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Archive for November, 2006

If not, you should consider starting.

Simulation is all about applied learning.

Simulations come in lots of flavors – some are computer-based, some are role-play scenarios played out in workshops, some are board games – but all simulations ideally share most or all of the following characteristics:

1. The simulation aims to mimic reality

2. Time is continuous, and a factor in the outcome(s)

3. Where you currently are in the simulation is a consequence of your past choices

4. Where you are going is completely your choice

In a simulation, you learn by performing actions and making choices – you experience consequences and outcomes in a time-compressed fashion, with feedback to help improve. A good simulation provides a risk-free environment to learn from your mistakes.

Simulations are often confused with emulations (e.g., an on-screen software tutorial) or interactive games, but these may or may not actually provide an environment mirroring reality, or a set of choices leading to pseudo-real-life consequences (wait – is it legit to talk about “pseudo-real”? – hmmm, never mind…).

If you’re interested in incorporating and developing simulations as part of your training, Impactiviti can help. Contact us to discuss your needs and ideas…

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The system is broken and everyone knows it.

When you have 100,000+ sales reps out chasing a limited number of doctors, with the average rep getting (maybe) about 8- 10 minutes of face time with physicians each day, you have an unsustainable business model.

Pfizer has just announced the change that we all knew was on its way.

An announced 20% reduction in field force size is big news, because it may mean that the pharma sales “arms race” has finally come to an end. Now the big question is: will other major pharmaceutical companies follow suit? Cost-cutting, in a time when pipelines are becoming less fruitful, may look very attractive – and the P.R. value of cutting sales expenses when there is so much public criticism of “Big Pharma” may prove irresistible. Not that such a move would satisfy the critics for more than a millisecond…

Unfortunately, this will mean serious professional and personal disruption for a lot of folks. Major business evolution always has a price tag, and this effort to “right-size” will make a very rough year-end for some…including, undoubtedly, some very good and talented people.

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The Impactiviti business model is simple, and uniquely designed to help you find the best training solutions (and providers). We seek to bring expertise, creativity, and guidance as you make successful decisions on your training.

Here is how it works:

Step 1: We discuss together what your current and upcoming needs are. I bring a blank sheet of paper and a lot of industry knowledge, and we brainstorm. We blueprint your needs and possible solutions. This process is actually quite enjoyable, and can lead to some very creative ideas.

Step 2: Impactiviti reaches out to best-in-class supplier(s) to help meet your business and training goals, and facilitates more detailed discussions to ensure that we’ve established an optimal “match”. Having a lot of experience with the vendor community and with the design and development of training projects, this step is part of the art and science of what Impactiviti uniquely offers. The goal is to make the client experience as pain-free as possible, by identifying well-targeted vendors (and avoiding choices that could compromise a successful initiative)

Step 3: Impactiviti, the client, and the vendor/supplier(s) agree on a proposed solution and budget, and move forward with the project, with much greater efficiency due to an intelligent design and sourcing process.

For training recommendations, Impactiviti is your Go-To Expert.

Steve provides quite a service. There are so many training solution options out there that most times it is a chore to sift through it all to find the right fit. I sat across from Steve at our initial brainstorming conversation and benefited tremendously from his insights and expertise. He was able to help me map out some possible training solutions, and connect me with just the right service provider for my needs.” Tom Donlon, Manager, Sales Training and Development, Intendis, Inc.

What’s the catch? None. Since Impactiviti works on a referral fee basis with its Preferred Partners, the service of basic needs definition and supplier recommendation is free of charge to the client (Impactiviti also provides more traditional consulting services on a fee basis for larger-scale engagements). Give us a call and let’s start brainstorming!

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My regular readers have probably detected that I tend to have an interest in oncology-related news and products. That’s no accident – before spending 10 years working with pharma training organizations, I spent the previous decade in the radiation medicine field, working with systems to measure radiation and treat cancer.

It has been a privilege to work with some exceptional people in the field, and over the past ten years, to work on a number of oncology-related training projects (product learning systems, global assessment strategy, virtual preceptorships, launch training, an Oncology University). What makes the field so interesting are the recent remarkable advances in the field (I remember with still-felt excitement that first human trial with Glivec/Gleevec, when an amazing percentage of leukemia patients who were non-responders to other therapies experienced phenomenal results, even remission). But also, the astonishing complexity of the oncology field, which will require endless energy and ingenuity to make progress.

If you have upcoming oncology training needs, let me know…not only will I try to help out with ideas and possible solutions, but you’ll also find a sympathetic ear!

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I spent Monday and Tuesday at the eyeforpharma Sales Effectiveness conference in Philadelphia – actually, there were 2 co-located eyeforpharma conferences (the other on E-communication and On-line marketing), and I was able to time-shift between them.

Overall, it was a well-organized event. eyeforpharma is a UK-based organization, and there was certainly more of an “international” flavor among the attendees, speakers, and organizers. It is clear, however, that there are some very universal challenges facing pharma sales and marketing.

One of the more striking presentations was given right out of the gate by an AstraZeneca Promotional Regulatory Affairs professional, discussing how the many layers (and sources) of regulatory restriction impinge on selling practice. Federal regulations are troublesome enough, but one of the growing issues that will add complexity is the move among states to create their own specific regulations. This atmosphere may well make it very difficult to retain self-motivated, entrepreneurial sales professionals who yearn to just sell – in fact, one trend noted by an audience member when discussing retention issues was the growing number of field reps/managers simply leaving the industry altogether.

An interesting statistic given out by Stewart Adkins was that although the average number of drugs launched per year is roughly steady (about 44), the profit-value-per-drug is trending downward, as the number of blockbusters decreases, and the number of in-licensed drugs increases. Stewart also introduced the interesting perspective that, increasingly, pricing and reimbursement issues (commercial viability) may well trump drug approval issues (clinical efficacy) as companies have to make decisions on pipeline candidates.

Although the program is young and specific approaches and results had to be veiled for proprietary reasons, Abbott is apparently doing some innovative things with targeted sales approaches for group practices, which constitute a growing percentage of overall prescribers. This appeared to be an innovative response to the ever-changing marketplace.

I admit to a bit of disappointment that there was little active discussion about the impact of opt-out practices for physician-level prescribing data. Also, the sales training presentations were fairly basic – though there was a good bit of discussion around the need for better management training, especially provoked by the input of Mike Capaldi from sanofi-aventis (who also presented some solid information on measuring training effectiveness).

On the marketing side, I was quite pleased to see how much active wrestling was occurring with the need to find a way to participate in the “Web 2.0″ movement of user-generated media, community discussion, etc. The major web trends, moving away from centralized and controlled information flow toward a more personalized and user-centric model, seem to be in conflict with the highly regulated/controlled approach that must be followed in pharma marketing (and sales training). Putting some toes in the water will require risk and courage and wisdom – not doing so will mean simply being left out as a participant in the discussion. These will be tricky waters to navigate, as evidenced by the lively exchanges that occurred in these sessions. Reprentatives from such companies and Yahoo and Google gave their perspectives as presenters.

The co-located conferences got me thinking about the “ideal” pharma sales conference. These 2 topic areas (Sales Effectiveness; E-marketing) are quite separate and so there was limited “flow” between the two, and it also led to a vendor area of unrelated companies that serviced very distinct groups. Nonetheless, I think very highly of the idea of co-locating conferences, or, perhaps more precisely, creating broader conferences that have related tracks. Here would be my ideal pharma sales conference, consisting of tracks and vendors focused on the following themes/target needs:

- Sales Training

- Sales Effectiveness

- Promotional/Sales Compliance

- Global Sales

Such a conference could lead to great cross-pollenization among related disciplines, and have a more cohesive set of attendees, speakers, and vendors. Keynote adresses could span multiple areas (e.g., The Use of Technology to Equip Global Sales Forces; Certification of Sales Professionals; The Impact of Corporate Consent Decrees on Sales Practices, etc.), while specific “tracks” could dig deeply enough into the major themes that all attendees would be able to enjoy a full conference of sessions that interest them (including cross-over into other tracks). While each of these areas of focus could be (or has been) its own conference, often those events are lightly attended – a better critical mass would be reached by having a larger conference with inter-related themes. My two cents.

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Meltdown

The first tremors were felt in the car last night – calling home after 2 days at a conference in Philly, a relatively innocuous statement about problems getting on the Internet. How many times have I fixed that, thought I?

Heh.
After setting up a home network this summer with reasonable success, and having only minor problems since then, I was not prepared for a Three Mile Island meltdown. OK, a bit of an overstatement. But I’m sure an outside observer would have been quite amused at the assortment of wires, computers, and other paraphernalia as I spent the whole morning troubleshooting.

It seemed obvious that the router had experienced a visitation from some other planet, and decided to make a voyage to where no router has ever gone before. Fortunately, I had another one on hand from a previous attempt to set up a wireless node, so, with some phone coaching by a neighbor (who does this stuff for a living), I finally got the new router in place.

Still no Internet.

Then I noticed that the little DSL light on the modem, which indicates that, yes indeed, it is talking DSLish to the outside world, was not lit up. Uh oh. Another call, this time with skillful navigation through an endless “if you are…please press 2″ menu put in place by the DSL provider, finally got me through to an actual helpful human being who diagnosed that, yes indeed, DSL was no longer being spoken by my line (another extraterrestrial visitation?), and then, amazingly, she got it re-configured “live” as we spoke. She may or may not have been halfway across the planet – it didn’t matter. Via electronic network, she was able to access and “heal” my connection on the spot. That was cool.

More monkeying with Windows settings and playing around with wires, and finally, home and work computers were basically back to working (mostly) properly. Chernobyl averted once again.

I hope tomorrow is a bit more….productive.

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This book, written by David Currier (with Jay Frost), is a superb introduction to the career of pharmaceutical selling. David is an experienced professional (having worked with both pharma and biotech, and now with medical devices), and his practical and positive perspectives are very helpful for someone just starting out.

The amount of information is just right, and what I appreciated most was the tone (or the “voice”, as it would be expressed among medical writers) of the book. There was a realistic familiarity to the writing style, a personable approachability, so that the reader feels that the author is serving as a helpful mentor.

I kept asking myself, while reading, whether this volume would be most appropriate for someone seeking to break into the field, or a new rep trying to get underway. I finally decided that it was well-targeted for both. In fact, I have a friend looking to break into pharma sales and the next destination for this book is going to be his briefcase, tomorrow.

(A professional colleague suggested that one target would be brand-new hires, as an overview before the first round of initial sales training….a good thought.)

A very helpful element of the book is David’s continual practice of defining terms – as we all know, the pharmaceutical industry is full of jargon, and I cannot think of a better introduction than this one to help a new arrival get familiar with the basic landscape. Also, one of the best training methods is storytelling, and the book is sprinkled with a number of helpful illustrations drawn from field experiences.

For any new, or hoping-to-be-new field sales rep – highly recommended.

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Recently, I was asked for guidance on training workshops for sales reps, focusing on basic Managed Care issues. Not an uncommon need. I was able quickly to find a great fit among my preferred partners. Having previously been more immersed in the world of technology-based training, I have been pleasantly surprised to see the wealth of “live” training workshops from my partner network that I can now recommend to my clients.

There are several aspects to Managed Care training to consider, including:

- Basic knowledge of the key terms and concepts (some of this can be done via pre-work)

- The impact of Managed Care on the physician practice, and how to promote product with formulary issues in mind

- The impact of the Medical Modernization Act (esp. “Part D”)

- Strategic thinking in dealing with institutional sales

Of course, there are also more advanced workshops as well for reps who focus solely on MCOs.

If you have a need for updated Managed Care training, contact me at info(at)impactiviti.com and I’ll be glad to provide guidance and make the appropriate connections for you.

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Indegene grabs another

Indegene, an India-based communications solution company, announced that it has purchased MedCases, the CME portion of the MedCases/IC Axon tie-up.

Indegene purchased MedSN last year.

The interactive development space is competitive and challenging. Custom development, in particular, is very labor-intensive and costly, particularly in a regulated environment (such as pharma) where multiple levels of review slow down the process of getting anything done. One way of trying to make it profitable is to have a major footprint in the United States, while moving some levels of development offshore.

It will be interesting to see what impact this type of consolidation will have on smaller, boutique development shops.

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Trying to catch the pitch

Medical schools training doctors and students to sift through pharmaceutical company pitches. An interesting twist – is this new practice to be called contra-sales-training?

Med Schools Warn of Drug Sales Pitches

Published: November 2, 2006

NEW YORK (AP) — Medical schools in several states are boosting programs that teach doctors and students to challenge the sales pitches of drug companies and avoid being dazzled by them.

The pharmaceutical industry spends billions of dollars a year on marketing to doctors — sometimes throwing lavish events to seal the deal on certain medicines.

Critics say slick promotion is unduly influencing how drugs get prescribed, sometimes to the detriment of patients. A small number of schools are now adding lectures and continuing education seminars aimed at persuading doctors to challenge claims made during sophisticated sales presentations.

”We want to appeal to physicians’ natural skepticism,” said Dr. Ethan Halm, an associate professor of medicine and health policy at Mount Sinai School of Medicine.

The prestigious Manhattan school is including a new type of training at its Morchand Education Center, famous for its use of actors to play patients.

For these sessions, the actors will play pharmaceutical company sales representatives. The students will be taught ”how to effectively spar with the drug reps” by asking aggressive questions, Halm said.

Another part of Mount Sinai’s program will advise health care providers how to tactfully deal with patients who see a drug on television and demand a prescription for it.

Almost daily, Halm said, doctors prescribe wonderful but lesser-known medications, only to have patients react as if they’ve been offered a second-rate imitation.

”They say, ‘What about that thing the actor was using on TV? Can I get that instead? My insurance company is paying. Don’t give me the cheap stuff,”’ Halm said.

Drug makers say there is nothing nefarious about having salespeople meet with doctors to discuss a new drug, and many physicians may there is nothing wrong with listening to a sales pitch over dinner.

Adriane Fugh-Berman, an associate professor at the Georgetown University School of Medicine, said she lectured fourth-year medical students last year about drug company influence on doctors, and got a hostile response.

”Physicians do not believe that they are affected by pharma,” she said. ”They all say the same thing: ‘We are too smart to be bought by a slice of pizza.”’

The number of medical school professors even willing to broach the subject with students in a significant way is still small, she added.

Stanford University in September joined a short list of institutions that have banned doctors from accepting gifts from drug industry sales reps. Others include Yale University and the University of Pennsylvania.

Dr. Jerome Kassirer, a professor at the Tufts School of Medicine and a frequent critic of the doctor-pharmaceutical relationship, said schools need to do more than just lecture.

”The question to ask yourself about these programs is: What are the faculty doing? Because if the students walk away from those sessions and find out their faculty are off speaking for Pfizer, what are they going to think?”

An industry lobbying group, the Pharmaceutical Research and Manufacturers of America, said sales reps help busy doctors understand the proper use, benefits and side effects of drugs.

”They are providing information that is both informative and important for physicians to know about new medicines,” said Diane Bieri, the group’s deputy general counsel.

Money for some of the university programs about drug advertising comes from a $430 million legal settlement over promotion practices at pharmaceutical giant Pfizer Inc.

The company was accused of illegally paying doctors to prescribe its drug Neurontin for uses that had not been approved by the U.S. Food and Drug Administration. Doctors may generally prescribe pills for whatever use they see fit, but drug companies are barred from promoting medicines for ailments they have not been specifically approved to treat.

The settlement has so far awarded $11 million to 28 institutions. This week nearly $2 million in grants were awarded to Mount Sinai, the University of Arkansas, Florida International University, the University of Minnesota and the Institute on Medicine as a Profession, affiliated with Columbia University.

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