value proposition ofa new sales model, please turn to page 48.)

While vitally important in this new environment,arming sales reps with evidence-based medicinecould increase the probability of compliance risk indiscussions between reps and physicians.

“Risk is a challenge,” Mr. Guthrie says. “Moreinformation doesn’t mean better information. Intoday’s Internet world, at the click of a button salesreps have a lot of information at their fingertips,but with this access comes a greater burden tounderstand the data.”

Mr. Guthrie says it is important that pharmacompanies ensure that their reps are getting bal-anced information and that the interpretation ofthat information is appropriate.

“We must hold evidence-based medical mate-

rial to the same standards of promotional materi-als and make sure we are meeting regulatory andcompliance guidelines,” he says.

To facilitate adherence to the standards, com-panies need to stay on top of scientific informationand review and interpret information for sales reps.

“Sales reps may be tempted to use unvettedinformation in promotional selling, but we are train-ing our reps to wait until the data have gonethrough the appropriate process,” Mr. Guthrie says.“When a breaking new study comes out, the soon-er the company makes the appropriate evaluationsand trains them on the appropriate use of the data,the fewer compliance issues there will be.”

Research and innovation can actually increasethe risk for the sales representative. Even the mostinnocent conversations around any research canhave serious implications for pharmaceutical com-panies, Mr. Hribek says.

“The industry must ensure that all informationdisseminated to physicians is on-label,” he says. “Thisbecomes challenging when new studies are pub-lished that discuss off-label use of an existing drugor a compound currently in research. Sales repre-sentatives might be asked by the physician to weighin on the data; however, they need to ensure theyare discussing on-label use only.”

However, the benefit of providing relevantstudy information to the physician far outweighsthe compliance risk, as long as pharmaceuticalcompanies develop sales materials that areapproved by their regulatory department and

adhere to the standards outlined by the FDA whendiscussing disease state and product information.

In general, presenting data that are based onresults of a randomized controlled trial or otherresearch study doesn’t present a compliance risk ifthe presentation is offered in an unbiased frame-work and follows FDA guidelines, Ms. O’Connorsays.

“Reps have very strict parameters about whatthey can and cannot speak to even when usingreprint materials,” she says. “For example, whenusing clinical reprints, the guidelines state that thedocument cannot be altered in any way. In otherwords, a rep cannot highlight a portion of reprint.”

Clinicians are taking a more objective look atscientific evidence than ever before, especiallywhen written clearly and logically, says RobertNorris, president and founder, Complete Health-care Communications.

“The credibility of promotional vehicles andmessages, as they have been presented in the past,are vulnerable in light of validated peer-reviewedscientific evidence,” Mr. Norris says.

Sales reps and pharmaceutical marketers mustadapt to a playing field in which highly technicalinformation is readily accessible to all clinicians aswell as savvy patient populations, he says.

“Being able to provide hard medical evidenceshould make carrying the bag easier in the longrun, but the challenge is adapting to the change,”Mr. Norris says. �

PharmaVOICE welcomes comments about this

article. E-mail us at feedback@pharmavoice.com.

Rick Rosenthal Health Strategies Group

The rising need for more evidence in sales coincides withthe need for clarifying risk to benefit,justifying price, and explaining thehealth economics of a treatment.

SEE DIGITAL EDITION FOR BONUS CONTENTWWW.PHARMAVOICE.COM

We get what we earn: if webecome less clinical and bring lessvalue to physicians, we get less oftheir time.

Kevin GuthrieSolvay Pharmaceuticals

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t has always been paramount that we providehealthcare professionals with the most up-to-date, fair-balanced efficacy and safety data, buttoday’s market is demanding more data for

several reasons,” says Kevin Guthrie, VP of sales, atSolvay Pharmaceuticals.

The demand for evidence-based data is com-ing from payers as well as traditional providers ofhealthcare and a more savvy patient. Evidence-based medicine is used to clarify the risk-benefit

decision and justify the price for treatment and toevaluate and compare treatment options to see ifone product is more efficacious than another in aparticular patient population.

“The industry is working feverishly to try toanswer this burden-of-proof question,” he says.“These are three key stakeholder segments thatare demanding greater proof of worth of a phar-maceutical treatment.”

Another factor is the push for clinicians to basetreatment decisions on widely accepted clinicalpractice guidelines to provide optimum patientcare, says Michelle O’Connor, senior VP, learningstrategy and innovation, CMR Institute.

“The need for improved patient outcomes isdefinitely fueling the use of evidence-basedmedicine,” she says. “Our research shows that avast majority of clinicians prefer to get the latestand most applicable information from repsbecause it’s targeted and gives them the informa-tion they want quickly without going through all ofthe literature, which busy doctors don’t have timefor.”

Additionally, more healthcare systems andmore insurance companies are basing reimburse-ment decisions on evidence-based medicine andwhether or not clinicians are following theseguidelines, Ms. O’Connor says.

Time is of the essence in the physician’s mind,says Don Hribek, VP of sales at EMD Serono. Intoday’s healthcare system, the demands on aphysician’s time are increasing. The time they haveto see their patients, review the latest research,and attend conferences is lessening, and physi-cians are looking to the healthcare industry tobecome more of a resource on the best treat-ment options.

“Therefore, physicians need more informationthan ever before on the latest innovations andbest courses of treatment and protocols, and theyare looking to sales representatives to providethem with these data,” Mr. Hribek says.

And more importantly, all our experts say, evi-

dence-based information is what physicians want. Rick Rosenthal, principal and practice leader,

sales force effectiveness, Health StrategiesGroup, says physicians, whether they are office-based, hospital-based, or pharmacists in hospitals,want to see more evidence-based reprints, jour-nal articles, consensus statements from medicalsocieties, etc.

SHAPING THE SALESFORCEOF THE FUTURE

The application of evidence-based medicinewill change a rep’’ focus from delivering mugs,pens, and totally promotionally focused messagesto delivering the next life-changing clinical message

SPECIAL FEATURE VIEW ON SALES

Driving Evidence-Based SellingThere has always been a real need for clinical selling and understanding of clinical

data and communications. The highest performing sales reps always had this as a key skill.

TODAY, MORE THAN EVER, THERE IS A GREATER NEED FOR MEDICALLY RELEVANT DATA, AND SEVERAL FACTORS ARE DRIVING AN

INCREASED FOCUS AND UPTAKE OF THE PRACTICE.

by Robin Robinson

Physicians report sales rep traits and actions predict prescribing change

� Understands appropriate use and role

of product relative to other

treatment options

� Understands physician practice and

the kinds of patients treated

� Respects office staff

� Tailors presentations to physician

needs and interests

� Consistently uses visual aids or clinical

studies to support discussion

Source: Health Strategies Group. For more information, visit healthstrategies.com.

A SURVEY OF MORE THAN1,000 PHYSICIANS REVEALSTHE TRAITS OF SALES REPSTHAT ARE MOST LIKELY TOIMPACT PRESCRIBINGBEHAVIOR:

I“

The application of evidence-based medicine willchange a rep’s focus from delivering mugs and pens to delivering thenext life-changing messages to physicians.

Celeste MosbyWilson Learning WorldwideCom

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DIGITAL EDITION — BONUS CONTENT

ously inform the organization of the types of clin-ical information needed by physicians.

“Traditionally medical, legal, R&D, and regulatorydepartments have played more of a support role forsales reps; in the future, representatives might needto rely more heavily on expertise in these importantareas,” she says. “Going forward, even primary-carereps will begin to closely emulate the role of spe-cialty reps, prompting evidence-based medicine tobecome the basis of most sales interactions.

“The value of this approach is that there willnow be an increased opportunity to continuouslyshare and disseminate clinical information withphysicians, using many different touch points,” Ms.Mosby says. �

Physicians need more information than ever before on the latest innovations andbest courses of treatment and protocols, and they are looking tosales representatives to provide them with these data.

to physicians who are looking to better serve theirpatients by positively impacting treatment out-comes, says Celeste Mosby, VP, life sciences, WilsonLearning Worldwide.

The current and future healthcare environ-ment is going to force sales reps to be highlyknowledgeable with respect to disease states andevidence-based medicine if they are to be suc-cessful.

“Reps will need to understand the critical roleof pharmaceuticals in the healthcare continuum,”Ms. O’Connor says. “The key point is that an edu-cated rep who can summarize results and relay

the validity of applicable trials can save the physi-cian time and money while contributing toimproved patient outcomes, and this is the type ofservice that physicians want and need — theyneed a resource that aids in the decision-makingof care for their patients.”

Experts believe that the salesforce of thefuture will need to be educated in the pharmacol-ogy of the drugs as well as business and ethics ofhealthcare in general.

Sales representatives will also need to be moreefficient on every call and be able to conduct in-depth conversations with the healthcare providersin a timely manner, Mr. Hribek says.

“With each sales call, representatives need tobring physicians updated information on how toeffectively use drug therapies in the approvedmanner to treat the indicated disease state; salesreps also need to know how patients can accesstherapies based on a cost perspective,” Mr.Hribek says.

More application of evidence-based medicinefrom clinically sound resources and delivered bycredible, medically educated sales professionalswill impact the way the industry is viewed by themedical community.

Solvay conducted some research regardingwhat the best profile is for hiring successful salesrepresentatives. Mr. Guthrie says the results wereinconclusive.

“Sometimes the best sales representative is anurse, a former school teacher, or a car rentalmanager,” Mr. Guthrie says.

With the need for more clinical expertise onthe horizon, however, the company is exploringmore professional-based reps, such as nurses orphysician assistants who can engage with keyaccounts who are desiring a more peer-to-peerexchange. The company is looking to discover ifphysicians will respond more readily to someonewith a clinical background.

“Physicians who will not see reps under thecurrent call model may be open to a more peer-to-peer interaction,” says Mr. Guthrie. “The posi-tion would be in addition to the current sales repmodel and might be called a clinical associate. Thisis a profile we are evaluating, and in 2009 we willbe taking on those positions with hope of initiat-ing a pilot program in the coming year.”

The rep of tomorrow will have to be able toguide physicians in the proper use of products.

“The feedback we hear from physicians is thatthey are disappointed in the knowledge they getwhen they ask about such things as adverseevents,” Mr. Rosenthal says. “Reps need to be ableto steer physicians to optimal patients wherethey’ll see the best result, and they are not alwaysdoing that now.”

According to Ms. Mosby, representatives ofthe future will have to manage a different type ofrelationship with physicians, where they continu-

SPECIAL FEATUREVIEW ON SALES

Survey says: Physicians value highly educated reps

� Physicians place a high value on a

well-educated, knowledgeable, ethical,

and unbiased sales representative.

� Physicians overwhelmingly want sales

representatives who have knowledge

beyond information about the

products they sell, including disease

management, drug classes and

indications, effectiveness, and

quality-of-life issues.

� Sales representatives who have

completed the in-depth requirements

for certification by the nonprofit CMR

Institute — a process that typically

takes two or more years — report

that their enhanced education

contributes to:

• Their ability to have a substantive,

in-depth conversation with

physicians (86%)

• Their ability to better explain their

products (80%)

• Their credibility with physicians (77%)

• The amount of time they spend with

physicians/other providers (53%)

Source: CMR Institute. For more information, visit cmrinstitute.org.

THE CMR INSTITUTE SURVEYED PHYSICIANS,INDUSTRY LEADERS, ANDSALES REPRESENTATIVES INFOCUS GROUPS, QUANTITATIVE SURVEYS,AND ONE-ON-ONE INTERVIEWS, AND FOUND:

Don HribekEMD Serono

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Pharmaceutical companies have begun a dramatic transitionfrom product-centric sales models to physician-centric servicemodels. More than 90% of company executives now say theyare adopting service models, expanding their focus from mea-

suring internal sales processes to motivating external sales drivers: thephysicians writing prescriptions and the stakeholders influencing them.

To understand this shift, consider that, of every 100 reps visiting apractice, just 20 see the doctor. Clearly, just throwing more reps intothe field isn’t the answer to generating business.

Add to that today’s dwindling pipelines and tightening revenuesqueeze, and it’s easy to see why companies are radically rethinkingwhere they spend promotional dollars. It’s no longer enough for repsto deliver sales messages. To have an impact, they must coordinate value—providing a range of services to doctors.

To understand service models from physicians’ perspectives, TNSHealthcare, performed new research with 1,500-plus primary carephysicians across the United States, the United Kingdom, France, Ger-many, Italy, and Spain. Following are some key findings:

1. Fewer Doctors Perceive Changes from the Moveto Service Models

In 2009, only one-third of doctors report seeing changes in theirinteractions with pharma, due to the new service models. This repre-sents a decline from 2008, when almost half of physicians said theywere experiencing changes. The decrease holds true across all countriesand is particularly dramatic in Spain and Germany.

2. Physicians Value the Sales Force But AlsoPlace High Importance on Education and Practice Support

In all countries, physicians place the greatest value on sales forceattributes, including reps’ conduct, knowledge, and expertise, as well ascall quality. Even though reps remain critically important, other experi-ences are gaining in value, particularly physician education, practice sup-port and patient services. For example, more than three-quarters ofdoctors place a high value on physician education.

3. Falling Rep Relationship Scores Reveal Challenges across the US and Europe

In the United States, four companies share the lead, based on theirreps’ ability to build strong physician relationships —GlaxoSmithKline,Merck, Novartis, and Pfizer. Even for companies earning high marks,however, TRI*M™ scores — TNS’s measure of relationship strength —have fallen since 2008. In the United States, TRI*M scores fell from 78

to 75. Relationship scores also fell in Germany. Scores in France and theUnited Kingdom remain low, showing continuing challenges in thosecountries. Spain bucks the trend, as the only country showing a signifi-cant jump in its TRI*M score.

4. Novartis Takes the Lead on Service Delivery inEurope, While Merck Takes Top Honors in theUnited States.In addition to assessing relationship strength, the surveyasked doctors to rate 17 companies from 1 to 5 (with 1being poor and 5 excellent) on a range of experiences: repconduct; rep knowledge and expertise; sales visit quality; patient man-agement, education and support; physician education; practice and staffsupport; Web services for doctors; Web services for patients; brandexperience; and corporate reputation.

In the United States, Merck is the leader with first-place scores in allservice categories. GSK and Pfizer ties for second place, and Novartisand Lilly for third. In Europe, four out of five countries — the UnitedKingdom, Germany, Spain, and Italy — give Novartis top marks. Sanofi-Aventis takes the top spot in France and ties for first place in the Unit-ed Kingdom and Germany.

5. Pharma Faces Negative Word of Mouth (WOM)around the WorldTRI*M identifies four customer segments: � Apostles: Customers who are satisfied and actively generating posi-

tive WOM.� Rebels: Customers who are dissatisfied and actively generating neg-

ative WOM.� Hostages: Customers who don’t want to stay with a company but

feel they have no other choices.� Mercenaries: Customers with low loyalty who will move on quickly

to what they see as the next “best deal.”TRI*M reveals a new and unsettling trend in the United States. The

percent of U.S. doctors now classified as “rebels” has risen sharply in thelast year, from 12% to 19%. For the first time, U.S. companies face a neg-ative market environment. All five major European markets have tradi-tionally had a high proportion of rebels and that trend continues in2009.

ConclusionAlthough many companies receive high ratings for their service

experiences, increasingly negative word of mouth and declining rela-tionship scores show there is still improvement needed. Successfulcompanies will be those that remember service models, first and fore-most, are about strengthening relationships. �

SPONSOR: TNS HEALTHCARE, a Kantar Health company, provides globally consistent solutions and custom advisory services to support product introductions;

brand, treatment, and sales-performance optimization; and professional and DTC promotional tracking. For more information, visit tnsglobal.com/healthcare.

Creating SuccessfulService Models

Mark Sales, Global Practice Leader, Stakeholder Management

TNS He

althca

re,

A Ka

ntar Hea

lth Com

pany

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Creating SuccessfulService Models

NEW Sales Performance OptimizationTM Reveals the UnseenRisks for Your Brand—and the Actions to Keep It Safe(Even When Competitors Try to Make Waves).

Your prescription data may tell you your brand’s sales are safe. But are they? In most major classes,up to 50% of high prescribers are ready to switch to a competitor. If you’re only looking at Rxinformation, you’ll never see that fall coming—or know how to avoid it.

That’s why TNSHealthcare’s NEWSales PerformanceOptimization (SPO) shows you not onlyhowmuch doctors write your brand but how committed they are to it. Then, it tells you howto create the ideal sales experience to drive doctors’ Commitment, reduce risk and buildshare. SPO looks at every facet of your physician relationships—from rep interactionsto patient communications to practice support to company and brand attributes.You knowwhere to focus your sales efforts—andwhat you’ll gain in return.

Why is Commitment important? Committed physicians delivermorethan double the patient share. Resist competitive efforts. And havelower price sensitivity. They’re farmore productive today—andtomorrow. When your high prescribers are also committedprescribers, you take the risk out of your future. And thatmeans smooth sailing for a long time to come.

Make sure you see the perils ahead—andknow how to navigate safely around them.

To find out how SPO can optimize your sales effectiveness,contactWes Michael at 410-559-0291 orWes.Michael@tns-global.com.

Your BrandMay Look Like It’s

Sailing Along.But Could Your Sales BeHeading

for aMajor Fall?

A Kantar Health Company

Learn results of new research onwhat US and EU doctors value

and how they rate 17pharma companies on delivering!

�

For your FREE copy, emailTNSHealthcareInfo@tns-global.com

and put "RESULTS"in the subject line.

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VIEW ON SALES

lthough great strides have been made in the innovation of newdrugs, the reputation of the industry’s brand has suffered. Nearlyone-quarter of physicians work in practices that ban pharmaceu-tical sales representatives and when they do allow contact with

a physician occurs about 20% of the time.1 Our reputation is just a notchabove the cable company industry, according to the August 2008 HarrisPoll, followed by health insurance, managed care, oil, and tobacco.

As Craig and I contemplated how we got here, we reflected on thesales teams who sold us products when we were the customer. Despitebeing on opposite sides of the country and in very different yetdemanding settings, we both held the Upjohn sales representatives inhigh esteem as integral members of our team and the community. I, asa community and hospital pharmacist, and Craig, as an assistant chiefresident and internist at a teaching hospital, always made time for theUpjohn rep.

Having since then led a global brand and sales team and both ofus having worked with numerous client sales teams, we believe we canlearn from the Upjohn reps — synonymous with trust and service —for inspiration today. We need to help re-establish the reps’ value forthis new era as they are our industry’s front line. It starts with rethink-ing our sales force strategy, rebranding our reps, and training them todeliver on their brand promise, not just that of the products they sell. What makes a sales rep essential in today’s environment?

We believe it comes down to three driving, interrelated factors:

1. AccessSales reps need to offer something of value to physicians’ practices

and their integral support teams. Train your front line to understandwhat drives their business, their community, and their reputation asquality providers. As Dr. Sponseller shares from personal encounters,“Stop asking me to make you successful, ask me what I need to be suc-cessful.”

2. CredibilityMake your reps indispensable for their wealth of insights, service

support programs, and connectivity to expertise beyond their knowl-edge. Give reps tools that help practitioners become heroes to theirpatients and caregivers. Don’t leave reps out to dry by forcing them tosell on the merits of their ability to debate product usage — alsoknown as overcoming objectives — day in and day out. The physiciansaren’t buying one-for-all solutions, and their customers are savvyenough to know their options as well.

3. SuccessA successful organization is not the sum total of its details.

Shifting away from silos and into a collaborative, community-driv-en total sales and marketing team will help you see oppor tunitiesin this dynamic marketplace. Change the motivation of the entireteam to go beyond single product scripts. Look for insights thatallow you to affect behavior within specific communities and lever-age those oppor tunities to benefit your entire por tfolio and cor-porate reputation.

The Rep of the FutureWhat does the new rep need to be successful?

To start, reps must have the experience and problem-solvingskills to be able to truly understand physicians’ varied needs beyonda “product-lens” approach. As clinical decision making is a complex,dynamic process, reps need a holistic training approach that requiresthe synthesis of clinical knowledge, business acumen, and individualpatient assessment. Becoming a source of credibility in the field, aswere the Upjohn reps, is now much more about being an ally than asales person. So how do we build the new training curriculum?

Content should be developed in conjunction with the very prac-titioners, patients, and caregivers you’re trying to serve. Their inputhelps define the learning objectives and certification process as itbegins with the premise: “What’s in it for the customer and his/herpatients?” Clearly prescriptions still matter. But you can’t get pre-scriptions without maintaining access. And you can’t maintain accesswithout credibility. All of which you have to define up front and cre-ate quantitative and qualitative metrics of success by which to incen-tivize a diverse team of stakeholders.

Back to the futureIt brings us full circle to the respected sales force of yesteryear,

the sales force that intuitively understood how to see the worldthrough the eyes of the clinician, the sales force that was integral. Ifadopted in critical mass, the model will also help precipitate the slowtransformation of an industry with a battered public image to one ofgenuine corporate responsibility. We can only optimistically predictgreater benefits for all of us in our professional and personal lives. �

Footnote: 1. WSJ Health Blog, March 29, 2009. http://blogs.wsj.com/health/2009/03/23/the-

long-decline-of-drug-sales-reps/. Accessed on April 8, 2009.

SPONSOR: VOX MEDICA INC. delivers inventive, cost-effective communications solutions, including novel education and adult learning programs,

to healthcare clients worldwide.For more information visit voxmedica.com

Making the Sales Rep Essential

in Today’s Environment

Vox Med

ica Inc.

SPECIAL FEATURE

We need to help re-establish the reps’ value for this new era as they are our industry’s front line.

It starts with rethinking our sales force strategy, rebranding our reps, and training them to deliver on their brand

promise, not just that of the products they sell.

George Glatcz, M.S., R.Ph.President and Chief Branding Officer

Craig Sponseller, M.D.Executive VP/Chief Medical Officer

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See the opportunities.

voxmedica.com

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hat does service really mean to physicians and otherhealthcare providers? Many physicians have defined itas unexpected value that helps them deliver better careto their patients and impacts the efficiencies of their

practice. This value is qualified in different ways and it is up to salesrepresentatives and others within life-sciences organizations to findout the unique intricacies that will define the specific needs of health-care providers.

We all know that physicians are looking for more medically soundclinical information delivered by more medically educated professionals.How will the industry support this paradigm shift and meet theseexpectations? Let’s be realistic. The conversations that sales representa-tives will now need to have will be more complicated than writing oneprescription for success; it will take a shift in go-to-market strategy. Salesreps will serve as captains of a very integrated service team. The waythis service team is rewarded should not just be individual; incentives,rewards, and recognition of the team’s productivity and success, it mustalso be the focus of sustaining this new service model.

An Integrated Sales Team Approach Although sales representatives should remain the primary point of

contact for healthcare providers, it should be transparent that the serviceteam supporting them includes many other critical functions, specificallysales operations, marketing, medical, legal, and R&D. These teams can cre-ate an innovative environment internally and one that builds credibility inthe eyes of customers. This visionary approach to servicing the needs ofcustomers will create new opportunities and ultimately solutions that willbe generated and tested by a more inclusive service team.

Sales Managers. Sales managers, who traditionally focused on mea-suring adherence to sales processes and usage of promotional materials,will see a dramatic shift in their role. In today’s environment, they mustbecome strategic partners with sales representatives. They will be instru-mental in helping develop customized plans to service key customers andaccounts. These plans will address critical issues, such as impact on treat-ment guidelines, compliance, and better patient outcomes. Sales man-agers will focus on measuring the impact that sales reps’ efforts have oncreating value, customer loyalty, and commitment. Many are waiting to seeif this more consumer-centric approach to service will have the expect-ed results, but those who are forward thinking recognize that these shiftswill have a drastic impact on sales performance.

Marketers. Marketing professionals will be expected to align tacticsthat support delivery of clinical information, marketing messages, andtools through venues that support the new industry environment. Dis-ease state and product information for all therapeutic classes should be

tailored to allow those in sales roles to actually speak specifically to thedifferent emotional and behavioral styles of healthcare providers, whilehelping them visualize the impact this information will have on the dif-ferent types of patients they treat. Sales reps, who are skilled at manag-ing a two-way communication platform between their customers andthe organization, will be able to get real-time guidance regarding cus-tomer challenges and needs that can be immediately addressed by mar-keting and brand teams. These challenges that healthcare providers arefacing are opportunities for the marketing team to help, lean in, and part-ner with representatives to come up with important solutions. Addi-tionally, marketing groups need to leverage technology and electronical-ly send information that is important to healthcare providers’ regionalneeds and specific to the patient populations they treat. Not only willthis approach support your organization’s focus on creating more touchpoints with physicians, it highlights a growing focus on going green.

R&D. R&D teams will clearly continue to do research that helps physi-cians understand the efficacy, safety, standards of care, and treatmentguidelines of key products. Innovative ideas regarding what clinical infor-mation will help physicians treat patients should take into considerationchallenges that physicians face in clinical practice, such as alternativecombination therapies that could lead to better compliance and patientoutcomes. Since clinical evidence seems to be of the highest impor-tance, when the strategic plan is developed to decide on research andfuture studies for new and existing products, healthcare customersshould be at the center of helping to understand the unmet needs.

Medical Affairs. Historically, medical affairs has been focused on thevalue of developing strong relationships with physician thought leaders.This same level of value-based support will help build the trust and cred-ibility needed to ensure that more physicians become influencers andadvocates of better care and treatment options. Legal will make sure thateverything the service team communicates is on label and meets FDAguidelines so that confidence from the medical community is ensured.

Playing in the New EnvironmentOrganizations will have to rationalize the use of this service-team

approach, instead of working in functional silos, because customers aredemanding and expecting more. The competencies, skills, and abilities ofthe service team will have to be assessed to guarantee that they will beready to respond today and into the future. Skills that will sustain thisservice model include consulting, negotiating, influencing, collaborating,and communicating more effectively. Developing these key skills willimprove the effectiveness and productivity of the internal team andallow sales reps to communicate more powerful clinical messages thatwill truly impact prescribing habits. �

SPONSOR: WILSON LEARNING, a provider of human performance improvement solutions for the Global 2000, Fortune 500, and emerging organizations world-

wide. For more information, visit wilsonlearning.com.

RX: A Prescription for a New Go-to-Market Strategy

Wils

on Lea

rning

Doing Surgery on the Traditional Sales Model;Those Successful Will Focus on Delivering Science and Service

Organizations will have to rationalize the use of a service team approach, instead of working in functional silos, because customers are demanding and expecting more.

Celeste MosbyVP, Life Science

Ed EmdePresident

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