As a sales manager, you play a pivotal role in the success of your product when it comes to pull-though. Positioned between account managers who negotiate contractual agreements and sales representatives who call on physicians in the field, you are responsible for uniting policy with action to increase your product's sales and market share.

Five steps to successful pull-through

Pull-through is an integrated process aimed at moving market share and increasing sales for a certain product in a specific time frame, usually in response to a particular challenge or opportunity. To help ensure that effective pull-through happens in your organization, you first need to think teamwork! Next, consider these five steps:

1. Recognize opportunities and challenges.
2. Develop strategies and tactics.
3. Create a pull-through team.
4. Execute strategies.
5. Measure results.

Initiating and implementing each of these steps can help your organization as a whole improve its pull-through capabilities. Let's look at each of the five steps and, specifically, at your role as manager in facilitating the pull-through process each step of the way. Throughout this discussion, we'll also look at a simulated case study to illustrate the key points.

Recognize opportunities and challenges 

Everyone, from the tenured account manager to the newly hired sales representative, must keep their eyes open and be able to recognize opportunities and challenges when they see them. As a sales manager, you can participate in this initial step by:

* Keeping abreast of marketplace changes in your area.
* Training or mentoring your sales representatives on how to keep abreast of marketplace changes in their territories.
* Quantifying the potential return-on-investment of pursuing a given opportunity or challenge.
* Training or mentoring your sales representatives on how to quantify the potential ROI of pursuing a given opportunity or challenge.

As a manager, you have the dual responsibility of developing big-picture strategies to impact your entire area while also supervising sales representatives as they implement those strategies on a territory level. By keeping abreast of marketplace changes and quantifying potential ROI yourself, as well as teaching your representatives to do the same, you can work with your reps to identify and take advantage of the most promising opportunities and effectively address imposing challenges.

Case study -- step 1: Recognize opportunities and challenges. Imagine you are a sales manager at PharmCo. John Graham, the PharmCo account manager for Managed Health MCO, has been able to maintain a second-tier formulary position for your product. Your competitor is on the third tier. Your sales representative, Jessie Grimes, hears from a nurse that Managed Health has changed your competitor's status from third-tier to third-tier with prior authorization. Jessie relays this news to you. After notifying John Graham, who then confirms the change with Managed Health, you determine that the opportunity is quantifiably worth pursuing, as it will take few extra resources to get the message out that prescribing the competitor involves more hurdles than it used to.

Develop strategies and tactics

Once an opportunity or challenge has been recognized and quantified as worthy of pursuit, it is time to develop a plan to maximize the opportunity or minimize the challenge. As a sales manager, you can help develop strategies and tactics by considering the goals of relevant stakeholders and devising ways to achieve those goals.

Keep in mind that a strategy can be anything from a simple to an elaborate plan. Regardless of the complexity of the pull-through task, your job will likely involve:

* Communicating with account managers and representatives.
* Working with account managers and sales reps to develop appropriate strategies.
* Gaining buy-in from those who will implement the plan.

Case study -- step 2: Dev-elop strategies and tactics. Your overall strategy in this case is to get the message out to Managed Health doctors that your competitor is now more difficult to prescribe due to the formulary status change. With input from John and Jessie, you devise a plan that requires reps who call on Managed Health doctors to quickly get the word out that the formulary has changed. You also want your other reps who call less on Managed Health physicians to get the word out, but you decide to give them a little more time to do it.

Create a pull-through team

Effective pull-through is not a one-person job. It requires a team. As a sales manager, you likely manage several sales representatives and communicate with several account managers. Although an opportunity or challenge will typically require more than one person to address it, it probably will not require the entire sales team. How do you decide whom to pull into the effort? Consider these factors:

* Who is closest to the situation already?
* Who has the time to focus on the effort?
* Are there stakeholders other than the representatives and the account managers who need to be part of the effort? For example, do hospital representatives and contracting directors need to be involved?

Case study -- step 3: Create a pull-through team. You look at your data to see which representatives call mostly on Managed Health physicians, and see that 12 out of 20 spend 70% of their time calling on Managed Health physicians. Your plan is to encourage those reps in particular to contact their Managed Health physicians to inform them of the formulary change.

You e-mail the 12 to inform them of the competitor's new status and ask them to notify each of their physicians over the next two weeks, even if they are not scheduled to see some of these doctors. You provide a checklist of key messages you would like them to impart during their calls. In addition, you copy your remaining representatives on the message and ask them to determine which physicians they need to relay the message to and to do so within the next three weeks.

Execute strategies

The execution of a strategy can be complicated or simple, depending on the opportunity or challenge and the strategy developed. If the pull-through team includes a multitude of people, coordinating the execution will require more effort to ensure that the implementation of the strategy runs smoothly. As a sales manager, your role in execution could involve:

* Ensuring that representatives who report to you are fulfilling their roles in the plan.
* Communicating with account managers and representatives to monitor any marketplace changes that might require adaptation of the developed strategy.

Case study -- step 4: Execute strategies. Five days after sending out "marching orders," you check in to find out that seven of the 12 representatives have called on almost every physician on their list. Nine days after you sent out the original e-mail, you check in again, and with the exception of one representative who had a family emergency, all of the 12 representatives informed their physician customers of the change. You check in two weeks later with your remaining representatives and find mixed results. Three weeks later, you confirm with everyone that they have contacted all relevant physicians and informed them of the change.

Measure results

Measuring ROI can be a difficult task. How do you truly quantify the time and effort your people have put into pulling through your product in response to a specific opportunity or challenge? At the simplest level, consider the cost of your people's time and look at any data that measure relevant changes.

You should also consider what the potential cost of not addressing the situation would have been. Sometimes when you fail to address a situation, you do not end up with a net result of "zero," or maintain the status quo. You may in fact end up with a negative result and see your product's sales and market share decline.
When measuring results, consider:

* The cost in terms of time and money.
* The sales and market share gains associated with the effort.
* The potential impact on sales and market share of not addressing the change.

Case study -- step 5: Measure results. Two months after you initiate the effort to inform Managed Health physicians in your area that the competitor has been put in the third-tier prior-authorization category, you receive a prescribing data report for your region. The report is favorable.

Prior to the formulary change, 55% of physicians prescribed your product, while 25% prescribed your competitor. The new report shows that 5% of that 25% has switched to prescribing your product over the competitor. As the effort took little extra time and money, changing the behavior of 5% of the physicians who formerly did not prescribe your product looks to have been worth the effort.

Although you cannot know for sure whether those physicians would have switched anyway, you can be pretty sure that your team's efforts to inform their customers of the formulary change didn't hurt.

The pay-off of pull-through

By following an integrated, step-by-step, teamwork-based approach to pull-through, you and your sales team can maximize opportunities, minimize challenges, and increase your product's sales and market share. Remember these five steps, and most importantly, don't forget the power of teamwork. It is amazing what people can accomplish if they just work together.