ROSENTHAL: Reps who face the same managed care hurdles still demonstrate a wide variety of performance results at the end. So even though managed care can set up roadblocks that make it more difficult, you still find reps, regardless of the environment they're in, that outperform people with the same market dynamics.

SNOW: Obviously with single-payer systems in Europe, you still see lots of personal selling. We can take some satisfaction in recognizing that in markets where the margins are lower and the challenges higher, personal selling and conveying information is still an important part of the industry and is seen as valuable by the physicians in those markets.

A version of this article also appears in the February issue of Pharmaceutical Executive.