The Sales Process Plan Pre-Sale Sale Grow Building Relationships Grow Usage Customer Relationship Management Referral Systems Target Thought Leaders Territory Management Sales Call Product Knowledge Presentation Customer Service Value-Added Programs Support Support District Manager Influence Training & Development Marketing Support & Leadership Hire & Recruit Train & Orient Senior Leadership Thought Leaders & Influencers Buying Approval Process (Open or Closed) Source: Best Practices LLC, Chapel Hill, N.C. For more information, visit best-in-class.com. “B” Prepared — Motivating the Middle Performers Today, the average rep-to-physician call lasts less than two minutes. It’s no wonder that physicians say they don’t get to know their reps or even remember the content of the meetings. While the amount of time physicians spend with pharmaceutical representatives shrinks and the number of reps continues to grow, it’s not surprising that pharmaceutical firms are looking for ways to maximize sales effectiveness. Research shows the expectations of physicians is leading to changes in the educational process about prescription drugs. Physicians say they want information that helps their practice and their patients, such as clinical data, updates on diagnostic techniques, and comparative costs of treatments. They want a substantive call. The high-performance reps do just that; they prepare extensively for the meeting. This translates into valuable interactions that build physician trust and earn the time needed to thoroughly educate the physician. Focusing on the “B” Players In most businesses, the high performers, or A players, represent just 10% of the salesforce. The average performers, or B players, make up a majority of the salesforce (up to 80%). To significantly shift outreach efforts to physicians, pharmaceutical companies are looking for ways to improve the performance of the B players to make a difference. This makes even greater sense if one thinks in terms of sheer numbers: 90,000 reps targeting 250,000 physicians with B players representing 72,000 of those reps and managing about 200,000 valuable physician relationships. If companies divide their salesforce into three segments based on rep performance — A, B, and C — they wind up with a standard bell curve. The A level high performers and C level low performers make up the two “tails.” The majority are the average B performers. If a company can find ways to move the middle to the right, toward those A high performers, it can translate into a significant gain for the organization. B players are well worth the effort. Typically, they are intelligent, competent, and hard working. They also tend to be loyal to the organization — much more so than the A players who are coveted. B players are neither fast-tracking nor struggling; some are simply risk averse. Understanding what motivates B players is helpful in designing an approach to drive their performances. Performance Rewards Research has shown that the tangible rewards of employment (pay and benefits) are simply the minimum returns that employees look for from their jobs — the threshold of acceptability. What truly differentiates employers in workers’ minds is how the company behaves toward them and the degree to which it fulfills their psychological needs. According to the Hay Group Research Compensation Reports, the reasons people leave an organization are: first, because of management; and, second, because of compensation. This has implications for pharmaceutical companies along with just about every business that relies on an effective salesforce to drive results. Dissatisfaction can lead to turnover. Although turnover in the pharmaceutical industry may appear to be at a manageable range of 10% to 15%, this is only acceptable if turnover is primarily among lower-level performers rather than top or middle performers. Companies invest heavily in training, and the loss of even an average performer represents a significant replacement cost. A players, while valuable, will come and go by the very nature of their ambition and aggressiveness. Companies cannot afford to also lose the next tier of performers, the B players, especially when the reasons are identifiable and reversible. A change in how this middle group is trained, measured, coached, and rewarded can have considerable value on the bottom line as well as on physician satisfaction, trust, and future accessibility. Organizations are finding that they can get more from their salesforces by identifying the best practices of top performers and exposing their B players to those methods. This should not affect the company’s relationship with its A players and does not mean that they would be coveted any less. They will always be the best producers and represent the most recognizable growth. Likewise, it’s not about turning B players into A players. Rather, it’s about identifying the behaviors of the over-achieving A players and helping the B players focus on those performance methods. A Continuous Improvement System Pharmaceutical companies should consider a continuous improvement system that capitalizes on the proven success of the best representatives and then pinpoints, measures, and rewards activities that lead to sales. The approach includes a unique set of quantitative measurement standards that allow organizations to establish a preprogram baseline, and then chart the progress of every rep. The approach also improves the level of manager-rep discussions by providing an in-depth analysis of individual performance and desired levels of success. Some of the basic features and benefits of such an approach include: • Assessment: A detailed assessment of the organization’s objectives and desired areas of improvement, which provides the basis for engaging top performers in the development stage. • Task Force: A top performer task force captures characteristics and best practices and creates performance criteria for the entire sales organization. Examples include extending measures beyond physician reach and sales to encompass adherence to code, safety record (how does safety record apply to pharmaceutical sales), training completion, teamwork, and physician satisfaction levels. • Solution Design: A solution design should ensure maximized performance and include such key elements as research, analysis, communications, training and education, metrics, and feedback. • Analysis: There should be ongoing analysis through measurement of program effectiveness based on historical and current performances, guiding future direction and course correction. For example, the approach establishes individual performance baselines and tracks performance within the variety of criteria identified and validated by management and top performers. • Training and Communications: Comprehensive training and communications are important to provide the appropriate level of awareness, alignment, and skills development. What may be common sense to the A player, might require instruction for the B player. Training and communications would deliver knowledge and skills beyond typical new hire courses so as to address real physician issues. • Performance Evaluations: Periodic evaluations should measure performance against criteria and ensure an effective level of dialogue. • Reward and Recognition: Companies should establish appropriate and effective reward and recognition based on the organization’s culture. Companies need to align recommendations with research that identifies key considerations, such as making the awards meaningful and truly special; using infrequently purchased items or services; maximizing social reinforcement qualities; communicating splurge value; varying award types to meet diverse needs; and minimizing the potential for confusion with existing compensation or entitlements. Measuring Performance Beyond Reach Pharmaceutical firms can improve overall sales effectiveness by measuring performances other than simply physician reach and scripts. Driven by the best practices of the A players, B players can become more effective in their interactions with physicians and achieve higher levels of performance. Or, as stated by Marcus Buckingham and Curt Coffman in “First Break All the Rules: What the World’s Greatest Managers Do Differently,” “Paint a picture for your most talented employees of what excellence looks like. Keep everyone pushing and pushing toward the right-hand edge of the bell curve.” Source: Stan Striker, VP, Managing Consultant, Maritz Inc., St. Louis. For more information, visit maritz.com. Stan Striker VP, Managing Consultant Maritz The performance bell curve Focus on more than just the performance of the A players, the top 10% of the salesforce. The B players offer the greatest impact on the organization’s desired results. Number of people Performance Salesforce Effectiveness: Getting It Right Global pharmaceutical sales currently exceed $350 billion annually, but according to Accenture, the prospects for growth in profitability and shareholder value have never looked so challenging. Pharmaceutical companies have tried to ensure continued double-digit returns by entering a seemingly endless pharmaceutical “arms race,” with each company constantly increasing the size of its salesforce. But that model, which once almost guaranteed profitability, is becoming a proposition of diminishing returns. For years, pharma has taken a bigger-is-better approach. The top 40 pharma companies have doubled the size of their salesforces in the past five years, according to InPharm. But in the same period prescribing has increased only 15%. Return on Investment? Pharmaceutical companies spend an average of $31.9 million annually on sales for each blockbuster primary-care drug they market and $25.3 million annually selling each specialty pharmaceutical product marketed, according to recent research from Cutting Edge Information. That’s about $150,000 per primary-care rep annually and $333,000 per specialty drug rep spent on salary, travel, and technology, not including promotional materials and samples, the analysts say. The overall average field-force budget in the pharmaceutical industry is about $875 million, with top-spending organizations committing more than $1 billion to their sales budgets. In fact, spending on sales activities among pharmaceutical companies is second only to investment in R&D. And with the number of reps continuing to skyrocket, sales budgets continue to rise as well. The discrepancy between growth in salesforce size and growth in prescribing has made salesforce effectiveness the top challenge among pharmaceutical sales managers for the foreseeable future. The True Magnitude of the Problem Data presented at eyeforpharma’s 2004 Sales Force Effectiveness Congress revealed that 70% of physicians are actively implementing policies to restrict sales rep access. Those actions, among other factors, have resulted in only 43% of rep calls leading to face-to-face meetings with physicians lasting less than two minutes each. According to Scott-Levin research, the average length of a sales rep visit has fallen from four minutes in 1998 to just 90 seconds today — with 30-second hallway visits being commonplace. Considering the difficulties in securing detail time with physicians, reps need to be sure each contact is productive and well targeted. But data from the 2004 eyeforpharma congress also show that fewer than 30% of detail calls contain a product message and less than 13% of those messages when delivered are on target and recalled by physicians. What physicians want, What Pharma delivers Research by Lou Sawaya, author of “Super Reps — From Ordinary Detail Men and Women to Physicians’ Most Trusted Advisors” finds physicians see reps as an important source of information but worry the information is not always objective or unbiased. Physician participants in a 2003 survey by Accenture concurred. Participants said although one-third of sales visits from reps are “helpful,” 36% said they want more medical information, including current, comparative, or clinical data analysis relevant to their practices and objective sources of information on usage and side effects. Nearly half (48%) cited their time and availability as the factor that most influences their willingness to meet with reps. Other factors included free samples (14%), an existing relationship with the rep (14%), interest in new products (10%), and a need for product-specific information (8%). David Blumberg, a partner in Accenture’s Health and Life Sciences Practices, says after several decades “the basic detailing model is ripe for evolution.” Mr. Blumberg advises that the opportunity for the industry lies in moving beyond salesforce growth and mass promotion to arming reps with tailored information for individual physicians — information that will help them improve their practices and patient care. Pfizer: A Case in Point Rick Martin, head of European and Canadian Sales Force Effectiveness for Pfizer Inc., told attendees at eyeforpharma’s 2004 Sales Force Effectiveness Summit in Philadelphia that his group is moving from the familiar share-of-voice blitz toward a CRM-based approach through improved targeting. Pfizer has 11,000 sales reps in the 21 markets for which Mr. Martin manages effectiveness strategies, and he says the company is spending more than $1 billion a year on field-force costs. “And 60% to 70% of the calls we’re making are to physicians with little or no prescriber value,” Mr. Martin says. “There are a significant number of calls where product market messages are not delivered and where there’s little to no value to the physician.” Mr. Martin says Pfizer’s European sales reps are viewed as credible sources of information by 31% of physicians. The traditional share-of-voice approach has created a situation for Pfizer of “self-competition.” In one country in Europe, Pfizer’s own salesforce exploded from 167 reps in 1990 to more than 1,000 reps in 2003, without an accompanying rise in the number of physicians being served. Mr. Martin says each rep is getting less time in front of physicians and that reps are competing more with one another, often outnumbering patients in waiting rooms. According to 75% of the 3,355 physicians surveyed across Pfizer’s markets, the physicians had more than one rep calling for a single product; 77% rated the tactic as “not helpful”; and 81% said they would prefer to see just one rep per product. “Customers have been saying this for years,” Mr. Martin says. “But the dilemma we’ve had is that when we throw another field force out there, even if physicians don’t like it, it still seems to work.” Pfizer finds that physicians expect both professional and social relationships with reps, but that the information delivered by reps must be considered valuable and must be delivered efficiently by someone perceived as an expert. Pfizer is taking an approach that it hopes will make reps feel more empowered and allow them more control over the management of their own territories. Mr. Martin says leaving the share-of-voice approach behind is difficult, but that improved targeting will diminish the importance of the more traditional approach. Mr. Martin advocates defining a process to determine the optimal field-force structure and to develop a common sales process. The Pfizer teams are working to establish a common approach through collaboration, best practices adoption, and development of a common training program. Sales Strategy and Sales Effectiveness RM Consulting International (RMCI) told eyeforpharma conference attendees that successful sales organizations must excel in both sales strategy, choosing the most effective and efficient salesforce deployment, including size, for the product portfolio; and sales effectiveness, creating the right processes and coaching climate to draw maximum productivity for the salesforce. RMCI finds that growth in salesforce size over the past years has masked the gradual erosion of basic selling skills and that few companies display consistent competence in the key sales drivers — targeting, frequency, message, and coaching. RMCI research shows that most sales managers (90%) find less than half of their company’s sales calls are effective. “Companies now have the opportunity to rediscover the value of sales effectiveness and to institutionalize sales processes that will drive maximum top-line performance in good times and in bad,” RMCI analysts say. Sales productivity is not just a sales issue, analysts told attendees. Although the sales organization can make incremental progress on improving productivity, significant and sustainable effectiveness requires continuous support of the salesforce from other functions working together. Tracking and monitoring progress and adjusting implementation is also important to success. Technology And Sales Effectiveness The Aberdeen Group reports investments in salesforce automation applications have done little to improve sales effectiveness. The group says this is because sales technology investments have primarily focused on the needs of sales management rather than sales reps. More than 70% of companies have misdirected spending on sales technology and would benefit from realigning investments toward “helping sales sell.” In part, this comes from aligning marketing with the sales process. Clear benefits can be seen with those companies that take steps to formalize this alignment. David Kerr of NoInk Communications, a provider of Web-based and handheld salesforce technologies, agrees. “While management’s goal is to arm its sales professionals with all the resources, technical knowledge, and credibility of the entire organization, the end result is an overwhelmed salesforce and disappointed physicians,” he says. Because of the limited time reps have in a typical detail today, Mr. Kerr finds traditional printed sales aids are losing their usefulness and analysts estimate that 18% of corporate printed materials become outdated within 30 days. But he says many high-tech options have proved to be too expensive, cumbersome, and complex for many field sales teams. Mobile and Web-based technologies allow companies to more effectively prepare their sales teams to sell without literally weighing them down or changing existing business processes, Mr. Kerr says. Group buy-in is critical to the success of any new program and subsequently to the success of any sales effort, he adds. The People Component Leandro Herrero, CEO of The Chalfont Project, finds the majority of problems encountered when implementing salesforce effectiveness (SFE) initiatives can be traced back to vision and strategy issues, as well as change management road blocks on the people side of the equation. One difficult hurdle facing pharma companies, according to one training executive, is abandoning a sales culture and model that has been so productive in the past. There are few incentives for reps to share information critical to segmenting and targeting, leaving teams to “play a numbers game to ensure the best customers are hit.” Getting Back to Basics Eric Bolesh and his colleagues at Cutting Edge Information find many companies are returning to simple sales principles: recruiting and hiring with more care, avoiding territory realignment, and minimizing turnover. Retaining reps is becoming an increasing challenge for pharma companies. According to a study from the Hay Group, previously declining rep attrition spiked from 10% in 2002 to more than 14% in 2003. And with an estimated “hard cost” of $89,000 to replace a single rep with a less experienced one, the cost to the industry is estimated at $356 million annually. According to Mr. Bolesh, being innovative and demonstrating value to physicians sets the most successful reps apart from the pack. Today’s reps must position themselves as consultants who provide value-added information that helps physicians. Companies, Mr. Bolesh reports, are focusing, for the first time in a while, on finding the right people and keeping them. Note: This December 2004 eyeforpharma report was produced from a broad range of presentations from executives at large pharmaceutical companies at eyeforpharma’s series of 2004 Sales Force Effectiveness conferences. eyeforpharma’s 2005 Sales Force Effectiveness conference is being held in Philadelphia, May 10-11, 2005.. Source: eyeforpharma, London. For more information, visit eyeforpharma.com. The “arms race” model, which almost guaranteed profitability, is becoming a proposition of diminishing returns. More Than Half of Physicians Believe E-Promotion is the Same as or Superior to Face-to-Face Pharmaceutical Promotion MoRE than half of the physicians participating in Verispan’s ePromotion Annual Study reported that they felt e-promotion (technology-enabled pharmaceutical promotion) is the same as or superior to face-to-face promotion, and 88% of surveyed physicians reported an overall attitude of neutral or positive regarding e-promotion. More than two-thirds of physicians said they participate in e-promotion in addition to face-to-face promotion, while 5% participate in e-promotion instead of face-to-face promotion. For the fourth year, Verispan’s ePromotion Annual Study analyzed how e-promotion fits into the total promotional picture. About 1,000 physicians across 17 specialties reported on their behaviors and preferences regarding the Internet, e-promotion, face-to-face promotion, electronic prescribing, and ordering samples online. Both an overview of total physician responses and an analysis of e-promotion trends by physician specialty are included as part of the study. E-promotion not only affects where physicians are learning about medical conditions and prescription drugs, but also their prescribing behavior and patient interactions. Most physicians participating in the one-time online survey reported that the Internet had an impact on the following: how they facilitate prescriptions or dispense drugs; how dialogue with patients is created; and increasing the knowledge about symptoms, diagnoses, and new treatments. Participation in e-promotion is expected to grow; 43% of physicians reported that they expect their participation to increase in the next six months. Source: 2004 ePromotion Annual Study, Verispan, Yardley, Pa. For more information, visit verispan.com. Increasing Sales Productivity Through Superior Sales Performance Management IN all regions of the world, sales reps are saturating markets, making the job of distinguishing a company and its products far more difficult than in years past. To counter this, according to a Best Practices LLC benchmark study, the delivery of superior services to physicians is one of the only ways to stand out. Some companies emphasize service in terms of a rep’s ability to quickly initiate and navigate clinical conversations that are pertinent to each physician, including using that physician’s most frequent or difficult patient profile as a springboard for discussion. Companies also stress other services, including reps’ assistance of physicians with the effective operation of their practices, such as helping them complete reimbursement forms. Best Practices LLC analysts identified several key elements for increasing sales productivity through superior sales performance management. Evolution of the Salesforce Life Cycle Salesforces evolve in terms of size, markets, maturity, and portfolio complexity. Performance management systems must reflect the stage of the salesforce to optimize productivity impact. Stage 1: Gain Access • Call on prescribers • Call on pharmacists Stage 2: Build Credibility • 5 calls to “get known” • Product is stocked • Product is considered Stage 3: Earn Trust • Grows from frequency • Grows from info • Grows from dependability Stage 4: Value-Added Service • Samples and product info • Disease-management info • Patient education • Medical and market info Stage 5: Relationship Management • Learn office culture • Develop and cultivate friendships Stage 6: Team-based Service • High-performance team sales • Total coordination and service • Total office penetration • Total territory optimization • Business planning excellence • Launch powerhouse • Budgeting and program sharing Source: Best Practices LLC, Chapel Hill, N.C. For more information, visit best-in-class.com. Shifting the Focus to the District Sales Manager It is common for companies to focus the sales effectiveness effort on the sales representative. After all, it is the representatives who generate sales. But, according to RM Consulting International, the most critical position in any sales effectiveness initiative is the first-line or district sales manager (DSM). For this reason, it is critical to include the regular participation of several DSMs in any sales effectiveness team. The DSM is the only individual in the company who regularly interacts with the sales rep. It is the DSM’s responsibility to align sales execution with corporate, sales, and marketing strategies. The rep may receive training in key sales skills from the sales training department, but the DSM is responsible for reinforcing, managing, and coaching those skills in the field. Without the active support of the DSMs, the best strategic and tactical plans will not be effectively implemented across the salesforce. A recent U.S. sales effectiveness initiative study surveyed senior managers, district managers, and sales reps regarding key sales activities. Senior sales management rated frequency performance as a high priority and critical determinant of success. Yet a survey of DSMs showed that few considered frequency a high priority, and as a result, few reps considered it a high priority either. In this case, the DSMs were failing to effectively align sales execution with the sales and marketing strategy. The DSM position should be a key focus of sales effectiveness initiatives. Superior sales execution requires excellent and regular coaching. Many companies are rediscovering that the DSM’s primary responsibility ought to be coaching reps to effectively manage their territories. Studies demonstrate that the most successful managers spend more time traveling with and coaching their representatives. Unfortunately, in many companies, managers spend most of their time in the field being “super-reps,” and out of field handling administrative or other non-coaching duties. Providing appropriate training in coaching skills is critical. No company would think of sending a sales representative into the field without training in key aspects of the job. Yet because many companies think of DSMs as super-reps rather than coaches, they don’t make the investment in training DSMs in the key skills and behaviors that are critical to coaching success. As a result, many DSMs are poorly prepared to succeed in their new position. Once DSMs are effectively profiled, recruited, and trained, it is important to ensure that they put that training to use. Best-in-class companies expect DSMs to spend 70% to 80% of their time traveling with reps in the field. They track and evaluate DSMs on compliance with the field travel goal. Improving sales effectiveness requires sustained and focused effort. It is a process that must be institutionalized at a high level in the organization to foster cross-functional cooperation and maintain a continuous focus on the link between effective sales activities and sales results. Source: RM Consulting International, Wilmette, Ill. For more information, visit rmcionline.com. Cephalon’s Sales Training Approach Cephalon’s sales training program is based on the philosophies of Benjamin S. Bloom, who developed a taxonomy of educational objectives, and Donald L. Kirkpatrick, who introduced four levels of evaluating programs. Each one provides a way for educators to categorize, execute, and evaluate learning situations. In 1956, Mr. Bloom and his colleagues presented a taxonomy of educational objectives within the larger domains of a learning framework. The larger framework consists of three learning domains (categories): the cognitive, affective, and psychomotor domains. These categories represent the universe of learning that occurs. With relation to an individual training program, the taxonomy can be used to classify objectives and test items with the goal of demonstrating the breadth of learning across the categories. When evaluating an entire training curriculum, the taxonomy can be used as a means for determining uniformity of learning objectives, activities, and assessments across the curriculum. In 2001, Mr. Bloom’s colleagues developed a modern version of the taxonomy to more readily meet the needs of today’s educators. In 2001, L.W. Anderson and D.R. Krathwohl separated the cognitive process (the process used to learn) and the knowledge dimension (the kind of knowledge to be learned). Mr. Bloom’s taxonomy integrates well with Mr. Kirkpatrick’s model as a means to guarantee that learners meet expectations after instruction. The four-level model of evaluation has become standard practice for training departments because it presents a simple, sequenced approach to evaluation. It also has become more important as training directors strive to justify the existence of the training function by demonstrating its contribution to an organization’s goals and objectives. Training directors use the model to examine an existing program to determine how to make improvements for the future or, in some cases, to eliminate a program completely. Cephalon is applying Mr. Bloom’s and Mr. Kirkpatrick’s models for Phases I and II of its sales training components. Source: Dan Scott, Senior Director of Sales Training and Development, Cephalon Inc., Frazer, Pa. For more information, visit cephalon.com. Benjamin S. Bloom — Revised Taxonomy of Learning Objectives for the Cognitive Domain Structure of the Cognitive Process Dimension Remember Retrieve relevant knowledge from long-term memory. • Recognizing • Recalling Understand Determine the meaning of instructional messages, including oral, written, and graphic communication. • Interpreting • Exemplifying • Classifying • Summarizing • Inferring • Comparing • Explaining Apply Carry out or use a procedure in a given situation. • Executing • Implementing Analyze Break material into its constituent parts and detecting how the parts relate to one another and to an overall structure or purpose. • Differentiating • Organizing • Attributing Evaluate Make judgments based on criteria and standards. • Checking • Critiquing Create Putting elements together to form a novel, coherent whole or make an original product. • Generating • Planning • Producing Structure of the Knowledge Dimension Factual Knowledge The basic elements that students must know to be acquainted with a discipline or solve problems in it. • Knowledge of terminology • Knowledge of specific details and elements Conceptual Knowledge The interrelationships among the basic elements within a larger structure that enable them to function together. • Knowledge of classifications and categories • Knowledge of principles and generalizations • Knowledge of theories, models, and structures Procedural Knowledge How to do something; methods of inquiry, and criteria for using skills, algorithms, techniques, and methods. • Knowledge of subject-specific skills and algorithms • Knowledge of subject-specific techniques and methods • Knowledge of criteria for determining when to use appropriate procedures Metacognitive Knowledge Knowledge of cognition in general as well as awareness and knowledge of one’s own cognition. • Strategic knowledge • Knowledge about cognitive tasks, including appropriate contextual and conditional knowledge • Self-knowledge Donald L. Kirkpatrick — four levels of evaluation Level Description Uses for this Level Measures What? 1 Reaction Used to determine if Measures learner’s reaction objectives can be met. to training. Measures perceptions. 2 Learning Used to determine what knowledge Measures whether has been acquired, what skills learners actually learned have been developed or enhanced, anything in the classroom. and what attitudes have changed. 3 Performance/behavior Used to determine if Measures performance applied objectives have been met. on the job. Measures whether the learner can perform in the work environment. 4 Results Used to judge the value or Measures what impact worth of the objectives. the training achieved. Cephalon’s Sales Training and Curriculum Development Program Training Activity Description/Options Initial Prestudy: At home prestudy for the trainee to remember and understand factual information prior to formal, instructor-led training in the classroom. Pretest Assessment: Pretest assessment should take place at the beginning of the classroom-based training session. Initial Sales Training: Classroom-based training program that moves learners from remembering and understanding facts to applying knowledge. Remembering and understanding activities should occur throughout the initial sales training. For example the evening assignments should reinforce key facts and knowledge, or the classroom-based training should place an emphasis on introducing more facts (factual knowledge) and concepts (conceptual knowledge) early in the program. Remembering and understanding frequently relate to the factual knowledge category within the knowledge dimension. Applying activities should occur throughout initial sales training. These activities should demonstrate how to apply the factual information. For example the learners should demonstrate how to reply to a product objection using clinical reprints, promotional pieces, etc. Applying frequently relates to the procedural knowledge category within the knowledge dimension. Initial Sales Training — Final Assessment Initial Sales Training — Participant Satisfaction Evaluation A program evaluation should take place at the end of the classroom-based training program. Corresponding (Bloom’s) Cognitive Process Dimension Remember: Recognize and recall knowledge presented during prework assignment from long-term memory. Activities to support this cognitive process may include: • Make a list of main products. • Name the components of (a specific part of) the human anatomy. • Identify the function of each anatomic landmark. • Match a product with its specific indication. • Make a facts chart about a particular product and its prescribing information. Understand: Establish the significance of the information presented in prestudy. Activities to support this cognitive process may include: • Place related products into the appropriate categories (i.e. by indication, by usage, by physicians that prescribe). • Write a ‘textbook’ type sales call and act out the selling process for a particular product. • Create a chart that compares and contrasts the features and benefits of a Cephalon product with one of its major competitors. Apply: Apply knowledge of a procedure to both a routine and/or a nonroutine task. Activities to support this cognitive process include: • Write a brief outline of a sales call. • Conduct a sales call with a mock physician (trainer) where trainer challenges trainee to clarify information about the product and to provide additional explanation beyond basic product information. • Write a persuasive letter to a physician encouraging him/her to set up an appointment with the sales representative to present a specific product. • Develop a SWOT analysis. Remember Understand Apply No corresponding Bloom’s for the Participant Satisfaction Evaluation Corresponding (Kirkpatrick’s) Evaluation Level Level 2: Progress checks throughout the prestudy training course should correspond to the learning that has taken place. Options to assess remembering include a written assessment that incorporates: • Multiple choice • Matching • Fill in the blank Level 2: Progress checks throughout the prestudy period should correspond to the learning that has taken place. Frequent progress checks should assess knowledge learned. Options to assess understanding include: • Written assessment that includes short-answer and multiple-choice questions. • Write a sales call and then act out the call. Use a checklist to evaluate key learning components (i.e. ability to cover all features and benefits of product, convince doctor to write a prescription, cover all elements of a successful sales call). • Create competitive comparison chart. Use rubric to assess and determine score. Level 2: An initial assessment is essential to provide a baseline data point for future measurement, and to assess the learner’s ability to remember and understand knowledge presented during the prework assignment. Options for this assessment include: • Multiple choice • Matching • Fill in the blank • Written assessments such as short answers Level 2: Progress checks throughout the classroom-based training course should correspond to the learning that has taken place. Frequent progress checks (every day) should assess knowledge learned from the previous session. Options to assess apply include: • Assessment of the sales call outline using a rubric to assess and determine score. • Observation of roll-play sales call with checklist to evaluate key learning components and determine score. • Assessment of the persuasive letter using a rubric to assess and determine score. • React appropriately to simulation exercises. Level 2: A final assessment at the end of the program will be used to compare learning from the pretest. Options to conduct the final assessment include: • Written assessment that covers all material presented in pretest. Compare data to pretest and use to demonstrate that learning has occurred. • Written assessment that covers new material presented in classroom-based program. Level 1: Should provide feedback about the trainee’s reaction to the classroom-based training program to determine if future changes are needed. This evaluation does not assess the learner’s cognitive processes. Suggestion for assessment format: 5-point scale Evaluate communication about program, instructors, course design, facilities and equipment, learning technologies used, overall course. Provide subjective questions to allow trainees to offer additional feedback. Note: It is important to remember that this taxonomy builds and relies on the mastery of one level before going on to the next level. While remembering and understanding will be continually reinforced, the learner must master these tasks before entering the next phase of learning. Thought Leaders Michael Capaldi. Senior Director, Sales Training, sanofi-aventis, Bridgewater, N.J.; sanofi-aventis operates in more than a hundred countries, marketing major pharmaceutical products derived from its research and a wide range of medicines adapted to local needs throughout the world. For more information, visit sanofi-aventis.com. Charles R. DeLoach. VP, Sales, Nabi Biopharmaceuticals, Boca Raton, Fla.; Nabi Biopharmaceuticals leverages its experience and knowledge in powering the immune system to develop and market products that fight serious medical conditions. For more information, visit nabi.com. Brian Fagan. Executive Director, The Society of Pharmaceutical and Biotech Trainers, Roanoke, Va.; The Society of Pharmaceutical and Biotech Trainers is a nonprofit organization dedicated to providing the resources and education trainers need to develop their knowledge, skills, and career. For more information, visit spbt.org. Lawrence Gallahue. District Sales Manager, King Pharmaceuticals Inc., Bristol, Tenn.; King Pharmaceuticals is a vertically integrated branded pharmaceutical company. For more information, visit kingpharm.com. Jay Ross. Director, Training, Eyetech Pharmaceuticals Inc., New York; Eyetech is a biopharmaceutical company that specializes in the development and commercialization of novel therapeutics to treat diseases of the eye. For more information, visit eyetech.com. Dan Scott. Senior Director, Sales Training and Development, Cephalon Inc., Frazer, Pa.; Cephalon is a biopharmaceutical company focused on developing and marketing products to treat neurological diseases, sleep disorders, cancer, and pain. For more information, visit cephalon.com. John Talanca Jr. Head, Learning Technologies, Global Marketing and Sales Learning, Novartis Pharmaceuticals Corp., East Hanover, N.J.; Novartis Pharmaceuticals is an affiliate of Novartis AG, a world leader in pharmaceuticals and consumer health. For more information, visit novartis.com. John Worobey. Director, Sales Training and Development, Biovail Corp., Bridgewater, N.J.; Biovail is a fully integrated pharmaceutical company engaged in the development, manufacture, marketing, licensing, and distribution of pharmaceutical products primarily in North America. For more information, visit biovail.com. or most pharmaceutical companies, the salesforce represents the second-largest investment after R&D. With such a large resource commitment, it’s imperative that companies improve not only their sales strategy — choosing the most effective and efficient salesforce deployment for their product portfolios — but excel in creating the right learning and training processes and coaching climate to draw maximum productivity from their field forces. Integral to the success of any salesforce and the effectiveness of sales professionals in the field is the training department. These senior-level executives are the men and women charged with developing the educational curriculum and training programs that arm their companies’ sales professionals with the appropriate information to gain an edge in a highly competitive landscape. According to industry statistics, in the past five years there has been a 75% increase in the size of the pharmaceutical salesforce. Because of this growth, the marketplace has become overly saturated; therefore, physicians are unable and/or unwilling to dedicate time to sales representatives. Now, more than ever, a company’s sales trainers must develop their professional sales people to better meet the needs of their customers. According to RM Consulting International (RMCI), pharmaceutical companies are trying to improve salesforce productivity and make better resource allocation decisions across markets in a cost-efficient manner. These analysts say building internal capabilities on both fronts has taken center stage at many companies. Furthermore, to achieve salesforce effectiveness, there must be a sustained commitment on behalf of the organization. In a recent RMCI study, more than 90% of senior managers reported that less than half of their companies’ sales calls were effective. Yet, many managers remain uncertain as to how best to implement effective solutions. RMCI has identified four key initiatives to improve sales effectiveness: high-level sponsorship and governance; cross-functional cooperation; appropriate performance measurement; and a focus on the first-line sales manager — the district sales manager (DSM). Companies are not maximizing their returns from detailing spend despite the continual focus to maintain high salesforce numbers. According to one industry source, one in every five pharmaceutical sales calls results in a conversation with a physician, and only 8% of those calls lead to chats that the doctors remember later. To ensure long-term revenue growth, pharmaceutical companies must rely heavily on their sales team to do more than just drop off information. Sales professionals must be trained and coached first on their company’s products, their competition, the market, clinical benefits, and then on developing lasting relationships with physicians and other customer stakeholders, which is particularly important as Medicare Part D comes into play. The trainers’ jobs are compounded by limited budgets, regulatory compliance issues, and bridging the gaps between various departments, including marketing, information technology, human resources, and sales operations, all of which can contribute toward or inhibit the effectiveness of a salesforce. According to RMCI, although the sales organization can make incremental progress on improving productivity in its own silo, significant and sustainable effectiveness requires independent functions working together continuously to support the salesforce. To drive consistent cross-functional focus on sales effectiveness, best-in-class companies rely on experienced managers to head their salesforce effectiveness initiatives and give them the authority and independence to bridge the relevant functions. The Trainers’ View Training must not only be focused on new hires, training executives say, but must occur across the sales enterprise and have buy-in from senior management to ensure superior results. Talanca. As trainers, our jobs are becoming harder and harder. More and more reps are being asked to sell more and more products in less time. At the same time, management keeps saying product knowledge isn’t good enough. Eventually training is going to get to a breaking point in the industry, where the concept of a learning organization is going to have to be opened up. Upper management is really going to have to view learning departments as strategic partners in the company and not as end users or an end-stage department. Typically we say in training: last to know, first to go. When there are budget cuts, typically training is cut. In the future, even the best companies won’t be able to afford to do this. Capaldi. We spend a disproportionate amount of our time and resources in this industry on foundational training. The unfortunate reality is that there is going to be turnover, whether it is 7%,10%, or 15%. We tend to ignore the fact that 85% of sales associates don’t leave on an annual basis, and we don’t always proportionately allocate resources to this group. My rallying cry is not to ignore the people in the field who help us reach our objectives year after year. At sanofi-aventis, we are doing some things here to address this, such as holding managers accountable for the annual development of their people. We provide them with the necessary resources and a blended approach to achieve their goals. DeLoach. The training strategy should always be a part of the discussion of corporate and brand strategy. We have had a training strategy in place since we created our training department; and each year as our corporation and brand teams update their strategy, the training department has to understand what changes, if any, were made to the strategy and then make adjustments to the training strategy to help the company and brands meet their respective objectives. I also believe that understanding our customer — the healthcare professional — plays an important part in setting our training strategy and preparing our salesforce for success. The trend toward less access to the physician is not one that happened overnight. We listen to our customers and our management team, and we develop our strategy to exceed the expectations of our customers. We understood several years ago that our sales team had to do more than deliver a message on our products. Today our product specialists are truly experts in a number of areas that will provide value to a physician’s office. I believe that training has become much more important to the success of companies today in the pharmaceutical industry. I believe those companies that understand the changing environment in which they compete and that train their sales teams accordingly will enjoy a competitive advantage over their competitors until the industry eventually “forces” everyone to do the same. Fagan. Any training initiative or any training program has to have buy-in across the board. And the importance of training has to be constantly reinforced. That’s why it is so important, in my opinion, that the sales, marketing, and training departments work collaboratively and not independently. This combined effort hopefully will produce better outcomes and corporate results. Also, by working together, it gives everyone the opportunity to enhance their capabilities. Gallahue. I believe there is some culture shock as far as the number of daily interactions reps have with the physicians. When they are seeing 10 to 12 different physicians a day and there are numerous staffs and nurse practitioners and physician assistants, they have to deal with a lot of different personalities. Sales reps have to have great interpersonal skills to relate to those individuals. Scott. At Cephalon, I structured our training based on Benjamin Bloom, a well-known individual from the 1950s who developed a taxonomy, which sets up a structure for the different levels of learning as a result of instruction. For example, remember and understanding are the very basic levels, and then learning grows from there into the higher levels of apply, analyze, evaluate, and create. (For more information, see related charts on page 26.) Ross. Our goal at Eyetech is to provide our specialty representatives, who are also called retinal account managers, with the same knowledge base as that of a medical resident when it comes to the clinical aspects of the products. We ask our sales reps to attain a very high level of clinical expertise. This is driven by the fact that our senior managers are retinal surgeons and clinical experts themselves; our CEO is a world renowned retinal surgeon. We build this level of expertise by using medical textbooks from the American Medical Association and from the American Academy of Ophthalmology, and we blend that knowledge with proprietary customized learning systems. Fagan. For far too long, the training focus has been on short-term results. That doesn’t address the issue that the public perception of the industry and the perception on the part of customers — the physicians — is very negative. But as trainers, we’re optimistic. This is a relationship business. It’s a relationship between the representative and the physician, as well as the company and the customer. The reputation and credibility of the company comes alive through the representative. Every issue is an opportunity for credibility. Companies need to spend time training people on issues, such as direct-to-consumer marketing, research and development costs, and the value of medicines, so that when the reps go in to the physician’s office, they have the mentality that “we’re all in this together.” It’s not an us-versus-them scenario. But if companies focus only on short-term results, the vision becomes short sighted. The other thing that I think happened — and this is a generalization — is that when there was such an increase in the size of the salesforces, there were a lot of inexperienced people out there. There were also a lot of inexperienced managers. Companies have had to spend a lot of time developing their people; it’s not simply the delivery of the product message. Basic Training For most pharmaceutical companies, foundational training is a tiered or phased process that builds a sales professional’s knowledge and skills, starting with home study then moving to regional or headquarters training. Talanca. Novartis’ training programs are fairly traditional in that most new hires have a home-study period soon after the hire date, which averages anywhere from two to four weeks depending on when they are hired and when the next training class is. The home-study period requires individuals to do a lot of reading and prepping on product training skills. We go into more depth when they come for their first sales training session at the home office. This is a three-week class. We take some of the core knowledge from the home-study period and build upon it, emphasizing key areas that we may want to repeat. These key areas cover a range of topics, including anatomy, physiology, pharmacology, and product information. As product training ramps down, selling-skill training starts to occur. Capaldi. I have responsibility for about 7,500 sales professionals. Our group is responsible for all training, from new hire foundational training through continuous learning for our field force. We take an approach that is probably not dissimilar from other organizations in that we have a phased-foundation training approach. It’s headquarter-based, but it’s also married to a field component. Over the course of a sales professional’s first year, he or she has the opportunity to come in for headquarter training as well as training that is conducted out in the field with his or her district sales manager or district trainer. Worobey. For new representatives, our training comprises a four-phase training program; each phase advances their knowledge, sales skills, and understanding of our products. Phase one is a typical home-study training program, during which the reps learn about the products. Phase two is all about application. They come into the home office for three weeks, and we go through everything from products and disease states, to selling skills, and so on. They learn how to apply the knowledge they’ve gained. Phases three and four are more advanced, with more detailed information on disease states, advanced selling training, and clinical training. We use case-study scenarios, and we get into managed-care training at this point. Depending on timing, it may take a sales rep between 12 months and 18 months to go through all four phases. Talanca. Our specialty reps take separate classes, and their level of instruction is typically wider, with a bigger focus on the customers to whom they are selling. The sales message for products may be very similar, but how they sell the products is based on who the customer is. Capaldi. We have a primary-care track for sales teams and we have a specialty track. One of the main differences with the specialty tracks is a heavier focus on institutional selling. We employ some preceptorships for the specialty teams in the first year, which we don’t offer to our primary-care teams. From a 30,000-foot view, selling skills are the foundation for all training. On top of that, we provide training on disease states, clinical information, product information, and managed care as well as reimbursement issues. We make a concerted effort at understanding the health marketplace as it relates to managed care. We provide basic training as well as pull-through training in the office-based setting, and in addition we train reps on reimbursement issues for some of the products. Scott. At Cephalon, the sales representatives usually come from other pharmaceutical companies. Normally they are on their second or third career, and they like the fact that our training is more real-world. DeLoach. At Nabi Biopharmaceuticals we have a small specialty sales team that focuses its efforts on the nephrology and transplant arenas. Until recently, we sold in the hematology and oncology field as well. Our specialty and hospital representatives are individual members of our sales team known as product specialists. This is because they are well trained and highly specialized in our products and the disease states in which we compete. Our training materials are developed internally and delivered through a variety of media by our senior director of sales administration. This individual has a microbiology background, and his talents in the area of teaching make our training program one of the most effective I have seen in my 18 years in the industry. In the two phases of training — two weeks of initial training followed six-to-eight weeks later by two more weeks — we cover basic immunology, disease states, product knowledge, competitive information, and guidelines and recommendations by various regional and national governing bodies. Additionally, we cover the basics in managed care, reimbursement, contracts, training on our SFA software, working a hospital, selling skills, and finally compliance, which includes a thorough understanding of our company’s compliance policy. Gallahue. Our sales professionals go through prebasic training before they attend the home-office training. This starts shortly after the official offer is extended. From there, they go into basic training. Then there is postbasic training. All this takes place over the course of about three months. The basic training usually involves the rep going to a regional training facility for two weeks. It is the expectation that each sales professional will arrive at regional training 100% prepared to pass the test. From there, they focus on areas where they may need improvement, and then sales professionals are sent for national training and for final testing. Ross. Our phase one training is self-directed/self-paced learning. This is a balance between the cognitive portion of learning in terms of reading, interpreting, and internalizing distance learning and one-on-one learning with the regional director, medical science liaison, and reimbursement manager. The phase two training is in-person training with medical experts and practice administrators/reimbursement managers. Phase three is blended learning, distance learning, and in-person learning at various meetings. Scott. The Cephalon home-study program is roughly one-month long and is completed before sales professionals come in for initial training. It has been developed for an individual to achieve the “remember” and “understand” levels of Bloom’s taxonomy. When they come to the classroom-based training program, our objective is to develop and facilitate the training workshops at the more complex “apply” and “analyze” levels of the taxonomy. For example, during the higher-level training program, we might ask sales representatives how to handle an objection based on a clinical reprint that they reviewed during home study. We’re trying to have the class participants apply the clinical reprint in a selling scenario. Ross. I would say the biggest difference for our salesforce is that it works in a Medicare Part B environment. Because our product is in-office injectable, our salesforce embraces a comprehensive account management approach with our customers. The focus is not on writing prescriptions but on a direct office acquisition (“buy-and-bill”) model. Our reps must not only be experts on the clinical aspects of the product, but on the financial/reimbursement environment that our customers vie in. We must also have a mastery in understanding office operations and the ramifications that a product introduction may have on any given account. These operations may include patient flow, auxiliary staff necessary for the procedure, and so on. Continuing Education Once sales professionals have completed basic training, more often than not, they are required to keep up to date on various topics, and they are tested and certified on their understanding of the concepts being delivered. Talanca. On an ongoing basis, we require our representatives to be recertified every two years on their product knowledge. We do that via remote testing and remote training. In addition, we have a continuous learning program where each sales representative and sales manager is required to obtain a certain amount of continuous learning credits per year, and we track each person’s compliance. This is over and above anything else that is required. If we have a product launch, that training does not contribute to the learning credits a rep is required to obtain per year. Worobey. We currently employ several approaches to the continuing education of our representatives and managers. We do some distance-based learning though Web-based programs and an audio library. We also use traditional home-study programs from the American Management Association (AMA) and The Certified Medical Representatives (CMR) Institute. We are a member of both of these organizations. Continuing education also is provided as the need arises. For example, we are currently working on a virtual preceptorship program and product backgrounder to enhance the knowledge of our sales representatives on key topics. Ross. We believe that is important to address continuing education of the salesforce by giving sales professionals access to many different physicians who have various thoughts and theories and who hold various positions during the in-person training process. Our representatives have an average tenure of about 15 years experience. They understand there are differences when it comes to physician personalities, but what we want them to appreciate is the differences with respect to physician treatment algorithms. The best way to provide them with this information is to have various physicians come and give their perspectives during training sessions. This also allows us to gain insight into how physicians base their decisions on various algorithms. If we hear that physicians are basing their decisions on a particular algorithm based on a particular clinical trial, we can then drill down and look at that clinical trial and determine if the algorithm is a credible trial or not. Talanca. Our U.S. and global training groups are starting to work together more. One of my responsibilities is to help integrate the two more often. We want to build materials that can be repurposed. We also want to build training materials that contain a core knowledge base whether the materials are for in-person courses or Web modules; these materials can then be customized based on location and geography. Gallahue. Our materials are developed from input from our marketing, sales, and operations teams. This cooperative effort works extremely well as far as defining what our goal is for the marketing aspect of products and what our goal is for each sales professional in terms of relaying product information and competitive information that is relevant to the physician. DeLoach. Our initial training is completed in house in the traditional manner. Advanced training takes place in a variety of ways, including CDs, DVDs, and Web-based training. The most recent addition to our training methods includes conference calls where our medical affairs directors spend 30 minutes to one hour on a conference call with a district — eight to10 individuals — to explain a topic in detail and answer questions. The conference call has proven to be a very effective method of delivering training to the sales team. Developing the Learning Program How people learn is as individual as the person. As such, companies employ a wide variety of blended learning techniques to achieve maximum results, including in-person training sessions, Web-based programs, distance-learning programs, CD-ROMs, paper-based manuals, and more. Fagan. The way people learn is highly individualized. When it comes to training and development, the problem companies have is developing individualized training programs. If a certain group of people learns visually and another group learns auditorily, it takes time and money to develop programs for these different groups based on time-tested adult-learning principles. The growing availability of e-learning options adds another dimension to training. Companies want to do things faster, better, and more economically. But if the goal is to have well-trained sales reps, managers and companies have to understand the different learning modes of the people being trained. Capaldi. We take a blended approach to training, especially during the foundational year. There are self-directed study programs, distance learning programs, instructor-led components, and CD-ROM-based, dynamic learning programs. There are also some online components, especially the assessment portions. And then there are satellite group interactions, as sales professionals prepare to come into headquarters. Ross. I believe one of the most important elements for providing reps with a full mastery of the clinical information is the instructional design and the flow that is used to deliver the information. We start with disease knowledge accumulation and then drill down with focused techniques in terms of introducing the diagnostic and the evaluation tools, information about the product and how it fits in with the clinical treatment, and then how it compares with the competition’s product. The goal is to layer the delivery of the topics in a flow that is palatable and digestible. Fagan. The delivery of healthcare is very complex. So is training in healthcare. In recent years, our training has become even more rigorous with more training on compliance issues, the PhRMA code, increasingly more sophisticated scientific products, and changes in reimbursement. Capaldi. I’m a big believer in a blended approach. We try to leverage all of the tools for the various learning styles. I just finished a project for a master’s of education course. All of the research that I’ve looked over in the last couple of months points to the fact that instructor-led programs are the most beneficial and have the greatest impact. But only picking one, is never as good as a blended approach. Scott. What I find to be most effective in the classroom setting are interactive workshops where the participants do the majority of the facilitation versus the didactic approach where people use a PowerPoint presentation. By working in groups, sales representatives have more opportunity to learn from each other. Fagan. Historically, the marketing team came up with the training program and then threw it to the training department. I don’t think there are many companies where the integration of sales, marketing, and training is done really well. But the better the integration, the better the organization. In the past, sales and marketing took the lead and training came afterward rather than being involved from the beginning. DeLoach. In today’s environment, I am surprised that access to physicians is not becoming more difficult. The past strategy was based on a larger share-of-voice than the competitor. I have heard of some companies that did not want the sales representatives to do more than mention the name of a product and drop a sample. But with outside pressures on the industry and pressures on the physician for time, this old strategy will not work in today’s environment. In any conference or seminar one attends today or in any trade article about the “new sales representative,” all of the information points to a sales person who can add value to a clinician’s office. To add value, the sales representative must be able to talk to the physician about his or her product and deliver a balanced message, while understanding the disease state, when and where their product is appropriate, and at the same time understanding all aspects about the competition. An effective sales person today must know where to go to get answers about a variety of areas to add value to the office. In today’s environment, the sales representative must be able to provide information on managed-care formularies and how this impacts the office. He or she must be able to work with the insurance manager or office manager on reimbursement issues and point that person in the right direction to get answers for the patients. Sales representatives must be able to use the clinical group within the company to address off-label issues a physician may have or to point the physician to this same group to discuss ongoing clinical trials. This profile of a sales representative is much different from five years ago, but we believe it is a profile that we must strive for if our sales people are going to be successful in a saturated field. We have been training our sales team on all aspects that I have mentioned here — and many more — for the past five years. Because of the nature of our products, we recognized this was the profile that gave us a competitive advantage. Because of the size of our salesforce, we are able to give one-on-one attention and assure that each individual can provide the value that I have discussed. I believe that as long as the big pharmaceutical companies continue to have to train hundreds or thousands of representatives each year, their ability to train the sales people at this level and assure that the training is effective is limited. The reality is that most physicians do not mind seeing a sales representative so long as that individual will provide some type of value to their office. E-learning Web-based learning programs provide a number of cost and time advantages, but according to training experts, this mode of learning should never completely replace face-to-face interactions. Talanca. In the last two years, we have ramped up our Web-based training. We have a very robust learning management system that delivers the majority of our e-learning. It also serves as an online library for educational materials and files, as well as an online ordering system for certain training materials. We’ve saved significant budget dollars with our e-learning and learning management system. The managers love it because now they have complete learning histories and have a tool to identify learning materials for their reps. Sales professionals know that e-learning is a necessary part of the job. They like the ease of being able to take the training when they need to. The e-learning management system also allows them to keep track of everything they’ve done. So that’s beneficial. Unfortunately, reps and sales people are extroverts, and I think seven times out of 10, they’d rather fly somewhere to attend training for a change of pace. But little by little, that mentality is changing. Scott. We’re starting to use more Web-based training programs. For example, our market-development managers are responsible for special markets, such as long-term care. We are currently providing training on the long-term care marketplace via Webcasts. Based on initial responses we’ve received from participants, they like this approach. It provides them with a way to enhance their skill set without taking a lot of time out of their schedules. Capaldi. We’ve delivered some limited synchronous Webcasting. We are finding that more senior sales professionals appreciate this approach because it means less travel for them, while the newer sales professionals actually prefer the live, instructor-led training because it gives them the opportunity to ask more questions. We do have a synchronous tool at sanofi-aventis that we leverage based on business needs, although this hasn’t been a big part of our programs in the past, we think that it will be in the future because of our sheer size now, so we’ll be pushing out more live training via the Web. In the first year, e-learning comprises maybe 10% to 20% of the program; in the continuous learning years, it’s at least 50%, if not 75%, of the program. Worobey. I am a big fan of e-learning programs. As a matter of fact, in 2004 and 2005, I’ve tried to advance the use of this type of learning. We just completed the interim training of new representatives in Puerto Rico using Webinars. This was a new step for us; I believe the trainers and other folks in the organization are recognizing the value of these types of programs now. Web-based training provides a real value in terms of costs. We don’t have to fly everyone to the home office for some of the training that can be accomplished via the Web, for example covering certain aspects of disease states, competition, and anatomy and physiology. These don’t have to be done in a live classroom setting. But I think we have to pick and choose what things can be done face-to-face versus what can be done via the Web or electronically. For example, I don’t think role playing can be done effectively over the Web. It just doesn’t work that way. For these types of interactions, I prefer live meetings because we can gauge the reactions of people and understand what is working and what isn’t. Although Web-based training provides a nice alternative for employees, I don’t think it will ever totally replace the effectiveness of live training sessions. DeLoach. As a company we have started moving to do some e-based training, and this will accelerate as we move to launch new products in the coming years. Because of the small size of our organization, we have not been forced to use this method more, and I believe that conference call, plan-of-action meetings, and other one-to-one encounters are more effective training methods because the training is live and individuals have an opportunity to interact and ask questions, which benefits the entire group. Ross. We use a lot of Webcasting and telecom programs for reinforcement training. We have a field force advisory team that provides us with the most pertinent information to train on and the best delivery methods to disseminate the training. For example, our field advisory team told us that because the sales professionals have large territories it’s important to maximize their “windshield time.” Based on this, we have in many cases made the conscious decision to roll out “low-tech” training in lieu of higher-tech Web-enabled initiatives. We are providing more and more training materials that can be used during drive time, such as audio CDs that can also be viewed on the computer to reveal accompanying PowerPoint slides and transcripts. Other drive-time maximizing approaches include archived teleconference roundtables in which reps can listen at their leisure on their hands-free speaker phones. There is always in-person training, which is more effective than distance training in many cases. One-on-one or one-on-eight interactions provide for a better dialogue than one-on-50, Web-based programs. Often, we will present something in a Web-based conference and then roll this out in a one-on-eight regional dialogue. Although more challenging for a trainer from a logistical perspective, we have found that we get much more interaction and a better Q&A session during a regional conference call versus a national one. Gallahue. We have continued sales professional training that involves Internet programs, which certainly seem to be effective. There are designated start and stop dates; the sales professionals have to complete the program within a specific time frame. They know that it doesn’t pay to put off completing the program because they have to pass the test. Ross. There is certainly a need for blended learning. Web-based training is a valuable tool but should be balanced with the recognition that this medium does tend to intrude on the sales professional’s personal time. I just don’t recommend an over-reliance on any one type of training vehicle. I am bothered when there is an expectation that a sales professional has to go home and stay connected to an entire Web-based training course on a continual basis. People in a home office often forget that the down time for a rep occurs while they are driving. Although evening learning is certainly part of the job, to expect representatives to come home and complete comprehensive online courses while their families are waiting is not always fair. Talanca. Most of the learning that sales professionals have to do is typically done on their time; and we are sensitive about how this impacts their work-life balance. But I don’t know too many pharma companies that have a different approach. Everyone talks about how wonderful e-learning is because people don’t have to fly to get a training program. But when we tell managers that we still need an hour of their time during the day to go through material, they’ll say no. We still have to work through this, and little by little it is becoming more accepted. We’re also starting to make more of our e-learning modules downloadable so that the program can be taken offline, allowing the sales representative to complete the program during lunch or other down time. Measuring Training Effectiveness Determining the effectiveness of a training program can be difficult, according to some industry experts. The most frequently used evaluation tools are traditional methods, such as exams and quizzes. Worobey. How to measure the effectiveness of training is the million-dollar question. Until a company measures the outcome of one group of representatives who participated in a well-run program against a group who received no training, which no company is ever going to do, we have to rely on traditional methods. One way to determine the effectiveness of a training program is to evaluate how well reps score on exams and quizzes along the way. We have an expectation that reps will score 90% or better on these tests. We allow reps to retake exams once. This helps us to determine if we were effective in helping them learn the material. We also developed our own evaluation grid to assess the effectiveness of reps in role-playing scenarios. Are they getting the message across? Are they using the appropriate selling skills? We have criteria to evaluate particular skills, and we use that information to determine if we are hitting our mark. Are we having a problem with an individual representative? Or is there a problem across the board in that no one understands a particular topic? If this is the case, we’re not getting our message across appropriately, and we have to go back and redo a section of the training. Another way to help gauge the effectiveness of training is to look at market-share change or product uptake after a representative has completed a training event. Although many variables would have to be considered, one can usually determine if a training event was successful by the positive impact it has on sales. Finally, and probably one of the most important ways of measuring effectiveness of training is by the feedback we receive from our managers. We look to them to give us feedback on how well they believe their representatives have been prepared for selling in their territory. Gallahue. Measuring training effectiveness often is a difficult question to address, but I don’t think it should be. We can definitely tell how effective the initial rep training is by evaluating how sales professionals interact with the physician and carry on a conversation. For our existing sales reps who are currently in the field and who are receiving additional training, we can tell the impact that the knowledge is having by gauging their increased confidence. I am required to spend four or more days a week with our sales professionals in the field. I can tell through these interactions, as well as the testing that takes place, if the training is effective.The sales representatives who I’ve had the opportunity to work with are very knowledgeable. Our training, right from the start, gives the sales professionals a sense of ownership. They know the territory they are going to be running; and the information they are going to be carrying and relaying is their business. This sense of pride and ownership will either make or break a sales professional. Talanca. We assess training in a couple of ways. First there are evaluations when the course is completed; we want to know what they thought about the materials. Second, we evaluate what they learned through a series of sophisticated assessment models and tests. Like other sales-training departments, we are doing our best to design and deploy level-three assessments. Fagan. The honest answer to what makes training effective is time and money. Training should have the same emphasis as any other department, but the fact of the matter is it’s one of the areas that is cut first from a budget. If companies want people to be well trained, if they believe that education and training are critical to the development of people, then they need to invest the time and money. Companies also may need to rethink the career paths for trainers. In many companies, the training position is a rotational one — a trainer may only stay in the department for a year or two before being promoted back into the field or into marketing. While some rotational positions are important to help bring some of the superstars into the company, there also needs to be enough career trainers to maintain stability and continuity. The development of people is a long-term relationship, and trainers have a lot to bring to the table. Capaldi. We have annual requirements that sales professionals are required to maintain. The learning requirement is broken into credits; on an annual basis the sales professionals are required to acquire credits, similar to physician CME credits. It is an accountability measure that allows sales professionals to differentiate themselves. And this allows us to identify our low performers and recognize our peak performers. Ross. We have an assessment tool that measures the memory retention of our sales professionals, but we put more focus on verbal assessment tests. With our salesforce we conduct a lot of one-on-one telephone assessment training, in which we ask the representative to present a concept over the phone rather than having them choose answer A, B, C, or D. This method eliminates a lot of the guess work from the equation, and allows the evaluator to understand how well the sales professional knows the level and depth of the concept. DeLoach. In today’s environment with 100,000+ sales reps, I’m not sure how effective the industry is as a whole when measuring training effectiveness. With 5,000 to 10,000 sales reps in any given organization, there are a number of factors that can impact sales, and this has traditionally been a measurement of training effectiveness. With a smaller organization such as ours, we can see a correlation between those individuals who have performed well throughout the training program and the results of those individuals. When an individual has two to three states to cover, a complete understanding of the market, the company’s product, and the environment in which he or she is working is necessary to be successful. Regulatory Compliance In the past few years, the pharmaceutical industry has come under regulatory and public scrutiny in terms of its selling and marketing practices. Today, more than ever before, validating a sales professional’s completion of a training program is vitally important. Gallahue. OIG compliance training is handled via the Internet. We will have different requirements as new updates take place. We require our sales professionals to take an exam and sign off that they are fully knowledgeable and that they will comply with regulations going forward. Capaldi. OIG compliance is easy to address in the foundation year because we have the sales professional in the training setting anyway. It’s the ongoing training that is a bit more of a challenge. But our legal team does a great job of making sure that we’re updated on the information. In doing so, they are able to provide content that is validated. Scott. Cephalon has a new chief compliance officer, and I spend a fair amount of my time with him developing and disseminating training. The compliance training is currently tracked using a learning management system, which is more efficient than our old paper-based system. If somebody wants to know who completed what, it’s very easy to run a report from the learning management system. Talanca. From a sales perspective, we have rolled out OIG training. Initially this training was paper based with an online assessment, so we had a record. The last version was totally electronic; it was delivered online with interactive components and an assessment at the end. From an overall ethics standpoint, last year every Novartis employee took 13 e-learning courses. Worobey. Last year we rolled out a new program to our sales organization through a self-study book from our legal counsel. The sales reps have to read through the program, they have to understand the dos and don’ts of compliance in our industry, and then they are tested. Upon successfully completing the program, the rep fills out a form, signs it, and sends it back to the training department where we keep the results on file. DeLoach. We place a strong emphasis on compliance. In specialty areas we are faced with a group of physicians who have to try a variety of treatments for their patients both on and off-label. We spend time in our initial training discussing these issues as well as industry guidelines on promotion to healthcare professionals. Additionally, we bring in outside counsel each year to give the sales team a two-hour update on changes in the guidelines and discuss specific situations that the team may have questions around. There also is a method for the sales team to contact the home office with any questions about industry guidelines; and by working with our internal counsel, we are able to offer advice quickly after we receive the question. The Role of District Managers The district manager plays a key role in any salesforce effectiveness strategy. These front-line players need to be included in the development and roll out of training programs. They also need the training and tools to effectively interact on a regular basis with the salesforce. Fagan. When it comes to implementing and allocating resources, programs, and initiatives in the field, the district manager is critical to the process and needs to be involved in the planning. Otherwise when a district manager goes to a POA meeting and somebody says, “This is what we’re going to do,” the sales rep may try it for a week or two, and then the program is dropped. Consequently, the training initiative becomes short lived. We’ve found that many organizations are developing new, formalized management-development programs. According to our last benchmark study, district managers receive an average of nearly four work weeks, or 19 days, of training during their first year. That is an increase from the 12.5 days of initial manager training reported in 2000. Companies realize that effective managers are absolutely critical if they want to “close the loop” and get the right message to their customers. DeLoach. Our national account managers (managed care) attend industry-sponsored training programs that have been reviewed and selected by our director of national accounts. These individuals already have received the same training as our product specialists as we promote these positions from within. Both the product specialists and the national account managers have career ladders in which they can advance their careers through additional studies and programs, including CMR, that will allow them to increase their skill sets. Our district managers, who also are promoted from within, have a strong product knowledge background. But we spend the first year taking them through a series of training programs that align with our philosophy of developing individuals’ talents and focusing on their strengths. In their first year on the job our district managers attend a variety of training programs, including Results Oriented Coaching, a Gallop program designed to develop world-class managers (centered around “First Break All the Rules”) and internal training programs that are provided by our human resources department. One of the most important aspects of the training for the district managers is one-on-one sessions with their regional director. This gives the sales director and district manager an opportunity to discuss issues, situations, and so on, and creates a learning experience for the district manager. The regional directors meet quarterly with their district managers to assure that the training they need does continue. We also are currently starting a clinical management team (MSLs) and are in the process of developing the curriculum for this group. Gallahue. We have different coaching seminars for the district managers. These involve numerous outside companies that come in and go over coaching styles and situational leadership. At management meetings three or four times a year, we supply the district managers with additional training on whatever the focus of the meeting is. When the district manager is first hired, we help them with the prebasic training of their sales representatives. We meet with them multiple times throughout their prebasic training to go over quizzes and provide any additional product information that might be needed. Capaldi. Our approach to continuous learning focuses on holding people accountable for annual development. But this is developed based on individual needs. The district sales manager helps to build that plan on an annual basis. We’re also finding that there is a gap between month two, when initial training ends and month six, when more advanced training begins. To address this, we are relying more on sales managers, but we keep in mind that they are leading sales teams and they are not trainers. For example, we created some product materials that we put in the district sales managers’ hands to help them pull through product training in the field. While this is very low tech, it’s something that they can bring with them on field visits to assist the sales professional to bridge the gap in product knowledge. Gallahue. District managers have a lot of the responsibility for what our sales professionals are doing on a daily basis, the interactions that they have in the field, and, of course, ensuring that the reps comply with all of the directives put forth by the company and from outside the organization. Scott. The area managers are responsible for training new sales representatives and assume the responsibility for overseeing the home-study program. Each area manager has an area sales trainer who assists them in the training of new employees. The area sales trainer and the area manager both receive documents that describe expectations of a new sales representative, what he or she is supposed to be doing on a daily basis, and the material that should be covered before he or she comes into the training program. Talanca. Typically we provide district managers with the standard agenda and the same materials that the sales professionals receive. In more than 90% of the cases, the district manager had been a sales representative, so he or she is familiar with the materials . We are starting to provide the district managers with a greater variety of question kits and other types of tools that they can use to assess the knowledge and skills of their representatives when they work with them during the day. DeLoach. The most important resource that we provide to our district managers to ensure effective training is teaching them how to coach a sales person and how to develop the talents and strengths of the individuals on their team. Most district managers were, at some time, very successful sales people. Our goal is to train the managers to develop the skill sets of the individuals on their teams. We depend on our training department and clinical group to train our product specialists on the product knowledge they need to be successful. The manager must train them on the other aspects of making a successful call. I believe that the approach we have used here has been very successful and we have taught our sales team how to add value to a physician’s practice. Developing Partnerships Most companies don’t have all of the in-house resources to develop and deliver the number of training and learning initiatives that are required today; companies are relying on service partners to fill in the gaps. Talanca. From an e-learning standpoint, we probably outsource half, and we build the other half ourselves. From a classroom-training standpoint, we probably build 90% of the courses and outsource 10% of product training. For unique topics, we may have a supplier build the course for us with our input. Typically this is done with direct contracting with the sales training department using the appropriate Novartis RFP and RFP process. Capaldi. One of the things that we outsource is assessment. We work with different companies for customized pieces or even something that is off the shelf. We find that we can deliver a much higher quality of training by tapping into the various experts on the vendor side. Ross. We have outsourced on a couple of occasions when we found we didn’t have the content expertise in house. But, at the end of the day, we must build the content to be populated by the outside partner. Worobey. We outsource between 10% and 20% of our training needs, depending on how outsourcing is defined. We bring training vendors in to write manuals and create interactive DVDs. We don’t have those capabilities in house. We also might contract with a vendor for some of our live training sessions. This can include training on things like interviewing skills, coaching skills, or advanced selling skills. DeLoach. Currently, we outsource very little of the training for our salesforce. We do work with vendors on training programs, but ultimately the training is delivered internally. This is an advantage of being a small group. By keeping the training internal, we have been able to continue consistency with our training program. For our district managers and our national accounts team, we do use outside vendors for about 50% of their initial training. Scott. The Cephalon sales-training department was started five years ago, and the training team currently uses various vendors to assist in the development of the training material. The sales training managers provide the actual facilitation of the training programs. Capaldi. We tend to take a bit of a pragmatic approach when we work with vendors for the first time. If they are good partners on the initial project, then there is a greater likelihood that we will send them more business and we will have a long and prosperous relationship. If they try to sell me everything up front, this is not a great approach. Talanca. We’re looking for suppliers that have experience in the particular medium, whether it is classroom-based, book-based, or Web-based training. We’re looking for content experience. And we’re looking for strong project management skills. I’m looking for suppliers to tell me what they don’t do versus what they do. I want them to show me things that showcase their skills. I won’t award a job to a company that won’t show me a piece of work that it has done for another client. And, most importantly, I’m looking for quality instructional design. Some companies get most of it right, but a lot of companies get most of it wrong. DeLoach. We always have had the option to reuse our learning-content management systems. Any time we write a contract for this type of a system, we secure the right to reuse the system, within reason, in the training of our field team. This ability varies depending on the type of system that we use; an off-the-shelf system provides less flexibility than a custom system. But I believe that every contract written to purchase a training system should include language that will give the company the right to go back and use that system in the future. Worobey. We look for the best product we can get based on our budget. Having been in the training arena long enough, we realize that there are certain vendors that do things really well. And we tend to lean toward those companies. I like to use a company I can work with, that meets my deadlines, but one that is flexible enough to understand that during a project my priorities may change a little bit because the company’s priorities change. Capaldi. I have found that our people in the purchasing department are very supportive, and, unless I am doing something that is completely out of sync financially, they tend to confirm the new vendors that I would like to work with. They allow us to make the initial decisions, and then they get involved from a pricing and negotiation standpoint. Ross. I have found that most of the industry vendors are producing very similar products. When I am at a conference, such as the SPBT, I look for new out-of-the-box ideas. I do like to vary our training medium. I look for a vendor that has worked in my position before and understands why I might choose to move forward in one aspect and not move forward in another. I look for a partner who understands why I might resist high-tech learning and lean toward a traditional, lower-tech tool instead. I look for vendors that don’t have a lot of overhead. Oftentimes, I find a 12- to 15-person company can offer me what an 800-person company can for far less. Additionally, I believe that a smaller company may often be more responsive to my needs. This is not always the case and I will certainly include larger companies into our request-for-proposal process and factor in numerous things before deciding. Worobey. I tend to use suppliers that have worked for us before and that have done a good job. To grab my attention for the first time, a supplier has to bring something unique to me and my department. I appreciate vendors that are willing to provide services to us above and beyond what we’ve contracted them for. DeLoach. Our purchasing department really does not get involved in the selection of our training vendors. I believe that to select the most effective training programs or individuals, a company must understand what it is trying to accomplish and understand what a variety of individuals or companies have to offer. Our senior director of sales administration makes all of these decisions, and I trust him to do so because he has a real talent for identifying those vendors that offer programs that will complement his training program. Our purchasing department simply makes sure that we have properly documented our request and helps us to follow through on the actual order. PharmaLinx LLC, publisher of the VIEW, welcomes comments about this article. E-mail us at [email protected]. Our materials are developed from input from our marketing team and our sales and operations teams. This cooperative effort works extremely well as far as defining what our goal is for the marketing aspect of products and what our goal is for each sales professional in terms of relaying product information and competitive information that is relevant to the physician. Lawrence Gallahue District Sales Manager King Pharmaceuticals Dan Scott Senior Director of Sales Training and Development Cephalon What I find to be most effective in the classroom setting are interactive workshops where the participants do the majority of the facilitation versus the didactic approach where the facilitator uses a PowerPoint presentation. By working in groups, sales representatives have more opportunity to learn from each other. I am a big fan of e-learning programs. As a matter of fact, in 2004 and 2005, I’ve tried to advance the use of this type of learning. I believe the trainers and other folks in the organization are recognizing the value of these types of programs now. John Worobey Director, Sales Training and Development Biovail Corp. Jay Ross Director, Training Eyetech Pharmaceuticals I believe one of the most important elements for providing reps with a full mastery of the clinical information is the instructional design and the flow that is used to deliver the information. The goal is to layer the delivery of the topics in a flow that is palatable and digestible. We spend a disproportionate amount of our time and resources in this industry on foundational training. The unfortunate reality is that there is going to be turnover, whether it is 7%,10%, or 15%. We tend to ignore the fact that 85% of sales associates don’t leave on an annual basis, and we don’t always proportionately allocate resources to this group. Michael Capaldi Senior Director, Sales Training sanofi-aventis I believe that training has become much more important to the success of companies today in the pharmaceutical industry. I believe those companies that understand the changing environment in which they compete and that train their sales teams accordingly will enjoy a competitive advantage over the competition until the industry eventually “forces” everyone to do the same. Charles DeLoach VP, Sales Nabi Biopharmaceuticals Training should have the same emphasis as any other department, but the fact of the matter is it’s one of the areas that is cut first from a budgetary perspective. If companies want people to be well trained, if they believe that education and training are critical to the development of people, then they need to invest the time and money. Brian Fagan Executive Director The Society of Pharmaceutical and Biotech Trainers As trainers, our jobs are becoming harder and harder. Upper management is really going to have to view learning departments as strategic partners in the company and not as end users or an end-stage department. John Talanca Jr. Head, Learning Technologies, Global Marketing and Sales Learning Novartis Pharmaceuticals April 2005 VIEW on Sales Training

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