SNOW: In the past, we were trying to coordinate 10 or 12 different selling teams in primary care. Top-tier physicians could have as many as 175 reps across the industry calling on them. That's not being customer focused, I'd say.

We started to do some research in 2004 around other options out there, and we tested several variables to understand what might work for us. However, I want to emphasize that the portfolio dictates a lot of what the structure of your sales force will be.

In January, we altered our sales force structure to drive fewer faces. But we found the real benefit is that it clears up a lot of the complexity of trying to manage across 12 different teams — that difficult dance reps do to keep out of each other's way on a four-or six-week cycle.

That's made the reps feel more accountable, because they have ownership over their practices in key physician relationships. And it helps us to be much more flexible in driving changes, and understanding what's going on, at the physician level. It's really been a good change for us — and other larger companies' experience has been consistent with that. Lilly and Merck have also been down that path.

COUNT ON ME

HERMAN: Accountability is not a new concept in pharma sales. But we're hearing more about it. Are companies using accountability in a new way?

RICK KEEFER (chief operating officer, Publicis Selling Solutions Group): Accountability is what has generally appealed to high-performing reps in the specialty market. It's what attracts the high-performing rep to say, "Let me show you what I can do."

Now, in the large primary care sales forces, pharma companies are trying to assign product accountability and responsibility to one rep, rather than a pod or a multitude of reps. It's changing the model. We're now seeing a different profile of rep that companies are beginning to hire because some reps don't like that accountability. It's hard to hide.

PAUL STICKLER (senior director of sales, Ovation): I've seen that holding reps more accountable for their activity drives superior performance, and that performance is going to drive more value. It's a simple thing that really can make a big difference.

BREITSTEIN: How do you make reps accountable?

LAMBERT: Well, sales, right? Ultimately, sales is about driving prescriptions — it's the metric that analyzes your impact and ability to influence prescribing behavior.

SNOW: I'd be careful about suggesting that it's only about the prescription. We care a lot about the quality of the call, and we recognize that it's a bigger world out there than just this rep/physician relationship and just driving a message and driving an Rx.

NEW MODEL, NEW SKILLS NEEDED

HERMAN: Are companies redefining the profile for representatives? What are the skills reps must possess to be successful in the new sales model?

SCOTT HULL (manager of field sales technology, Abbott): We need to make reps smarter and better able to handle multiple products across disease states. But they need to have more than just product and disease knowledge. It's about knowing the payer mixes and the lifecycle of the product, which has relevance to how reps promote and bring value into doctors' offices. That takes a much higher level of business acumen on the part of the rep.

ROSENTHAL: Based on a study on business acumen among sales reps and regional and district managers, I can tell you that pharma companies generally think of business acumen as a collection of facts reps can recite and knowledge they appear to have.