Pharma Reform

As owner of a pharmaceutical company faced the following scenario, what would you do?

• Many of your products are losing patent protection

• Pipeline is slow to replace older, off-patent products

• Market changes and regulatory constraints are negatively impacting sales

• Traditional advertising and promotion are becoming less effective in driving revenue

• Sales force operating costs are a major expense (becoming harder to justify)

• Your company faces prosecution for allegations of illegal sales and marketing activities

• Customers perceive little or no value from sales visits

• Your sales people don’t get sufficient time to make sales presentations to key customers

• Sales people are suing you because they now claim to be hourly employees

• Industry gossip boards are filled with complaints and discontent from your sales people

What do you think you would do?     mike@pharmareform

I would say that from the feedback, comments, and tone of comments I have received pharmaceutical sales representatives definitely hate scripted presentations.  Here’s my take on it.

I should have made a point that pharmaceutical sales representatives should not be expected to deliver the exact same script verbatim to the same physicians more than once. I don’t believe there is any way to make the exact same scripted presentations not sound disingenuous.

If your company feels that compliance with a Corporate Integrity Agreement mandates tightly scripted sales presentations, then those responsible for drafting those scripts must do a much better job of crafting them as prescribed in the previous blog.

Companies and commercial management that feel scripted presentations will be more impactful than letting reps “wing it”  must also do a much better job of crafting the presentations, making them much more rep and physician-friendly as prescribed in the previous blog.

Perhaps I got this from my first District Manager ( one of the best I ever met in the industry)  but I am a firm believer that for product presentations there is always “a best way to say it.”  Getting a scripted presentation right is really hard work and requires an iterative process to get it right.

I also know that when I am shopping to make an important purchase I prefer a sales person who is well prepared with a carefully crafted, well thought out, information packed, and smooth flowing logical presentation (including answers to my questions and objections) than somebody who just “wings it.”  You may nail it occasionally by “winging it”, but I believe you will be more consistent in delivering important information and come across as more professional with a well scripted, prepared presentation.   Again, I also believe the more you practice delivering the presentation the less it will sound robotic and monotonous.

My impression from the feedback is that the scripted presentations pharmaceutical sales representatives are being asked to deliver do not meet the quality of presentations I have referred to in these posts and no amount of practice will make them better.   That being the case,  I would probably hate them as well.   mike@pharmareform.com

For some pharmaceutical companies scripted sales presentations have become a necessity to assure compliance with Corporate Integrity Agreements.  For others it is a way to ensure consistent delivery of the marketing message.  And for a few, it is really intended to ensure that a professional presentation is delivered rather than leaving it to sales representatives to figure it out or just “wing it.”

I’m guessing most representatives see scripted presentations as demeaning, belittling of their competence, and unprofessional.

Let’s think about this.  Do stage performers such as for Broadway shows or comedians, feel this way?  Do musicians (think of your favorite singer or band) feel this way?  Do great orators and professional speakers feel this way?  Do even the best of news anchors feel this way?  When the president or another politician delivers a speech, do they feel this way?

Hardly.   So why do pharmaceutical sales representatives feel this way?

I believe there are several reasons why pharmaceutical sales representatives hate scripted sales presentations.  Here are just a few:

• The scripts are poorly written and not honed to perfection through an iterative process using real sales representatives with real customer feedback
• The scripts don’t accommodate different practice settings, physician personalities, patient types, or treatment alternatives
• The scripts are not conversational, sound scripted, and often intentionally avoid opportunities for customer engagement (lack interaction)
• The scripts are more focused on delivering message than they are about how they affect (“land on”) the customer (think emotionally and intellectually)
• The scripts (including answers to questions) are not practiced (rehearsed) to perfection with incorporation of natural voice modulations and corresponding supportive intonations
• The scripts don’t anticipate the questions that are likely to be asked (or reps don’t practice the answers) so it looks like the rep only knows the product message script.

Yes, there are legitimate reasons why pharmaceutical sales representatives don’t like and even despise scripted sales presentations.  In the context of the above issues, scripted sales presentations can seem demeaning, belittling of a person’s competence, and come across as unprofessional.  That doesn’t mean they have to be.

I believe it is actually unprofessional to think you are so good at sales that you feel you can “wing it” without a scripted, well rehearsed presentation on sales calls.

Like many sales professionals in other industries, professional pharmaceutical representatives should embrace and arm themselves with carefully crafted, engaging, information packed, rehearsed to perfection presentations.  And, answers to customer questions they have encouraged should just become a natural part of their well prepared presentations.

It is hard work to get the scripts right in the first place and then it takes more hard work and practice (to perfection, not just random impromptu “role plays” with your District Manger) to deliver impactful scripted sales presentations professionally.  mike@pharmareform.com

There is still considerable debate and experimentation as to how the proposed Accountable Care Organizations will be structured and function.   It is also hard to understand how widespread it will be once implemented. What is known is that as healthcare reform begins to take shape, the push (with financial incentives) for accountability in delivering higher quality care at lower cost will drive a more coordinated approach to comprehensive healthcare for patients.  As a result, hospitals and physicians are beginning to explore the best ways to work together to ensure that the quality of care they deliver will be accurately reflected in whatever measurements the government (CMS) decides to use for evaluation.  ACOs will in theory be rewarded by sharing the cost savings resulting from keeping their enrolled populations healthy and treating their patients efficiently and effectively.

The comprehensive care expectations for Accountable Care Organizations are beyond the capabilities of most solo physician practices or even small groups.  Also, hospitals will need to expand their roles to include better coordinated post hospitalization care to ensure patients continue their recovery without relapse and re-hospitalization.   This integration of care approach is causing some private practice physicians to consider joining larger group practices and encouraging hospitals to reach out to employ and align with the best physicians in their geographic coverage areas.

So how will this affect pharmaceutical sales?

The first implication of Accountable Care Organizations is most likely going to be a further reduction in sales representative access to primary care physicians as they join larger, busier group practices or hospitals.  Representative access to these physicians is  likely to be governed by even more selective product recommendations and administrative policies developed by the Accountable Care Organization.  The impact on physician time with patients and the potential for sales reps to influence expensive branded product use will also affect access decisions.  If representatives can demonstrate value by favorably impacting quality of care or cost reductions, they will find physician access less challenging.

Adoption of best practices and formalizing treatment guidelines will mean physicians will  be less autonomous in their prescribing practices. They will also have a financial vested interest in prescribing cost effective treatments, complying with formularies, and following recommended treatment guidelines established by the Accountable Care Organization. This will make it more difficult for pharmaceutical representatives to directly influence prescribing of products not supported by ACOs.

Electronic health records (a prerequisite for Accountable Care Organizations) will make the real world impact of drugs on provider quality of care and costs more readily available for evaluation.  Electronic medical records and e-prescribing will also allow for managing and monitoring compliance with treatment guidelines. These assessments and compliance monitoring will leave less opportunity for random use of expensive branded products with marginal clinical benefit.  Deviations from treatment guidelines will require justification and could result in reprimand or potentially expose physicians to financial penalties if repeated non-compliance results in increased costs without clinical benefit.

Companies with products that can demonstrate improvements in clinical outcomes (better than alternative treatment options) or reductions in overall healthcare costs will find a much more receptive institutional audience than they might have in the past.  Companies armed with compelling data will be able to influence the inclusion of their products on formularies and in treatment guidelines.  This is especially true for value-priced preventive medicines, vaccines, and companion diagnostics.

Sales representatives with new products or products that are not favorably received by the ACOs in their territories will be faced with the challenge of gaining acceptance.  Unlike having to convince (selling) individual physicians to prescribe your product, formulary and treatment guideline recommendations will be determined by healthcare provider teams with therapeutic and cost benefit expertise.  More importantly, electronic health records will provide these teams with easy to analyze comparative clinical outcomes and cost data from their own organizations, making it even more difficult for companies (and representatives) without comparable data to make their case.  Collective expertise, real world data, and financial incentives for delivering good clinical outcomes at low cost will make for a hostile environment for companies and representatives who are not equally armed with expertise and real world therapeutic and cost benefit data.

On the other hand, if the Accountable Care Organizations feel a product can help them achieve their quality of care and cost savings goals, representatives may be enlisted to assist the ACO achieve its goals.  Representatives could be encouraged to help educate physicians and other healthcare providers about the appropriate use of their product (within treatment guidelines).  They might even be called on to assist with implementing adherence and compliance programs to make sure patients take their medications as directed.  It might even get to a point where products are placed in treatment guidelines contingent on delivering the expected clinical outcomes and cost benefits.  This would require representatives to understand the metrics for assessing their product performance and staying current with how their products are performing (clinical outcomes and cost savings) within that ACO.

Regardless of how the ACOs are structured or how they decide to operate, it will mean a completely different work environment for pharmaceutical sales representatives.

mike@pharmareform.com

As we have discussed professional representatives may not be as focused on sales numbers and are less responsive to incentive pay than the traditional sales representative.  This alone can make it frustrating for a traditional sales manager.  But professional representatives are self motivated and driven by personal performance excellence.  They strive to be the best that they can be and never seem satisfied with the level of skill or expertise they attain.  This includes selling skills, persuasive techniques, and managing their territories.  So why do so many pharmaceutical sales managers hate managing these people?

I believe it is because it takes experience and a much higher level of coaching skills and management expertise to leverage the value and satisfy the performance expectations of a professional representative.

You may have heard the term “high maintenance rep.”  Well, they can exist on both ends of the performance spectrum but it is probably used most often to describe professional representatives.   The reason is that professional representatives will push sales managers, sales training, and marketing to their limits of technical and scientific competence, coaching skills expertise, and management capabilities.  When the skills and expertise of the professional representative exceed the management competence of the sales manager, it becomes personally threatening to the manager and makes their job much more difficult and sometimes even impossible.

Professional representatives are so good at what they do and they have such an instinctive sense for what is going on in their market that they are often the ones that ‘complain” about the crappy marketing materials and boring marketing messages they are being asked to use.  When they point out that they really don’t have the data to support the claims or the efficacy implications of the marketing materials they get labeled as trouble makers.  Professional representatives also expect insightful post call coaching for improvement not just critique of what they did wrong.   And, despite being less driven by numbers, when they point out that their sales forecast makes no sense as it applies to their territory, professional representatives are frustrated by the lack of rationale for their increase, especially in the context of other conspicuously low territory growth rates.

Experienced, skilled sales managers with expertise treasure and nurture professional representatives.  They lean on them for help. They tap their technical and scientific expertise for the benefit of the district or region.   Experienced and skilled sales managers know how to inspire and help professional representatives achieve their seemingly impossible expectations for excellence.  They have the exceptional coaching skills necessary to identify the nuances of interpersonal and presentation skills that can make the difference between an impactful discussion and merely delivering another marketing message.  It takes a confident (not arrogant) manager to hear what is really being said in the “complaints” of the professional representative.  You have to be a much better, more experienced sales manager to appreciate and effectively manage a highly skilled professional representative.

If you lack experience, sales management skills, coaching expertise, and technical competence, you will hate managing a professional representative.

mike@pharmareform.com

Unless you really understand and appreciate the mindset difference between that of the professional representative compared with that of the traditional pharmaceutical sales representative, this compensation discussion will not make sense to you.  As GlaxoSmithKline recently discovered, a change in sales compensation structure, especially incentive compensation,  away from traditional sales and prescription volume model will take an organizational and perhaps even industry realignment of pharmaceutical sales compensation philosophy.  Most pharmaceutical companies, their commercial management teams, and many representatives are not ready for this.

In fact, I predict that sales organizations will be most resistant to this change as most pharmaceutical sales representatives and managers are too grounded in the traditional sales mentality.  Many sales people are just going to see this as a take-away and will want nothing to do with the job.  It will also be hard for managers to get their arms around how to manage sales (“drive sales”) and evaluate performance without sales quotas and other activity based numbers.   They will complain about the inability to fairly and consistently assess performance if they don’t have hard numbers.  They ignore the fact that today’s prescription data and sales volumes are not accurate and are filled with national, regional, district, and territory caveats.   They also like to think that today’s sales goals and territory alignments are fairly distributed and accurately reflect potential.  And when was the last time we correlated the number of territory activities to sales results?

In the end, none of this matters because incentive compensation is not a performance driver for professional representatives the way it is for traditional sales representatives.  Incentive pay is not a scorecard like it is for traditional sales reps.  In fact if the lack of incentive pay is the reason for a representative to quit, you really didn’t lose a professional representative, you lost a sales representative and this is fine because they wouldn’t be happy or satisfied trying to make it work.  This is the hardest concept to get comfortable with if you have a traditional sales and sales incentive mentality.

Professional representatives want to be paid for their expertise, their stature in their medical community, and recognized for their personal performance excellence.  They prove their expertise and the effectiveness of that expertise by the business health of their territory in terms of how their products are perceived, formulary and reimbursement status, their access to key decision makers, and the professional respect those decision makers have of them personally.   They appreciate that actual sales of their product depends on a number of factors, some they can influence while for others it would be inappropriate to influence (e.g., encouraging the use of their product for patients who are not good candidates or where there is a better product available).  Sales and prescriptions are merely surrogate markers for a lot of things going on, not just their performance.

So how do you compensate the professional representative?  You pay them relatively high base salaries (compared to traditional sales representatives) consistent with their expertise and ability to create or maintain a healthy market environment for your products.   How many people can you hire with that level of expertise and ability to keep a territory healthy?  If you think you can find a lot of these people, you don’t have much for expectations and you are probably not looking beyond physician prescribing.  Are the people you are talking about able to hold their own in a scientific discussion with the Medical Director of an insurance company or pharmacy benefits manager that is considering how your product should be used in their patient population?  Can your representative cite the scientific literature to support their claims and recommendations for appropriate use? Is your professional representative so knowledgeable and good at their job that the insurance company Medical Director wants to hire them?

As for incentive pay, you might as well save it or better yet, invest it in your professional representative’s development.  You’d be better off spending the $20,000 per year on training, development, or sending them to more scientific meetings not to stand in an exhibit but to go to sessions and interact with their professional and academic colleagues.  If you still feel compelled to provide incentive pay, test them regularly on their expertise and give cash awards for testing performance.

You have to remember, professional representatives don’t do things because there is an additional pay opportunity associated with it.  They inherently want to do it because they see it as their responsibility. Their job is a big part of who they are and they take pride in themselves and the work they do. They view their compensation as a reflection of the level of expertise they have and the value they bring to the company when they apply that expertise.  They get more job satisfaction out of applying their expertise than any incentive pay could possibly achieve.   In fact, they’d rather have a pay raise as recognition of their advanced expertise than an incentive to drive sales.

The industry’s strong sales mentality will make it difficult to embrace the professional representative concept and even more challenging to formulate sales compensation plans that are not tied to sales and prescription volume.  You have to start someplace so perhaps this at  least has got you thinking about it philosophically.

mike@pharmareform.com

So what keeps representatives from having more engaging, more informative, and more credible discussions with physicians?  One of the most frequent reasons, or excuses, I hear about is the regulatory constraints placed on representatives.  Regulatory restrictions get in the way of being more effective as a sales representative when opportunities for product use exceed the label claims or where representatives could drive more sales by implying or even making comparative claims they can’t support with label claims or “substantial evidence.”

To ensure regulatory compliance, many companies, especially those with Department of Justice Corporate Integrity Agreements, now require representatives to stick to verbatim scripted presentations that mostly do not resonate well with physicians.  This “regurgitation of the company message” is an immediate turnoff for physicians, lacks credibility, and makes for awkward representative – physician interactions.

Now, keep in mind the premise of our discussion here. You are a professional representative and your mindset and focus is on making sure patients in your territory are getting the best treatment possible.  You are not just “driving sales” by doing and saying whatever it takes to get physicians to prescribe your product as much as possible.   Professional representatives don’t need to be reminded of fair balance or to stick to label claims and approved literature, they just do.  The challenge for them is whether or not they have the claims and sufficient regulatory compliant data and literature to meet the information needs of their customers.

Some sales representatives might suggest that they have all they need in terms of claims and published data and regulatory is just getting in the way.  If that is the case, then why would there be a regulatory compliance issue?  Why is regulatory review such a big deal?  Why would companies and representatives feel a need to promote off-label to make their sales? Why would companies feel compelled to script boring marketing messages to ensure sales representative compliance? More importantly, why is the market still clamoring for more comparative trials and better data to help them identify best treatment options for patients?

In this competitive market and knowing that products we now have were developed with a “get it to market “ mentality and indication – driven clinical trials to satisfy regulatory requirements for safety and efficacy, I’m going to suggest you do not have the claims or data you need.  How many of your products have two well controlled comparative efficacy trials to support claims of differentiation that you can use in sales presentations?  Can you claim superiority?  If not, how can you discuss why your product is better than another for a particular patient type? Can you do this and be compliant with regulatory requirements or are you expected to just cleverly implying a difference?

Here is the problem.   Even today, research gets the indications and it is up to marketing and sales to differentiate the product in the market.  When a physician or managed plan decision-maker asks why they should use your product rather than a competitive product, how do you answer?  Blatant claims of superiority or implied differentiation are the only way to convince them why your product should be used over another product.

What’s interesting is that when research and management talk about products to investors or in company presentations, especially before launch, they talk about and always answer questions about how the product is better than anything else out there, often using historical data from competitive products compared to their just released clinical data.  They highlight all the wonderful features and benefits that your product has over the competition, even quote data that imply superiority.

But, when marketing and sales wants to take those same messages to the market they have this regulatory issue.  While the research and management statements may be true,  they don’t necessarily come with the label claims or “substantial evidence” to support those same claims in advertising and promotion.  Yet, revenue forecasts are driven off those claims and expectations for differentiation.   And besides, who ever launched a product that wasn’t considered by their research team and management to be better than anything out there?

Pharmaceutical companies can no longer expect, pharmaceutical representatives to fill the label claim and “substantial evidence” data void for products.  The disconnect between product differentiation assumptions used for revenue forecasts and the regulatory constrained messaging puts the representative in an unfair position of having to deliver sales expectations beyond that which would be or ever could be achievable given a compliant presentation.

To be effective, even professional representatives need regulatory compliant information, comprehensive label claims, and more importantly, “substantial evidence” documented in peer-reviewed published literature.  This is the responsibility of management and the research team.  It is then marketing’s responsibility to develop forecasts that are aligned with the label claims and regulatory compliant information available for presentations and discussions by representatives.   mike@pharmareform.com

Ok, this will be a little controversial and I will probably touch a sensitive nerve or two but I am trying to help identify a way forward for the industry that will ultimately restore business viability while reestablishing trust and credibility.  You also have to be thinking 3-5 years from now when you have an even more managed market where there are far more influences on physician prescribing than sales representatives.   Which means representatives will have different, more analytical target audiences (think insurance company Medical Directors and their staffs , technology and product review committees, etc).  If you are thinking in today’s world this may not will make no sense to you.

So here goes.

When it comes to skills and expertise each of the following representative profiles has its strengths and these strengths may or may not be a good fit for a particular industry or job function.  Here is how I see the two profiles:

Traditional Pharmaceutical Sales Representative:

• Strong interpersonal and social skills help build rapport and establish relationships
• Exceptional selling skills and persuasive techniques
• Tactically oriented, relying on sales materials, promotional programs, and samples
• Customers are seen as prospects and a source of sales revenue
• Selling is seen as a competition (if I get more prescriptions I win, you lose…even if my product isn’t as good as yours)
• Sales numbers are a scorecard for incentive compensation
• Work Objective:  “get the doctor to prescribe your product as much as possible”

Future Professional Representative:

Has many of the skills of the sales representative including interpersonal, social, and selling skills but…

• They have a patient-oriented focus around meeting or exceeding customer and market expectations (want the best product for the patient)
• Rely heavily on technical and scientific expertise as their base of confidence  to establish rapport and build credibility and trust
• Sales numbers and incentive pay are not performance motivators
• Work Objective:   “make sure patients  get the right product and customers realize the maximum benefit from your products”

The biggest differences between these two profiles for selling pharmaceuticals are the level of expertise and the mindset about their jobs.  The professional representative goes well beyond the company training and resources to understand the science around their products and diseases.     They pride themselves in staying current and knowing more about their products, the diseases being treated, and competitive products than anybody in their territories, including the physicians.  They base their knowledge, presentations, and conclusions on data from the literature which they can quote objectively and accurately.  They do this because they see this not just as their job but their responsibility.

The professional representative has a different motivational mindset.  They are motivated more by personal performance excellence and expertise than sales numbers and incentive pay.   The reason they like and do their job goes well beyond making the sale.   In fact you might even think the sale is a collateral benefit of their work.   This is a very hard attribute and concept to describe because it is inherent in the thinking of a professional representative.  This is one of those “you know it when you see it” type things.  Their drive and motivation may not even make sense to the hard core traditional sales representative and certainly isn’t compatible with most traditional pharmaceutical sales management thinking or expectations.

There is nothing wrong with being a traditional sales person.  This profile drove sales in the pharmaceutical industry for decades.  And, there are industries , especially retail and consumer products, that require a sales mentality to succeed.  And, you can be a professional sales person, mastering the skills and acquiring the expertise related to sales of the products you are selling.  But if your mindset is still that you  are motivated by making the sale and the only reason for your interaction with a customer is to generate a sale, you are a sales person.

The healthcare market has changed however, and one of the changes that the pharmaceutical industry must accommodate is the declining effectiveness and diminishing tolerance for the traditional sales representative role and profile.  Declining physician access was perhaps the first indication of this market change.  State legislation to restrict sales representative activities followed and intensified regulatory scrutiny has now made for a much more challenging environment for pharmaceutical sales representatives.  As a result, I believe that a professional profile as described here and in  a previous post is the only hope for pharmaceutical companies to have a local “in the field” presence in the evolving new healthcare market.

I can hear it now….but the regulatory and legal constraints won’t allow for this profile.  I’ll address that in the next post.  Stay tuned.  mike@pharmareform.com

Ever notice that when professionals (it doesn’t matter if it is a corporate executive, lawyer, actress, or athlete) are interviewed in their offices or homes they almost always have a library full of books in the background.  There is a reason for this.  It’s not just for looks, although it is impressive.

Professionals have an inherent need to know as much as they possibly can about their profession and the work they are doing.  This includes learning about differing points of view and why people might hold them.  This includes different ways of doing things,  even though they may not agree with the method.  Professionals strive to keep themselves up to date and ahead of their colleagues and anybody else for that matter.  They go well beyond what the average person will do to stay current or to do their jobs better.   And, while they know they can command higher compensation than non-professionals doing similar work in the same field, compensation is not a motivator for true professionals.

Professionals maintain their expertise and keep it current because it is a big part of who they are and they know that being a true professional with genuine expertise is rare.  They  continuously look  for ways to improve and enhance their expertise, often evaluating and employing new technology quickly if they think it might help them.  And while the internet makes it easier for them, books, including electronic versions, still provide information, insights, and unique author perspectives that can not be found on the internet.

Are you a professional or are you just doing a job?  It really is a personal choice and being a professional may not be for you.  It is also not a right or wrong choice, good or bad choice type thing.   It is also not about doing your best but more about being the best.  It takes commitment, dedication, skill, expertise, and an internal, self motivating drive to be the best at what you do.

So, if you consider yourself a professional, what’s on your bookshelf?  What have you read lately?

mike@pharmareform.com

For professional representatives to flourish in the evolving new healthcare market executives must create a corporate environment that understands the importance of and is committed to changing the commercial model.  An environment where executives and commercial managers are committed to do whatever it takes to help professional representatives be successful in this evolving new healthcare market.  With the professional representative focused on the customer (again, not just physicians), corporate and commercial management should be focused on developing the products, label claims, data, information, and programs that help professional representatives meet the needs and expectations of the evolving healthcare market customer.

This organizational transformation will require that commercial management step up their game and the level of their own professionalism.  Expertise in traditional marketing and sales tactics is not going to help much in this evolving new healthcare market. There are no slick technology quick fixes or gimmicky tactics that will substitute for meeting product and data needs of the market.  It is critical that marketing and sales management understand and accept that tactics that worked in the past and the bad behaviors that drove revenues in the past, are no longer going to be tolerated and will not work in the evolving new healthcare market.  It means marketing and sales management must reformulate their strategies and acquire new skills and expertise that are better aligned with the needs and expectations of the evolving new healthcare market.  This includes being able to effectively deploy a  sophisticated team of professional representatives and arm them with products and support resources that address the evolving healthcare market needs and expectations.

Unfortunately, most executives and the people running commercial teams today are grounded in a traditional mentality about pharmaceutical marketing and sales.  This is where I predict most organizational transformations will fall short and stall out.  Those who can make the changes and should be championing the changes will feel threatened by a move away from their own expertise, experience base, and comfort zone.

Here is something to think about.  Let’s assume the company decides to embrace the organizational changes we have discussed and it is ready to embrace the new professional representative profile. Where do you find marketing and sales management with the new skills, expertise, and mindset needed to formulate and implement the new commercial strategy?  For example, will sales managers understand and appreciate the differences between sales reps and professional representatives?  Will marketing managers understand that they need to spend more time comprehending the complexities of the evolving decision-maker processes and nuances of customer expectations (not just market research) rather than worrying about the copy and graphics for their next TV commercial?

Again, don’t underestimate the need for executives and commercial management to really understanding the market at the customer level and having the right mindset about how to approach this new commercial model.  Some sales representatives and some commercial management may be close to the desired profile and mindset needed for these changes but they also need corporate executives who can create an environment in which these individuals can champion these changes and flourish.   Unfortunately, there are probably more who don’t get it, won’t get it, and will probably fight it, if not actively, passively by doing nothing.

mike@pharmareform.com