Managed Care Plan (Health Plan of Nevada) had ACE Inhibitors as the preferred agent for hypertension, and allowed use of Calcium Channel Blockers (CCBs) only with prior authorization. Team objective was to convince the plan to approve of company product in a non-prior authorization setting.

The Plan leadership was unwilling to allow the physicians access to the product. Faced by this roadblock, recruited key cardiologists within local major physician groups to conduct an informal study around the efficacy of the product. Agreed to present their findings to the plan, no matter the outcome.

The study had a positive result and the cardiologists did present their findings to the plan leadership. As a result, the team gained access to the plan formulary without prior authorization. The plan leadership agreed to allow physicians to use the product in combination with ace inhibitors in: a) patients whose blood pressure was uncontrolled with ACE Inhibitor use alone and/or b) patients who were diabetic.

This initiative retained more than $1M in business for the company in the Las Vegas marketplace.

Startup company was having trouble attracting clients, resulting in low sales in the opening months. Traditional marketing vehicles (such as direct mail, newspapers, TV) were not effective due to the novelty of the service offering: programs designed to teach athletic skills to young athletes, such as speed, power, agility, flexibility, and quickness. This business concept was so novel that the team was creating a market from scratch. This made traditional marketing very ineffective in driving customers to the door.

Shifted the resources spent on traditional marketing vehicles to a grass roots campaign, the primary objective of which was to develop mechanisms where customers would refer new customers. A major part of this was the hiring of a sales manager to direct the campaign.

Increased foot traffic by 50% via this campaign. Additionally, found that the grass roots campaign cost 20% less to execute than the traditional marketing campaign. Referral customers tended to buy higher-priced programs and required less effort to sell in the closing process, in part because the company began with far more credibility from the referral process.

Company’s initial service offering was a group training setting, with a customer to coach ratio of 6:1. Many customers indicated they would prefer training in a 1:1 setting.

It would be significantly more expensive to train 1:1. Management was not sure whether the customer would be willing to bear the costs associated with this new service. Additionally, it would require hiring and managing more highly specialized coaching staff.

Instituted a new service offering for the customers with 1:1 training. This training was priced at a significant premium to the 6:1 training (100% markup). Added a nutrition advisory component to the 1:1 training, as well.

The results were dramatic with this new offering. The first month it comprised 50% of total sales for the month. The management team learned from this experience to pay close attention to the desires of the customer and attempt to respond to the customers’ wishes as quickly as possible.

Due to lack of access, company was experiencing a significant drop in market share for a key statin product at a major VA account in Eastern Washington. This product had sold $800,000 to this account the prior year. Market share had dropped to below 50% for this account from 80% the previous quarter.

The VA’s new pharmacist was hostile to industry and did not see a benefit in a relationship with the company. Because of this, he restricted representatives’ access to the physicians. He also implemented policies to promote physicians prescribing generic statin products. The company was thus losing market share to generic statin products.

Needed to convince pharmacy of the benefit of maintaining a relationship with us. Developed a series of pharmacy education programs using speakers with pharmacy backgrounds. Educated pharmacy on the contractual advantages associated with the company’s product. Finally, facilitated an agreement on a protocol for use of the company’s drug that pharmacy could support with the physicians.

This strategy resulted in halting the slide in market share and recovering much of the loss. Regained market share back to the 75% level within two quarters. More importantly, gained access to the facility where other companies were shut out.

By designing a series of educational programs targeted to pharmacy, earned their trust and maintained access to the facility. Historically, the pharmacy has been ignored regarding educational programs in favor of the physician staff. It has become a local best practice to target resources to this customer group to ensure access to the rest of the institution.

As company’s executive director, realized no one else was pursuing sales opportunities. The coaching staff had settled into their role as coaches only, and ignored their responsibility to help to drive sales as well.

Implemented a financial incentive program to motivate the coaches to become involved in selling the program. Instituted a weekly sales training program so that the coaching staff would be effective in selling the program.

Prior to implementation of this incentive system, personally sold 95% of the programs. After this system was put into place, the coaches sold about 80% of the programs, and the number of programs sold continued to increase by 20% (from 40 per month to 50 per month).

The incentive system dramatically reduced personal workload and freed time to focus on other business issues. It also created a business mindset with the coaching staff, and helped to turn everyone on staff into a sales person for the facility.

Sales team had a cluster of three representatives calling on the same accounts who simply did not get along. They allowed this interpersonal conflict to affect sales. As a result, only two of the three had achieved quota the year prior.

Lack of communication, constant bickering, inability to meet and move forward with an agenda all resulted in call cycle conflicts, confusion with key influential customers, and inability to drive market share.

Implemented a weekly meeting plan whereby each of the participants was required on a rotating basis to set an agenda and facilitate a meeting on a weekly basis. Each member was required to identify major/key events and their plan of action to address these events. From this, joint plans of action could be discussed and implemented.

The following year, the team returned 100% quota achievement. Each individual was able to operate a smooth call cycle that did not conflict with that of teammates. Although constant monitoring was required, the system for forcing supervised interaction with a dysfunctional team proved to be the solution to ensure communication and, therefore, goal achievement.

Company had underpriced initial services at the grand opening of the business, resulting in difficulties achieving breakeven with the number of customers attracted in the early stages. Customers had become accustomed to the low prices of the first three or four months after opening; therefore, raising prices would probably prove difficult.

Increased the price from 70% to 90%, simultaneously training staff to give a value-based sales presentation so that the customer understood the true value of the service.

No loss in customer count resulted, and the company achieved breakeven in the fifth month of business. The franchise standard for achieving breakeven is one year. The team learned that it is critical to establish the value of the service in the sales presentation to help justify in the mind of the customer the higher price for the service.

In development of the business plan, the management team sought opportunities for growth for mature anti-depression product. Market share was at 20% and declining, from a high of 30% the previous year. The anti-depression product represented about $2 million per representative or $20 million for the district in sales.

Share was declining for two principal reasons: the product was not on the formularies of any of the top HMOs in the area; and there was a new entrant to the market that was placed in the first position on the HMO formularies. The HMOs were only interested in price and the company would not negotiate on that basis.

At the field level, therefore, determined to find areas in which the product could compete. Required each representative to analyze their geography to determine where the HMO's influence was weak and where competitors did not spend time or resources.

By targeting resources to these areas, recovered market share back to the 25% level overall. Lost market share in the HMO-dominated areas was countered by targeting areas without HMO dominance and areas where competitors' influence was weak.

When faced with a scenario lacking favorable managed care access to the formulary, it became a local best practice to identify areas where the HMO's influence is weak and saturate that area with resources to drive growth.

The district was not performing well in achieving its sales goals: about 88% quota achievement on a sales volume of roughly $50 million. The district had responsibility for a very large product mix covering disease states as diverse as hypertension, cholesterol, bone loss, allergy, and arthritis in key hospitals in Oregon and Eastern Washington.

Analyzed the situation and concluded that the quota shortfall resulted from a lack of strategic focus on the part of the sales representatives. They were focusing equal resource allocation to all products across all accounts.

Implemented a business planning process, whereby representatives evaluated each account to determine where they could expect to derive business with the least amount of resources expended. They then focused their resources/time on the accounts where they could get the highest return on investment.

The district not only achieved the quota objective, but became #1 in sales in the region. The district achieved #1 ranking in cholesterol and osteoporosis sales and #2 in arthritis and allergy sales, finishing at 114% overall quota with 26% growth.

Use of this plan dramatically helped the representatives determine how they would allocate resources (both time and budget) with each of their products at each key institutions. This approach is still used and operational within that market area.

The pharmacy of a VA customer removed the company’s key cardiovascular product from the formulary while the Pharmacy and Therapeutics (P&T) committee physicians were away at a conference. They replaced it with a lower priced competitive product. This product represented $500,000 in business to the company.

Pharmacy was in favor of the lower priced product simply because of the lower price. They ignored both the clinical differences between the products and the pharmacoeconomic data that demonstrated the company’s product to be more cost effective when actually used.

Arranged appointments with all of the key P&T members over a two-day period after their return from the conference. Presented each with the clinical and pharmacoeconomic data supporting use of the company’s product over the competitor’s product.

The committee met that month and reversed the decision. This saved the company over $500,000 in annual business. Additionally, this VA was influential in the decision making of other VAs in the western region and helped to save business with other accounts.

This scenario was used in training new hospital representatives about the importance of being able to discuss pharmacoeconomic data with P&T members and with practicing physicians. Training new hospital representatives in this skill set became a regional best practice.

Company was experiencing decreased market share at a key military account for statin product. On sales of $1 million, market share had dropped to 70% from 90% the previous quarter.

The company had a contract in place that allowed for substantial volume discounts for use of the statin product. Sales representative had not communicated this key advantage to the pharmacy/physician staff recently. Additionally, a competitor had convinced the staff that its product demonstrated superior efficacy and was worth paying the additional costs.

Instituted a plan that involved calling on decision makers with data supporting the clinical superiority of the product. Additionally, reminded them of the contractual advantages associated with its use. Ensured that this was done on a systematic basis to reduce the probability of the competitor repeating this scenario.

Market share was increased to 95% within two quarters of implementation of the strategy. It has become best practice within the district to identify those key decision makers at each institution and present to them on a monthly basis the contractual and clinical advantages of retaining this product/relationship.

A tremendous amount of dissatisfaction existed at the territory level with the sales promotion process. It appeared to be based purely on relationships and divisional representation rather than on competence. There was no standard protocol for determining who was interviewed or who received promotions.

Established a protocol to ensure consistency around the methodology for promotions. This involved the implementation of a "funnel" process to get to the winning candidate. The steps involved the candidate's manager's recommendation, hiring manager review of a candidate's file, hiring manager personal interviewing, hiring manager conducting a field ride, and a regional manager interview with the finalist.

This process enhanced the visibility of the process and thereby gave it credibility to the field representatives, resulting in much less dissatisfaction about the promotion process. Process was embraced at the Regional Manager level in the Western Region and was greatly preferred by the field force.

All of the divisions in the San Diego area were experiencing problems getting physical access to the physician groups in the market. This was due to the pharmacy personnel looking to get more control over the prescriptions written by the physicians at groups.

Managed care plans were squeezing physicians to maintain prescription costs. The groups were therefore looking to control these costs and restricting access to the groups was a logical course of action for the physician group's leadership.

Worked with the other managers from other divisions to develop team-level business plans amongst the representatives. These team plans were developed to determine how to best maintain access to the physician groups, and to brainstorm ideas for maximizing share while minimizing restriction issues.

Maintained physical access at all of the 13 physician groups within area and achieved 100% of quota requirements in the area. This planning became a model for the rest of the Western Region, and the managers involved were called upon to present the strategy to the rest of the managers in the region.