IN TODAY'S COST-CONSCIOUS HEALTHCARE ENVIRONMENT, LONG-TERM SUCCESS FOR PHARMACEUTICAL products is often driven by effective
pull-through programs. Because pull-through programs are the direct, day-to-day responsibilities of field sales, this means
that it's up to you to generate share for your product while helping to manage drug costs for payers, employers and patients.
The importance of appropriate utilization
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But pull-through represents only half of the pharmaceutical sales equation. You also need to be aware of push-through programs.
This article will examine the big picture to see how the two concepts balance out, with special attention paid to the role
of the sales rep.
Definitions
Push-through refers to your company's overall efforts to demonstrate the clinical efficacy, safety and cost-effectiveness of a product.
Think of push-through as a strategic concept that starts where the contracts are signed with managed care organizations. Pull-through refers to the "pulling through" of the product at the physician level by field sales. Pull-through generates demand for the
product, usually in ways that are consistent with the health plan's goals and guidelines. Pull-through is a tactical concept.
It's an action designed to influence the prescribing behavior of individual physicians.
Pull-through programs are the formal agreements between pharmaceutical companies and managed care accounts that specify specific
product utilization targets, messaging themes and support programs. Pull-through activities and initiatives typically focus
on physicians, a health plan's members or both. Programs directed at providers are designed to educate physicians (and other
providers, such as nurses) about the product and the efforts by the health plan to promote appropriate use. Initiatives developed
for plan members are usually information programs designed to promote wellness, screenings and adherence to therapy.
Focus on the patient
From the account manager's perspective, the goal of every pull-through program is to help the client develop and implement
a strategy that complements its overall clinical and business goals. Successful pull-through programs deliver value and meet
the needs of their target audience. Although the audience may vary, the focus of every pull-through program should always
be on the patient – who should ultimately benefit most from what is being offered.
Orchestra analogy
It takes a team effort to help ensure that a pull-through program succeeds. It's easy to illustrate this by using the analogy
of a symphony orchestra:
- The account manager is the "conductor." He or she helps create the program, interprets the score and directs others.
- Regional, district and niche-market managers, such as institutional sales and specialty pharmacies, are the "section leaders,"
or captains, of the various teams, analogous to the principal players in the string, brass, woodwind and percussion sections.
They implement the conductor's instructions.
- Field sales reps are the "players" — they provide the music that delivers the finished composition to the audience.
Push-through starts with the contract
Push-through starts with the contract process at the account manager level. A contract with a managed care organization (MCO),
pharmacy benefit manager (PBM) or Medicare/Medicaid program sets everything in motion: messaging strategies, pull-through
campaign development, field sales activities, market-share targets, value-added services and so on. Solid contracts lead to
long-term, "win-win" partnerships with your company's customers.
