By way of example, let's take a closer look at community specialists, such as cardiologists. Most often, the specialist initiates the therapy and then directs the primary-care physician (PCP) to maintain that therapy in follow-up. In the traditional share-of-voice approach, companies would target the PCP because, given the number of refills, it may appear that the PCP's decile is higher in a given category and product. This approach devalues the cardiologist, who is writing scripts that are then being renewed by a PCP. But in fact, the cardiologist is the primary influencer—the PCP typically does not change the therapy prescribed without direction from the specialist.

For the most part, companies already identify and communicate with national and regional thought leaders—an activity that is at the core of medical education efforts. By educating "tier-one" and "tier-two" thought leaders, companies know that they are affecting physicians who have a dramatic impact on influencing their peers. But as the medical community's peer-influence relationships bear significant influence on a physician's prescribing behavior, it will be increasingly important to take a local view (see "Group Dynamics").

(2) Use integrated hybrid communications

To that end, companies should move to using integrated hybrid communications so that all tactics work together to leverage the appropriate influences. In doing so, companies can formulate strategies that move the needle, instead of just making more noise.

For example, in the share-of-influence world, companies that face strong managed-care influence in a geographic area will layer prescriber-level prescription data on local managed care formularies into strategic decisions, targeting efforts, sales training, and sales messages. In doing so, companies can leverage a brand that has a favorable position on a formulary in a region that is heavily influenced by managed markets, to gain more prescribing in patients on that formulary—and to effect a positive spillover to that doctor's other patients who may not have those formulary restrictions. On the other hand, if that same product has an unfavorable formulary position, reps can then influence that physician by focusing on the patients in his or her practice who are not impacted by this particular formulary, to maximize prescribing.

Another example shows the importance of leveraging outside influences. Let's say an important study is published in a prestigious journal on a particular brand a rep is detailing. In the influence model, reps should understand the importance a particular clinical study may have, analyze how that study may be of interest to an individual physician, and then communicate that information in a way that shows the rep understands the general implications of the study—as well as the implications for that specific physician.