The new world

April 1, 2008
David Werboff
Pharmaceutical Representative

Volume 0, Issue 0

In my experience, your product doesn't work as well as your competitor for my patient population."

DIAGNOSIS

Developing your trainees' knowledge and communication skills is always difficult

PRESCRIPTION

E-learning can help put them in real-world situations

In my experience, your product doesn't work as well as your competitor for my patient population."

"The generic costs half the price and works just as well as your product."

"Your product requires prior authorization and costs my patients the top-tier copay."

Sales representatives face objections like this every day from physicians, nurse practitioners and pharmacists. As a pharmaceutical sales trainer, part of your job is to equip your trainees with the knowledge and communication skills to respond in ways that overcome these types of objections.

Responding to objections requires two overarching competencies. The first is knowledge – a command of the science, competitive marketplace and managed care issues impacting sales of your product. As trainers, we have many familiar solutions to choose from, in a variety of media, to provide this knowledge piece to sales representatives (e.g., workshops, text-based modules, e-learning programs, etc.)

The second competency is communication skills. Providing sales representatives with communication skills can be a bit more challenging, and the options available to effectively teach these skills are fewer than those available to teach knowledge. Conventional wisdom argues that you have to bring people together, face-to-face, if you want to teach a soft skill like effective communication. However, conventional wisdom is not always correct. At one time, conventional wisdom said the world was flat.

The world is not flat

The world is not flat. We can all agree on that, I hope. And by the time you finish reading this article, hopefully you will also agree that self-study e-learning simulations can be used to teach effective communication skills in general, and objection handling in particular. Through e-learning simulations, learners can be placed in realistic conversations with typical customers – which, after all, is what they spend most of their time doing. Graphics used to display these conversations on screen can be as simple as scripted text with still photographs of a sales representative and a customer or as complicated as videotaped scenes with accompanying audio.

Simulations typically start by having learners observe an initial exchange of dialog that culminates in a decision point, like an objection, before choosing how to respond. The way in which learners are able to respond depends on design preferences and program capabilities. One option is to have learners explore a variety of alternative response paths, effective responses and not-so-effective responses alike. Another option is for learners to follow a path based on decisions they make about what to do next. Their decisions on which responses they choose may lead them down fruitful paths, or not-so-fruitful paths, where turning back is not always an option. With either option, the program can highlight the salient characteristics of each option to make explicit the lesson to be learned from each.

From modeling to practice

Regardless of which design is chosen, e-learning simulations that replicate conversations with customers are excellent for modeling "what good looks like" ... as well as what "not-so-good" looks like. Simulations develop the learner's cognitive ability to recognize effective behaviors, helps them identify what makes them effective, and helps them to discriminate between more-effective and less-effective strategies – all key stepping stones to being able to perform the behavior. Simulations also provide learners with practice in matching different strategies to different situations, developing their ability to think on their feet and to respond flexibly.

Communication is not a rote skill – representatives can't just repeat key messages verbatim in every situation they encounter without coming across as wooden, robotic or insensitive. Instead, they have to be receptive to the nuances in their customers' verbal and non-verbal cues; they need to tailor their remarks and responses to the customer's personality and background, and the situation at the moment. A lengthy clinical response to an objection about product efficacy might be appropriate when a customer has time to see a representative in his or her office, but not at all appropriate when standing in the threshold of a crowded waiting room.

By providing a wide variety of situations in simulated mode, trainers can expose learners to different variables that can affect the quality of the conversation. By sensitizing your learners to the importance of these variables and the role they play in determining the outcome of the interaction, you can equip them to tailor their responses appropriately. What they learn to do in successive, safe simulations they are more likely to do in real situations.

What would you do?

Imagine the following scenario and scripted dialogue between a customer and a sales representative and think about which responses you would choose.

Scenario: Pharmacist Gary Parrish has been a chain drugstore pharmacist for 20 years and has watched many new drugs and generics come to market. He takes pride in his ability to stay informed of current research.

Representative Wendy Michaels was a nurse for five years and then switched careers to become a sales representative three years ago. She calls on Gary about once a month and has built a strong relationship with him based on her ability to discuss her product and connect it to her real-world clinical experience.

Today, she would like to present a new clinical paper. Read how the conversation plays out. Then think about how to help Wendy craft a valid response to the challenge that arises:

Pharmacist Gary: Hello, Wendy. I'm a little short on time, but I can give you a few minutes.

Representative Wendy: I try to visit you when you are unlikely to be with a lot of customers. I know that many of them rely on you, and I don't want to get in the way.

Pharmacist Gary: I wouldn't say that you'd be in the way. I'd just say you might have to wait in line. Anyway, what have you got for me today?

Representative Wendy: I brought a copy of a clinical study published last week in the Journal of the American Medical Association titled "Potency of generic and brand name Xylocaine." This paper was written by Dr. Edward Balaski with his colleagues at the University of Massachusetts. I know you like to keep current with what's going on in the research, so you may have already heard of it.

Pharmacist Gary: Yes, I glanced at the abstract, but didn't have time to read it thoroughly.

Representative Wendy: This study compared my product with two generic products and found significant differences in expected potency. The results suggest that until the generic products become more uniform, physicians, pharmacists and legislators should not encourage product switching.

Pharmacist Gary: I agree with the study, but as you know, in this state, I am required to substitute the generic. And most physicians who write your product are not indicating that they want the product dispensed as written. My hands are tied.

As you can see, Wendy has a lot of work cut out for her. What do you think she should say to ensure that Gary advocates for her product with physicians, rather than substituting a generic?

Option 1: Explain the study's findings in more detail, relate it to his patient population and suggest an acceptable course of action.

Option 2: Explain that you are sharing this study with your physician customers as well and highlighting situations in which they might want to consider writing "No Substitution."

Option 3: Avoid addressing the pharmacist's objection and detail your product in another way.

Let's see what happens if you picked Option 1:

Representative Wendy: In addition to the potency differences found, the study reports that patients also taking antihypertensive drugs experienced a higher rate of side effects, specifically nausea and dizziness, on the generic versus my brand. Although this was not the focus of the study, the authors do discuss these findings and suggest further investigation to determine clinical significance.

Pharmacist Gary: So what are you suggesting ... that I counsel patients away from a generic if they ask for one? Or, that I suggest to prescribers that they write "No Substitution" for your product?

Representative Wendy: Yes. That's exactly what I'm suggesting, especially if you agree potency is an issue. At the very least, you might want to consider doing so for those patients on antihypertensive therapy. Beyond the potency differences, it appears that there are drug–drug interactions associated with the generic that are not associated with my product. I know from previous conversations that a fair number of your customers have hypertension.

Pharmacist Gary: I'll have a look at the study for myself, but from what you're saying, it could make sense for hypertensive patients to stick to the brand product, and I might also consider discussing these findings with physicians when appropriate. It will take some extra legwork on my part, but if it helps my customers, then that is the important thing.

Representative Wendy: Thank you. I'll stop back in next month.

Pharmacist Gary: See you then.

Option 1 is an effective response. Clinical studies that are approved for marketing by your company often provide sales representatives with favorable data that they can use to support the clinical use of their product. In this case, Wendy lets Gary know that the generics did not measure up against her product in the new study, and that despite the laws regarding generic substitution, he can work with physicians so that he can dispense her product in specific situations.

Option 2 also would have been an effective response to choose. However, had you chosen Option 3, you would have seen how an ineffective response could be modeled.

The above dialogues were excerpted from Informa Training Partners' "Calling on Pharmacists" e-learning simulation course.