In today's pharmaceutical marketplace, companies not only have to fight to win product placement on Managed Care formularies but also to "pull through" the business and increase market share after a formulary win. To benefit from formulary wins, savvy companies ensure that their sales forces and account management teams have the necessary skills and tools to pull-through demand for the favored products and increase sales. Study Objective : This research was launched to investigate pull-through challenges and the best practices that companies have developed to overcome them. The research will enable pharmaceutical, bio-pharmaceutical and medical device company leadership to identify program gaps, uncover insights and discover successful best practices to share with their employees.

1. Developing Managed Care
Pull-Through Program Excellence
Best Practices, LLC
Strategic Benchmarking Research
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2. Research Objective, Methodology & Topic Areas
This benchmarking research will provide comparative metrics that pull-through
leaders can use to evaluate their programs against those at other companies.
Study Objective & Methodology Key Topic Areas
Program types
The objective of this benchmarking
research was to identify best strategies Targeted customer groups
and tactics for increasing Managed Program leadership
Care pull-through for pharmaceutical,
biotechnology and medical device Process excellence
products. Training
Tools & templates
Best Practices, LLC collected data for
Education topics for healthcare
this study through on online survey of providers & patients
33 pull-through and sales leaders at 24
companies. Education channels & media
KOL management
In addition, interviews were conducted Effectiveness measurement
with selected respondents from five Resource levels for pull-through
companies to collect executive Top challenges
insights on pull-through effectiveness.
Best practices
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3. Benchmark Research Participants
Participants in this benchmarking research included 33 respondents at 24 leading
pharmaceutical, biotech and medical device companies.
Participants
Survey Only
Participating Companies include Abbott, Alcon, Allergan, AstraZeneca, Bayer, Boehringer Ingelheim, Caldera,
Daiichi-Sankyo, Galderma, GlaxoSmithKline, Johnson & Johnson, Merck, Novo Nordisk, Perkin Elmer, Pfizer,
Sanofi-Aventis, Smith & Nephew, Solvay, Takeda, Taro, Tibotec, Upsher-Smith, Wyeth and Xanodyne.
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4. Sample Key Findings
The following key findings and insights are among those that emerged from the field
surveys and executive interviews.
Programs: Pull-through programs can be highly effective at driving results. In rating four
types of pull-through programs, 45% of benchmark participants gave the top rating of “high
impact” to general pull-through support programs (aimed at increasing provider awareness
of products), while 24% rated therapeutic intervention programs and 23% rated education
support programs “high impact.” In contrast, only 4% found adherence/persistency
programs to have a high impact.
Provider Education Topics: The most effective topics for healthcare-provider education
programs are clinical data and practice guidelines, according to study participants.
Adherence and disease management issues are also rated effective by more than a third.
Training: More than 80% of study participants agree that they have received the training
necessary to understand and execute pull-through. A majority agree that educators in their
therapeutic area are important to pull-through, but only 24% strongly agree.
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5. Support Programs Influence Pull-Through Effectiveness
As many as 45% of research participants find that programs have a high impact on
pull-through effectiveness. General pull-through support is the highest rated
program type.
Q. Please rate the impact of each of the following program types on your pull-through effectiveness.
(Choose one for each program type.)
Program Impact
High Impact Moderate Impact
Total
Pull-through support 45% 45% (n=31) 90%
Therapeutic
24% 60% (n=25) 84%
intervention
Education support 23% 60% (n=30) 83%
Adherence/persistency 57% (n=23)
4% 61%
programs
% Responses
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6. Companies Target Multiple Customer Groups beyond Providers
Companies most frequently aim their pull-through efforts at physicians and physicians’
staff, but patients, health plan members, government agencies and large employers are
also common pull-through targets.
Q. Which of the following customer groups do your pull-through programs target? (Check all that apply.)
Customers Targeted by Pull-Through Programs
Physicians 97%
Clinical/office staff 79%
Patients 58%
Health care plan members 52%
State Medicaid 42%
Medicare 42%
Large employers 36%
Employer Coalitions 30%
Other:
Educators 30% • Pharmacists (2)
• ADAP programs
Other 12% • Full Risk/Medicaid/SCHIPS type plans
(n=33)
% Respondents
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7. District & Account Manager Roles Are Distinct but Changing
Interviewed partners identified distinct roles in pull-through for district and account managers today,
but noted that at some companies AMs are taking increased ownership of the pull-through process
beyond the contracting stage. Traditionally, account managers run things until a contract is signed and
then “hand off” leadership to the field. Today, AMs remain involved with edits, messaging and more.
Account Manager Roles District (1st Line) Sales Manager Roles
Planning, strategy Eliminate distractions & conflicting priorities for
Create account access the reps to help them clear their plates for a pull-
through initiative. – “Be a filter not a funnel.”
Communicate depth & breadth of each
new opportunity Set & monitor individual goals/ results
Communicate intricacies of the win— Provide training/ message customization based
why decisions were made, any extra steps on knowledge of unique regional plan or
that will be required of providers, etc. customer relationship
Help sales team integrate product Mobilize reps, providing call plan & tools
message into a Managed Care “wrapper” Help reps target appropriate prescribers
Work to prevent or (affected by a formulary change)
overcome NDC blocks Measure & report results of
Ensure edits are made initiatives
Participate on cross- Provide progress data to field
channel business calls Recognize individual achievers on
Work with payers to make a regular & frequent basis
sure they follow through with Maintain momentum/ attention for
actions necessary to achieve pull-through efforts through contests,
pull-through (send doctor rewards & general communication
letters, etc.)
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8. Use District Managers to Maintain Pull-Through Momentum
Pull-through initiatives can lose steam quickly unless there is a driver measuring and
reporting the progress. One executive described best practices he has used to keep
the field focused and interested in
“All too often, pull-through initiatives lose
District Managers Can Maintain Pull-Through focus and stall. You need someone driving,
Momentum By: measuring and reporting the progress. When
Providing progress data as the initiative I’ve seen pull-through work, it was because
continues the district sales manager took ownership.
The account manger creates access and
Making sure monthly reports get to the field communicates the pull-through opportunity,
Keeping attention on the pull-through effort but the ultimate responsibility is with the
through running contests toward weekly goals DSM and the reps. They are the tip of the
spear. The DSM provides the tools, tactics,
Rewarding and recognizing top performers individual goals and metrics needed to
on a weekly basis accomplish the job.”
Publicizing rep successes — Interviewed Associate Director
Making sure successes are entered in reps’
personnel records
Partnering with account managers
Ensuring good two-way communications are
in place between account management and
the field
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9. About Best Practices, LLC
Best Practices, LLC is a research and consulting firm that conducts work based on
the simple yet profound principle that organizations can chart a course to superior
economic performance by studying the best business practices, operating tactics and
winning strategies of world-class companies.
Best Practices, LLC
6350 Quadrangle Drive, Suite 200, Chapel Hill, NC 27517
919-403-0251
best@best-in-class.com
www3.best-in-class.com
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