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The Ideal Sales Rep GfK

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The Ideal Sales Rep GfK Powered By Docstoc
					GfK Market Measures   A Member of The GfK U.S. Healthcare Companies      October 4, 2006




The Ideal Sales Rep:
Identifying How Physicians and Sales Reps
Prioritize Key Selling Attributes




 October 4, 2006

                                                                      GfK Market Measures
 GfK Market Measures            A Member of The GfK U.S. Healthcare Companies        October 4, 2006




    Recent Industry Sentiments
                                                                                                       2


“The current healthcare environment has certainly taken some of the luster off of the ‘traditional’
 pharma sales rep job. It is challenging reps to be relevant to their physicians and
 managers in terms of providing true value and recognizable performance.”
                                        Bob Davenport (Hay Group), PharmaVoice, April 2006


   “Our reps differentiate themselves by focusing on science and on the concerns of patients—the
   doctor’s customers. This means of course, that reps must be forthcoming about the medicines
they sell. And along with that knowledge, they must bring integrity and honesty about
    the science to their jobs if they’re to build trust-based relationships with doctors.”
               Fred Hassan (CEO, Schering-Plough), Harvard Business Review, July/Aug 2006

“Sales forces have to become more comfortable in delivering clinical performance data about
 these drugs. The question is no longer where to deploy waves of sales people. Companies
 have to retool and replace this strategy with ways to amplify the drug’s worth to a
 doctor and get the drug to patients. And this requires a much more complex sales
 and marketing approach.”
 Charles Fireno (Dir. of Consulting, Health Industry Insights),
 Pharmaceutical Executive, June 2006
                                                                                 GfK Market Measures
GfK Market Measures       A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Introduction
                                                                                               3


  Objectives

      Identify the selling attributes physicians find most important among
      sales reps and how they prioritize them.

      Identify the selling attributes sales representatives feel are most
      important to the physician and identify any disconnects.

      Understand and identify the differences in perceptions of effectiveness
      between PCPs and specialists and why they occur.

      Discern which companies are perceived as the most effective and why.

      Ascertain what pharmaceutical sales forces could do to be more
      effective when interacting with physicians.

                                                                          GfK Market Measures
GfK Market Measures         A Member of The GfK U.S. Healthcare Companies        October 4, 2006




  Research Methodologies Employed for 2006 Studies
                                                                                                   4

                           Flow of Study Process

                                                          Sales Force Rep/
                  Physician                            District Sales Manager

       Qualitative        Quantitative                          Quantitative
        Research           Research                              Research

     Identify the trait   Quantify relative          Quantify the field force’s perceptions
     behaviors that       importance of              around the identified behaviors.
     comprise rep         the identified
     attributes that      behaviors.
     drive access,        Identify the
     value and intent     companies whose
     to prescribe.        reps embody
                          those behaviors.

                                 Identify the disconnects

                                                                             GfK Market Measures
GfK Market Measures         A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Background – Qualitative Method
                                                                                                 5

      GfK Market Measures (GfK-MM) conducted a qualitative study
      (June 2006) with physicians to identify specific behaviors of sales
      representatives (reps) viewed positively by physicians.
       ̶ A secondary objective of this research was to identify specific trainable
          behaviors that can be incorporated into sales force training.
       ̶ These specific behaviors have been incorporated into the physician
          and sales force quantitative studies in order to identify the degree
          of overall alignment between sales rep actions/behaviors and
          physician expectations.




                                                                            GfK Market Measures
GfK Market Measures         A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Background – Quantitative Method
                                                                                                 6


      GfK-MM conducted a quantitative study with physicians to
      measure the importance of specific sales rep behaviors
      identified during the course of our qualitative research.
       ̶ These specific behaviors were compared in the physician and
          sales force quantitative studies in order to identify the degree of
          overall alignment between sales rep actions/behaviors and
          physician expectations.




                                                                            GfK Market Measures
GfK Market Measures      A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Method
                                                                                              7


  Physician Study
      Self-administered interviews conducted via Interactive Voice
      Response (IVR), August 23-September 1, 2006.
      Previous waves of research conducted via IVR, June 21-July 1, 2005
      (W2) and July 9-15, 2004 (W1).
      691 physicians completed interviews in W3; 483 physicians completed
      interviews wave 2, and 310 completed interviews for W1.
      All respondents personally speak to pharmaceutical representatives
      when they come to talk about their company’s products.
      Physicians responding to the survey have been in practice
      an average of 16 years.

                                                                         GfK Market Measures
  GfK Market Measures                          A Member of The GfK U.S. Healthcare Companies             October 4, 2006




      Method            (cont’d.)

                                                                                                                           8

      Sales Rep & District Manager Study
        Self-administered interviews conducted via Internet 8/29 – 9/15/06
        78 sales reps and 20 district managers completed interviews
        All respondents personally detail physicians within various specialties

                                    Quantitative MD                                             Quant Sales Rep
                                Completes                                  Completes                      Completes
                           Wave 3 Wave 2                               Wave 3 Wave 2                        Wave 3

    GP/FP                      76          79         Urologist            51      53          Sales Reps       78
    IM                         51          85         Gastroenterologist   52                  District Mgrs.   20
    Cardiologist               51          57         Nephrologist         51
    Endocrinologist            51          53         Ob/Gyn               51
    Oncologist                 51          51         Dermatologist        51
    Psychiatrist               52          59         Neurologist          51
    Rheumatologist             52          52


                                                                                                    GfK Market Measures
Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
GfK Market Measures       A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Report Notes
                                                                                               9

      Totals are among those answering a particular question.
      Data for this study are tested for statistical difference at a
      confidence level of 90%.
      Total percentages may not add to 100% due to rounding.
      Total data are weighted by specialty to reflect relative physicians
      who speak to sales representatives.
      Superscript 1 means wave 3 was significantly greater than wave 2.
      Superscript 2 means wave 3 was significantly less than wave 2.
      Superscript PCP means Specialists significantly greater than PCPs.
      Superscript SPC means PCPs significantly greater than Specialists.


                                                                          GfK Market Measures
   GfK Market Measures                                               A Member of The GfK U.S. Healthcare Companies                                                          October 4, 2006




        Key Drivers of Access
                                                                                                                                                                                                 10
        100                                           Product                              Relationship                                 Reputation

          80
                                                                                                                              69
                                                           59               60                                                           61                    61
          60                                52
                                                 49                    48             50                                           51         51                                           50
                  47 47            46                                                                   47                                          45              47     47 45
                              42                                41                                                                                                                    44
                                                                                           40                     39                                     41
          40                                                                                       33                  33
                                                                                              29
                                                                                21                           20                     20                    18                     20
          20            16            15            17            16                                                                                                 16                     15
                                                                                                                        12                     10

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                                                                     The overall gap between relationship and product closed this year.
                                                                     Only PCPs, psychiatrists, urologists and gastroenterologists are
                                                                     emphasizing relationship.

Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
Q.08.00.0.0 Using a scale from 1 to 7, where 1 means not at all important and 7 means very important,
how important is the product under discussion in your decision to speak to the pharmaceutical rep?
Q.08.01.0.0 Using a scale from 1 to 7, where 1 means not at all important and 7 means very important,
how important is the manufacturer's reputation in your decision to speak to the pharmaceutical rep?                                                                 GfK Market Measures
Q.08.02.0.0 Using a scale from 1 to 7, where 1 means not at all important and 7 means very important,
how important is your relationship with the pharmaceutical rep in your decision to speak to the rep?
    GfK Market Measures                                          A Member of The GfK U.S. Healthcare Companies         October 4, 2006




        Who Determines Physician Access?
                                                                                                                                         11
                                                  Weighted Total
                                              of PCPs and Specialists                                     In 64% of the cases,
                                                                                                          physicians themselves
                                                                                                          decide who they see.
                                                                                             Physician
                                                                                              alone       22% of the time, the decision
                                                                                                          to see the rep is made jointly
                                                                                 64%                      by the physician and one
                                                                                                          other person:
                                                                                                           ̶ Receptionist 36%
    Physician                             22%                                                               ̶ Nurse 31%
   with 1 other                                                                                              ̶ Office Manager 25%
                                                                11%

                                                          Physician
                                                          with 2 others


Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                     GfK Market Measures
Q.02.01.0.0. Please indicate the person, or persons, in your office who is responsible for
determining if and when you can meet with pharmaceutical sales representatives?
   GfK Market Measures                                        A Member of The GfK U.S. Healthcare Companies                    October 4, 2006




        Physician Access Is Changing
                                                                                                                                                 12

        % yes

         100

                                                      Wave 3                     Wave 2                          Fewer physicians indicate
          80
                                                                                                                 that their practice of seeing
                                                                                                                 reps has changed compared
          60
                                                                                                                 to last year.
          40                                    2                                                           32   Physician access is stabilizing
                                         27                                 24
                                                                                  2              27
                                                                                                                 with the exception of
                           16                                 16
          20                                                                                                     psychiatrists (is this due to
                                                                                                                 lingering dissatisfaction?)
            0
                            Tot PCP                            Tot Spec                             Psych




Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                            GfK Market Measures
Q.02.01.1. In the last 6 months has your practice of seeing pharmaceutical sales representatives changed?
   GfK Market Measures                                    A Member of The GfK U.S. Healthcare Companies          October 4, 2006




       Why Is Physician Access Changing?
                                                                                                                                   13
                                                                          % of Physicians
        Top mentions                        Wave 3                             Wave 2      Wave 1
        MD restricts time allotted to reps    281                                  7           5          Nearly half of the
        Time spent with rep now by                                                                        physicians are
        appointment only                      22                                  14           9          restricting rep access/
        Seeing more reps/increase                                                                         time in some manner.
        number of reps available              21                                  22         19             ̶ PCPs drove the
        Less time available to spend                                                                          change to more
        with rep/too busy                     13                                   8         19               restricted time.
                                                                                                          Specialties likely made
        Changes in specialty                  10                                   4          -
                                                                                                          changes in previous
        Rep was informative/should have                                                                   years as was seen in
        information reference material         9                                   8           5          last year’s study.
        Too many reps visiting                 7                                   3           -
        Changes in office/hospital protocol
        not allowing reps to visit             4                                  10         14
        Rapid turnover in reps                 4                                   9          -


Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                               GfK Market Measures
Q.02.01.02. Please describe how it has changed and why.
  GfK Market Measures          A Member of The GfK U.S. Healthcare Companies      October 4, 2006


    Verbatims—
    Describe How Access Has Changed?
                                                                                                    14
“We had difficulty with being overwhelmed with reps. Many reps detailing
 us on the same products, and coming in throughout the day was
 interrupting our business. So we now restrict the reps that come in.”
                                                  —General Practitioner

              “The clinic decided that only formulary samples can be kept, and decreased the
                     access of reps, and has banned any detailing within hearing of patients.”
                                                                               —Psychiatrist

“It’s actually gotten better…they’ve coordinated themselves
 and not overstocking and over talking to the physician.”
                                               —Psychiatrist

                                  “The need for increased patient visits, patient time as well as
                                      paperwork has made it more difficult to meet with reps.”
                                                                              —Rheumatologist

“I have limited the number of reps I am able to see on a
 daily basis due to the competitiveness with the product lines
 and to maintain organization in the office for patient flow.”
                                                                               GfK Market Measures
                                                   —Urologist
   GfK Market Measures                                         A Member of The GfK U.S. Healthcare Companies                                     October 4, 2006




       Future Physician Access May Change
                                                                                                                                                                   15
         % yes
          100
                                                                               Wave 3                     Wave 2
           80

           60

           40
                                                         2
                              14                    13                   14                   13                     10            15   14 10
           20           9                     8                    9                    8                    8                8                      8   9
             0
                       Tot PCP            Tot Spec                GP/FP                  IM                   Card            Psych     Rheum        Uro


          100

           80

           60

           40                                          2
                             16                     21
           20                                                      10                    14                                       12      12
                       8                     6                                                                   6
             0
                         Onc                   Endo              Neuro                 Neph                 ObGyn             Derm      Gastro




Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                                            GfK Market Measures
Q.02.01.3. In the next 6 months, do you anticipate that your practice of seeing pharmaceutical representatives will change?
   GfK Market Measures                                   A Member of The GfK U.S. Healthcare Companies          October 4, 2006




        Ways the Practice of Seeing Reps May Change
                                                                                                                                  16
                                                                           % of Physicians
        Top mentions                                                      Wgt Tot    PCP SPC
        MD restricts time with reps                                         251       35      15         Less than 10% of
        Time spent w/ reps by appointment only                              181       24      10         physicians indicate that
        Less time available to spend w/ rep/too busy                        18        21      14         they will change the
                                                                                                         way they see reps in
        Seeing more reps/increase number of reps                            16        10      23
                                                                                                         the next six months.
        Reps are informative/should have
        reference material                                                  13        21       4         Specialists’ trend will
                                                                                                         remain stable as they
        Increased number of products/                                                                    made their changes in
        relevant products                                                   12        10      15
                                                                                                         prior years.
        Only speak to reps during lunch/
        allow them to bring lunch                                             6       10        2        PCP trend of restricted
                                                                                                         rep access will likely
        Reps inconsiderate of time restraints                                 5       10       --        continue over at least
        Too many reps visiting                                                5       10       --        the next six months.
        Reps no longer allowed in back offices                                5       10       --
        More reps coming in for same/similar products                         5       10       --
        Changes in practice/specialty                                         8        --     16

Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                              GfK Market Measures
Q.02.01.04. Please describe how it may change and why.
 GfK Market Measures           A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   Ways the Practice of Seeing Reps May Change
                                                                                                    17

“We will try to restrict multiple visits within a week for the same product…
 we’ve found that receiving the same detail on the same day is annoying
 particularly when they have three rep all promoting the same item.”
                                                       —General Practitioner

                            “We may ask the pharmaceutical rep if they have new information
                                          about their medicine prior to arranging the meeting.”
                                                                                  —Oncologist


“I will probably see fewer reps due to increased demands
 in my practice, including demands on my time.”
                                         —Neurologist

                       “Expect fewer lunch and learns,
                        particularly after the recent New York
                        Times article. Patients talk about it.”
                                           —Gastroenterologist                 GfK Market Measures
   GfK Market Measures                                       A Member of The GfK U.S. Healthcare Companies                              October 4, 2006




       What Determines Which Rep Is Seen?
                                                                                                                                                          18

                                                                                                   Total              Total
        Main mentions                                                                              PCP                Spc      Overall physicians are
        Interest/relevance of product information (net)                                             49                 62PCP   emphasizing the
           Interest level in product                                                                11                 16      importance of respect
           Relevance of product to my practice                                                       7                 16PCP   my time.
           Product info/new information about products                                              14                 15      Respectful of time is
           New products/products I am unfamiliar with                                               19                 171     driven by psychiatrists
           Products that I use/use frequently                                                       10                 10      (29%), while
                                                                                                                               cardiologists and
        Personal attributes (net)                                                                   25                 24      oncologists have found
           Respectful of my time                                                                    201                151     the right balance.
           Personally/friendliness/polite                                                            8                  9
                                                                                                                               Specialists (62%)
           See most/all reps/no restrictions                                                        23SPC              14
                                                                                                                               continue to place the
        Samples                                                                                     20SPC              13      highest value on
        Reps who are not pushy/aggressive                                                           11SPC               4      relevant product
        Familiarity with rep (net)                                                                  10                 11      information.
        Professional attributes (net)                                                               10                 14



Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                                      GfK Market Measures
Q.02.02.0.0 Aside from time constraints, what determines which pharmaceutical sales representative you see and why?
 GfK Market Measures         A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   What Determines Which Rep You See and Why?
                                                                                                  19
 “They’re friendly, personable, remember previous conversations, and
  respectful of time. Presents new information, not old information and
  information that is valuable to us. Provides us with things that can be used
  with patients that will save us time like questionnaires.”
                                                           —General Practitioner

                             “It’s largely if they’re knowledgeable. Pfizer has cardiovascular
                                                 specialists, and they tend to be much better.”
                                                                                 —Cardiologist

“My prior interactions with them, whether or not they have brought me
 valuable information or been a useful resource for my patients. In these
 busy times, if it does not augment my practice, I would not waste my time.”
                                                                —Oncologist

    “I’m most interested in the sales rep who can assist us
     with patient management issues such as reimbursement
     or insurance coverage for some of the difficult to cover
     medications. This can take a load off the practice.”
                                                                             GfK Market Measures
                                            —Endocrinologist
   GfK Market Measures                                      A Member of The GfK U.S. Healthcare Companies             October 4, 2006




       What Do Physicians Need From Reps?
                                                                                                                                        20

                                                                                 Total Spc        Total PCPs
        Main mentions                                                                           Wave 3    Wave 2
                                                                                                                    Specialists’ (62%)
        Product information (net)                                                      62PCP     532       64       increase in the
          Indications/usage                                                            21        19        13       need for product
          Safety/side effect information                                               22PCP     13        13       information is
          Product information                                                          16PCP      82       23       being driven by
                                                                                                                    OB-Gyns (77%)
          Good/useful information                                                       12        12        8       likely due to
        Research data/clinical literature (net)                                        562PCP    45        51       Merck’s new HPV
                                                                                                                    vaccine.
            New updates/data                                                           25        25        22
                                                                                                                    PCPs have shifted
            Clinical reprints/articles                                                 15        10         7       focus from product
            Study information/clinical data                                             92        52       24       information to
        Education (net)                                                                26        411SPC    29       patient education
                                                                                                                    materials, perhaps
          Patient education materials                                                  19        341SPC    21       because of time
        Cost (net)                                                                     241       25        20       constraints


Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
                                                                                                                   GfK Market Measures
Q.03.00.0 Aside from product samples, what else do you need from a pharmaceutical sales rep?
Please be as specific as possible in your response.
  GfK Market Measures           A Member of The GfK U.S. Healthcare Companies      October 4, 2006


    Verbatims—
    What Do You Need from a Sales Rep?
                                                                                                     21
“Educational material for the patient. Anything that we can hand to
 the patients that will explain the disease process…”
                                            —General Practitioner
                         “I like information about the medication, side effects, insurance coverage,
                                            patient types who can and cannot take the medication.”
                                                                                       —Internist
“…To be responsive to things in the lay press regarding those medications which
we deal with a lot with respect to…the new HPV vaccine…to keep us abreast of
what is going to be distributed to the public so we can respond.”
                                                                        —Ob/Gyn

                      “We need to know formulary status of major managed care products, Part D
               Medicare, Medicaid… We also talk about cost and patient assistance programs. We
                                                don’t feel this can be handled by phone or mail.”
                                                                                —Rheumatologist

“What we need is cutting edge data, and the kind you don’t find,
 really, on the computer or anywhere else, and which only the
 pharma company is privy to.”
                                                    —Oncologist                 GfK Market Measures
   GfK Market Measures                                                  A Member of The GfK U.S. Healthcare Companies                                  October 4, 2006




        What Makes a Rep Highly Effective?
                                                                                                                                                                         22

                                                                                                        % of Physicians
                                                                                                     Total PCP    Total Spc                            Similar to last
        Main mentions                                                                                W3     W2   W3     W2                             year, efficient
                                                                                                                                                       use of time
        Positive knowledge level (net)                                                                76               68              78      80      continues to be
          Product knowledge (subnet)                                                                  731              60              69      71      the growing
          Good product knowledge                                                                      20               25              24      19      dominant
                                                                                                                                                       theme.
          Able to provide/knowledge
          on studies/data/literature                                                                  15                18             25PCP   23      Increases in
                                                                                                                                                       internists’
        Positive Professional Attributes (net)                                                       86                 77             861     68      mentions for 3rd
          Sensitive to time constraints/                                                                                                               consecutive year
          does not waste time                                                                        521SPC             37             431     30      (possibly late
          Provide samples                                                                            311SPC             20             231     15      adopters).
          Efficient/concise                                                                          22                 25             24      21
          Unbiased/fair/no sales pitch                                                               10                 15             10       9
        Positive personal attributes (net)                                                            29                33             31      31


Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                                                      GfK Market Measures
Q.04.00.0 In the case of a highly effective pharmaceutical sales representative, that is, one who exceed your needs, what attributes
and/or actions make them so effective? Please be as specific as possible in your response.
 GfK Market Measures          A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   What Makes a Highly Effective Rep?
                                                                                                   23

“They respect me and my time. They don’t force me to agree with them. They
 don’t try to create debatable traps, they don’t quote obscure medical literature.”
                                                          —General Practitioner

                           “They understand the practice of endocrinology. They understand
                               how their product works in the practice of endocrinology and
                                      how best to integrate it with the needs of the office.”
                                                                          —Endocrinologist

“They don’t waste my time and they remember what is important to
 me in my program so I don’t have to keep reminding them.”
                                            -Gastroenterologist

    “They seem to be respectful of my time, seem to be
     giving well documented, detailed accurate, useful
     information. They are not lecturing, they’re choosing
     the information in a short sound bite…”
                                                —Internist                    GfK Market Measures
  GfK Market Measures                         A Member of The GfK U.S. Healthcare Companies                              October 4, 2006




     Effective Sales Forces
                                                                                                                                           24
                                                             Wave 3    Wave 2
                                                                                       MOST Effective Sales Force
                 Effective Sales Forces                                                                                       242
                                                                                        Pfizer                                       36
                                                                      542
            Pfizer                                                          64                                 10
                                                                                        Merck                       13
                                                      34
            Merck                                                                     Novartis
                                                                                                           10
                                                       37                                                    11
        Novartis
                                          21                                             Astra             8
                                           23                                          Zeneca         5
                                         20                                                           5
              GSK                          23                                             GSK              7
                                       17                                                              5
  AstraZeneca                             21                                              Lilly       4
                                   13                                                             0        10            20     30    40
          Eli Lilly                 14
                                 10                                                   Pfizer was again a top force by more than
           Forest            8                                                        half of the respondents and selected again as
                           52                                                         the top force by a quarter despite significant
              BMS                 12                                                  declines across several specialties.
                         5                                                            Forest has made steady gains over the past
          Abbott          6                                                           three years.
Sanofi-Aventis            61                                                          Lilly and AZ have made progress in the ‘most
                        3                                                             effective’ category compared to last year.
                    0        10          20     30      40       50    60        70

                                                                                                                    GfK Market Measures
Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
  GfK Market Measures                         A Member of The GfK U.S. Healthcare Companies               October 4, 2006




     Effective Sales Forces—Top 5 rankings
                                                                                                                            25
                                   1                     2                3                     4               5
       Total                    Pfizer               Merck            Novartis                 AZ              GSK
       GPs/FPs                  Pfizer               Merck            Novartis         GSK/Lilly/Abbott
       IMs                      Pfizer              Novartis             AZ                   Merck            GSK
       Cards                    Pfizer               Merck            Novartis                 AZ              GSK
       Psychs                    Lilly                  AZ             Forest            Wyeth/GSK              ---
       Rheums                   Abbott              Novartis     Pfizer/Merck/Wyeth            ---              ---
       Uros                     Pfizer          GSK/Novartis        Lilly/Astellas             ---              ---
       Oncs                  Genentech               Amgen          Sanofi Aventis             Lilly         Novartis
       Endos               Novo Nordisk                Lilly           Merck                   GSK            Pfizer
       Neuros                   Pfizer          GSK/Novartis           Biogen            Boehringer
       Nephs                   Amgen                 Pfizer      Roche/Ortho Biotech      Novartis
       Ob/Gyns                  Berlex               Merck          Pfizer/Wyeth          Organon
       Derms                  Galderma                  3M             Medicis            Connetics           Dermik
       GEs                        AZ                   TAP        Novartis/Wyeth         Roche/Salix


                                                                                                       GfK Market Measures
Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
 GfK Market Measures          A Member of The GfK U.S. Healthcare Companies       October 4, 2006


   Verbatims—
   Most Effective Sales Forces
                                                                                                    26
“They gear their presentation to their knowledge of my practice. They anticipate my
 questions and they do respect my time when they see I’m quite busy…” (Pfizer)
                                                             —General Practitioner

                   “She is better versed in the science, has better knowledge of comparative
                     clinical trials, keeps it on a high level, and she is older than some of the
                                          young girls that seem to be most of the reps.” (GSK)
                                                                                   —Cardiologist

“Maturity, recognition of our needs, ability to carry on a conversation
 on the medicine and everything else.” (Sanofi Aventis)
                                                          —Oncologist

         “Her detailed knowledge of her product, the unique
   attributes of her product. She is not pushy, she under-
  stands competitive products are prescribed. She’s also
           sensitive of time needs.” (Ortho Women’s Health)
                                                 —Ob/Gyn                      GfK Market Measures
   GfK Market Measures                                        A Member of The GfK U.S. Healthcare Companies        October 4, 2006




       The Sales Rep or Medical Liaison Preference
                                                                                                                                     27
                                                                                                              Med Liaison
           45%                                                              57%
                                                                                                              Sales Rep
                                                                          “The Medical Liaison visits are
           “It just seems to me that                                       more scientifically rigorous.
            they're more clinically                                        They involve discussion of the
            oriented rather than a                                                                            Not surprisingly in
                                                                           science, under-lying disease       the head to head
            sales approach.”                                               states, the science of thera-      battle, the sales rep
              —General Practitioner                                        peutic management, and have        wins out with PCPs
                                                                           little to no emphasis on           and medical liaisons
                                                                           marketing issues.”
                                                                                                              win with the
           55%                                                                           —Endocrinologist
                                                                                                              specialists.
           “I'm more interested in the
            samples than anything                                           43%
            else, and that's the only                                        “There's a more established,
            reason I actually meet with                                       longer term relationship with
            the drug reps.”                                                   the sales representative.”
                             —Internist                                                          —Ob/Gyn


                                PCPs                                                      Specialists
Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                 GfK Market Measures
Q.06.01.2.0 Comparing Sales Reps and Medical Liaison visits, which of the two types of visits
do you consider a more valuable use of your time?
 GfK Market Measures         A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   Why Sales Reps Are More Valuable than Medical Liaisons
                                                                                                  28


“The sales rep is someone who I deal with on a regular basis. I
 find the medical liaisons are people who come in with a satchel
 of articles…They tend to want to spend a lot of time with you.”
                                              —Rheumatologist


                                           “Because we see them more often, and that's who
                                                     we're going to gain a relationship with.”
                                                                                  —Internist


“They can usually address all the issues regarding the
 product, not just the medical issues.”
                                      —Dermatologist



                                                                             GfK Market Measures
 GfK Market Measures             A Member of The GfK U.S. Healthcare Companies       October 4, 2006


    Verbatims—
    Why Medical Liaisons Are More Valuable than Sales Reps
                                                                                                       29
“At some time, they provide more detailed information that
 I'm looking for. Often, my sales representative will arrange
 this meeting to answer specific questions that I need.”
                                                  —Internist

                                                       “They go into a lot more detail about their
                                             medications, and give updates on new drug studies.”
                                                                              —Rheumatologist

“Usually has a better handle on scientific advances with a particular drug.”
                                                              —Oncologist

                       “The medical liaison has a much better understanding of the disease process.
                           The sales reps, in some companies tend to be just marketing people that
                                 don’t have a clue other than memorizing one or two detail points.”
                                                                                     —Cardiologist

“I think overall they tend to be a little more honest in their
 approach. They don’t ask you to prescribe a drug.”
                                            —Dermatologist                       GfK Market Measures
   GfK Market Measures                                         A Member of The GfK U.S. Healthcare Companies                                           October 4, 2006




       Percentage of Physicians Who Are e-Detailed
                                                                                                                                                                         30
       100
                                Pct e-detailed                     Usefulness of e-detail (top 2 box)
        80
                                                                                                                                                  Overall, 23% of
                                                                                                                                                  physicians are e-
        60                                                                                                                                        detailed with 21%
                                                                                  43                                                              finding it useful.
        40
                                                                                                    38
                                    30                  29 27                                                                                     e-detailing is being
                 23 21
        20                                                                14                 15                                     12
                                                                                                                                             17   under-utilized with
                                           9                                                                     10
                                                                                                                        0
                                                                                                                                                  cardiologists,
          0
               Wtd. Total            GP/FP                IM                 CD               Psych              Rheum                Uro
                                                                                                                                                  psychiatrists,
                                                                                                                                                  endocrinologists and
        100
                                                                                                                                                  dermatologists that
         80
                                                                                                                                                  find it most valuable.
                                                                                                                      63                          GP/FP, oncologists
         60
                                                                                                                                                  and rheumatologists
                                           44
         40
                                                                                                                                                  appear to be over
                                                                           28 29                    25                                            e-detailed based their
                                     18
         20
                  10
                                                        14 14                                16                  16                15 13          usefulness ratings.
                         0
           0
                   Onc                Endo              Neuro              Neph               ObGyn              Derm              Gastro


Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
Q.06.02.0.0 Have you ever been e-detailed, that is, had a live interaction with a sales representative via computer rather than in person?         GfK Market Measures
Q.06.02.1.0 How useful do you find e-detailing?
  GfK Market Measures                         A Member of The GfK U.S. Healthcare Companies      October 4, 2006




     Changes in Ways Physicians Are Detailed
                                                                                                                   31
                                           Top Mentions in Detail Changes

          PCPs                                                    Specialists
          More PC based                                           More PC based presentations         7%
          presentations                                    46%    (for Gastros, this was 60%)
          Fewer Reps                                       18%    Less face-to-face visits          19%
          More Internet-e-detailing                        15%    More Internet-e-detailing         10%
          Reps more likely to ask                                 Reps are more aggressive          10%
          for physician’s business                                Free lunches/dinner
          (try to seal the deal)                             5%   meetings cut back                 12%

             In total, only 14% of physicians report there is a change in the way they
             are being detailed.
             Mechanical & tactical rather than value or substantive changes are being observed.


                                                                                              GfK Market Measures
Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures
 GfK Market Measures             A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   Changes in Sales Rep Details
                                                                                                      32

“Several companies have restructured to limit the amount of reps that call on me.”
                                                           —General Practitioner

                       “Minnesota has put restrictions on the dollar amount spent on physicians
                            during the year. Therefore, many companies cannot offer lunches.
                                         Therefore, access to sales reps has been diminished.”
                                                                                —Psychiatrist

“They bring in more computerized presentations.”
                                   —Oncologist

                  “There has been increased use of technology via computer such as detailed
                   information. The process of getting information has been streamlined and
                                    we’ve been able to request samples from the computer.”
                                                                       —Gastroenterologist


                                                                                 GfK Market Measures
   GfK Market Measures                                          A Member of The GfK U.S. Healthcare Companies                        October 4, 2006




       What Should a Sales Rep Recall from Last Detail
                                                                                                                                                       33

                                                                                          Wgt               Total       Total
                                                                                                                                Follow through on
        Main mentions                                                                     Tot               PCP         Spc     promised responses
        Everything                                                                          18                 16        20     to questions or
                                                                                                                                requests is of primary
        Prior discussion topics (net)                                                       30                 28        33
                                                                                                                                importance.
        Questions                                                                           12                 12        12
                                                                                                                                No differences noted
        Concerns                                                                               4                    3     5     between PCPs and
        Current discussion topics (net)                                                     63                 64        62     Specialists
        Questions physician asked                                                           31                 30        31
        Physicians concerns/issues                                                          14                 13        14
        Tier/reimbursement/formulary                                                           9               10         8
        Safety/side effects                                                                    9                    9    10
        New studies/data                                                                       9                    9     8
        Name of doctor detailed/
        how to pronounce name                                                                  4                    5     3
        Items physician requested (net)                                                     16                 15        18

Source: Fastape™ SFE Physician 2006 Study, GfK Market Measures                                                                   GfK Market Measures
Q.08.08.1.0 Doctor, please give specific examples of what you feel a Sales Rep should recall from a prior detail?
 GfK Market Measures          A Member of The GfK U.S. Healthcare Companies      October 4, 2006


   Verbatims—
   Prior Detail Recall
                                                                                                   34

“…that he remembered any concerns I had about the product or
 concerns about using it or specific questions I asked about the
 product he was unable to answer.”
                                         —General Practitioner

           “Any patient education aids that I asked for, any specific questions that I asked to
           be answered, what points we covered in the previous detail, so it’s not repetitive.”
                                                                                   —Internist

“If they remember what my concerns were about certain products, how the patients
 have been doing, whether I’m comfortable with the way they’re being managed, etc.”
                                                                    —Endocrinologist

            “The rep should remember the objections I had
             to data presented. They should have new data
             to overcome the last conversation.”
                                             —Nephrologist
                                                                              GfK Market Measures
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies      October 4, 2006




                                  Sales Force
                                  Research Findings…
                                                   … and Alignment
                                                    with Physicians


                                                                      GfK Market Measures
GfK Market Measures      A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Background—Physician & Field Force Alignment Research
                                                                                              36

      GfK-MM wanted to understand whether or not sales reps and district
      managers understood what physicians value in sales rep behaviors.
      GfK-MM took the physician results and descriptions of valuable and
      trainable rep behavior from the qualitative research, and asked
      physicians to rate the behaviors in terms of importance as well as
      the reps and district managers.
      The behaviors and their corresponding ratings were then compared
      across all stakeholders.
      There are 29 specific trainable behaviors rated based on
      7 broader categories.
      Physicians and field forces were in close proximity of importance on
      11 of the behaviors and out of synch on 9 of the behaviors (more
      than 25%) with the remaining 9 of minimal
      difference (less than 20%).
                                                                         GfK Market Measures
GfK Market Measures      A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Sales Rep & District Manager Demographics
                                                                                              37


      51% of the sales reps have been with their current companies for
      more than 3 years.

      More than 55% of district managers report their tenure with their
      current employer is 5 years or more.

      40% of sales reps indicate working for one pharma company;
      about 25% indicate working for two pharma companies and just
      over 25% indicate working for three pharma companies.

      Sales reps who indicated working in a sales capacity in other
      industries are more likely to have worked in consumer products
      and advertising/marketing/public relations.



                                                                         GfK Market Measures
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies        October 4, 2006




  Where Are Physicians and Field Forces in Alignment?
                                                                                             38
                                     Positive Alignment
                                            Respect time (ranked #1 by 60%
                                            of PCPs and 56% of Specialists)
                                            State number of minutes*
                                            Know when it is too busy
                                            Articulate
                                            Speak to major points without tools
                                            Do you have questions
                                            Ask to prescribe once*
                                            Patient education materials
                                            Patient compliance materials
                                            Patient diagnostic materials
                                            No disparaging comments
                                * District managers out of
                                  alignment with physicians
                                  and reps (base size small)            GfK Market Measures
                                Source: Pharma Sales Force 2006 Study
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies          October 4, 2006




  Where Are Physicians and Field Forces Not in Alignment?
                                                                                               39


                                      Mis-alignment
                                             Summarize 1-2 sentences*
                                             Make major point in 1-2 minutes*
                                             Well groomed
                                             Eye contact
                                             Ask about unmet need in therapeutic area
                                             Consistently answer questions
                                             Confidently answer questions
                                             Familiar with competitive agents
                                             Ask about unmet patient needs

                                * District managers out of
                                  alignment with physicians
                                  and reps (base size small)            GfK Market Measures
                              Source: Pharma Sales Force 2006 Study
   GfK Market Measures                                 A Member of The GfK U.S. Healthcare Companies         October 4, 2006




      Degree of Alignment Between Physicians & Field Forces
                                                                                                                               40
                                               - Articulate -                             Top two box
       100
         90                                                                                    PCPs             Sales Reps
                                                                                               Specialists      District Mgrs
         80
         70
         60                                                                                    Both PCPs and specialists are
                                                                                               in total agreement that the
         50
                                                                                               ability to be to the point and
         40                                                                                    concise is paramount.
         30                                                                                    Reps are in alignment with
         20                                                                                    physicians with the need for
         10
                                                                                               brevity.
           0
                                                                                               But few district managers feel
                                                                                               the ability to be concise is of
                                          nc e




                                                                              es ve
                      te




                                                            nu t




                                                             too r




                                                                                               the same importance.
                                                         mi poin




                                                         /o ajo
                                       nte riz
                                            es




                                                                                   ns
                                                               tes




                                                                 ls
                    ula




                                                                           qu u ha
                                     se ma




                                                                                tio
                                                      sw m
                   tic




                                                     1-2 ajor




                                                   int to
                                 1-2 Sum




                                                                             yo
                Ar




                                                 po peak
                                                       m




                                                                          Do
                                                    ke




                                                  S
                                                 Ma




Source: Pharma Sales Force 2006 Study                                                                    GfK Market Measures
Q08 : Using a scale from 1 to 7, how important to you is….
   GfK Market Measures                                 A Member of The GfK U.S. Healthcare Companies           October 4, 2006




      Degree of Alignment Between Physicians & Field Forces                                                         (cont’d.)

                                                                                                                                 41
                                              - Likeability -                             Top two box
       100
                                                                                               PCPs              Sales Reps
         90
                                                                                               Specialists       District Mgrs
         80
         70
         60                                                                                   Physicians likely view questioning
         50
                                                                                              around their unmet needs as
                                                                                              ineffective rather than intriguing.
         40
                                                                                              Reps and their managers place a
         30                                                                                   higher importance on being well
         20                                                                                   groomed than physicians do,
                                                                                              particularly specialists.
         10
                                                                                              Both specialists and PCPs
           0                                                                                  place less importance on eye
                                                                                              contact than do reps and
                                                                          e
                                                          ed




                                                                                     ct
                     eu eed ut




                             na g




                                                                        nc
                            are in




                                                                                  nta
                         rso in
                               lly
                  rap et n abo




                                                        om




                                                                                              managers (could be difference
                               a




                                                                      xo
                      pe w do




                                                                                co
                                                     gro




                                                                                              between extroverts & introverts?)
               the unm Ask




                                                                    R



                                                                                 e
                        tic


                         o




                                                                 to



                                                                              Ey
                                                    ll
                      kh



                                                 We




                                                                  k
                                                               As
                   As




Source: Pharma Sales Force 2006 Study                                                                     GfK Market Measures
Q08: Using a scale from 1 to 7, how important to you is….
   GfK Market Measures                                 A Member of The GfK U.S. Healthcare Companies         October 4, 2006




      Degree of Alignment Between Physicians & Field Forces                                                       (cont’d.)

                                                                                                                               42
                                              - Credibility -                             Top two box
       100
         90                                                                                    PCPs            Sales Reps
                                                                                               Specialists     District Mgrs
         80
         70
         60                                                                                 The physicians and sales teams
         50
                                                                                            show disconnect with two
                                                                                            elements of visit interactions.
         40
                                                                                               The level of confidence seems
         30
                                                                                               to be of less importance than
         20                                                                                    the response itself to
         10                                                                                    physicians asking questions.
                                                                                               In other words, “I want my
           0                                                                 er tly            questions answered.””
                        art ntify




                                                       er tly




                                                                                 Q's
                               s




                                                           Q's




                                                                           sw en
                                                    sw en
                           icle
                     2-3 Ide




                                                                         an nfid
                                                  an nsist




                                                                          Co
                                                  Co




Source: Pharma Sales Force 2006 Study                                                                    GfK Market Measures
Q08 Using a scale from 1 to 7, how important to you is….
   GfK Market Measures                                 A Member of The GfK U.S. Healthcare Companies         October 4, 2006




      Degree of Alignment Between Physicians & Field Forces (cont’d.)
                                                                                                                               43
                                              - Credibility (cont’d.) -                   Top two box
      100
                                                                                               PCPs            Sales Reps
         90
                                                                                               Specialists     District Mgrs
         80
         70
         60                                                                                   Sales force personnel put a
                                                                                              much higher value on knowing
         50                                                                                   competitive products than
         40                                                                                   their customers (likely goes
         30                                                                                   along with physicians trying to
         20
                                                                                              avoid disparaging comments.)
         10                                                                                   Physicians do not want to be
                                                                                              asked about unmet patient
           0
                                                                                              needs.
                                                            die -
                             ag with




                                                                                ne met
                                                         stu -to
                                                               s
                                 ts




                                                                                    s
                                                                                  ed
                               en




                                                     ad ad




                                                                          tie un
                         tive ar




                                                   he te he
                      eti mili




                                                                        pa Ask
                                                                             nt
                    mp Fa




                                                    Ci
                  co




Source: Pharma Sales Force 2006 Study                                                                    GfK Market Measures
Q08: Using a scale from 1 to 7, how important to you is….
   GfK Market Measures                                 A Member of The GfK U.S. Healthcare Companies           October 4, 2006




      Degree of Alignment Between Physicians & Field Forces                                                          (cont’d.)

                                                                                                                                   44
                                  - Product Comparison -                                  Top two box
   100
      90                                                                                       PCPs               Sales Reps
                                                                                               Specialists        District Mgrs
      80
      70
                                                                                              Sales reps and their managers
      60                                                                                      place high degree of importance to
      50                                                                                      remembering the last conversation
                                                                                              (mostly likely due to the training
      40                                                                                      emphasis on this by companies.)
      30                                                                                      Both specialists and PCPs are in
      20                                                                                      agreement that the last
                                                                                              conversation is not as important
      10                                                                                      as long as the rep answers any
        0                                                                                     previous questions and follows
                                                                                              up on requests.
                                                                              en g
                     ry




                                     ati st



                                                        ari ake




                                                                         mu st/




                                                                         mm in
                                                                                 ts
                                        on




                                                             ns
                                  ers la
                  ula




                                                                                              District managers appear very out-
                                                                                 y


                                                                      co arag
                                                                      for re co
                                                                             lar
                                                      mp M
                                                           so
                                nv er




                                                                                              of-touch with the importance of
                rm




                              co emb




                                                                          p
              Fo




                                                                                              formulary and cost information
                                                                        a



                                                                      dis
                                                                     mp




                                                                                              which is surprising given Part D.
                                m




                                                     co




                                                                  No
                             Re




                                                                  Co




Source: Pharma Sales Force 2006 Study                                                                     GfK Market Measures
Q08: Using a scale from 1 to 7, how important to you is….
   GfK Market Measures                                   A Member of The GfK U.S. Healthcare Companies                           October 4, 2006




       Sales Rep Call Frequency Quotas
                                                                                                                                                   45

                                How Are Your                                                          Do Call Quotas Interfere           Sales
                           Call Frequency Quotas?                                                      With Selling Ability?             Reps
     100                                         95                                             100                       95
      90                                                                                         90                                      District
                                                                                                                                         Mgrs
      80                                   72                                                    80
      70                                                                                         70                  65
      60                                                                                         60
      50                                                                                         50
      40                                                                                         40     35
      30           24                                                                            30
      20                                                                                         20
      10                   5                                       4                             10          5
                                                                    0
       0                                                                                          0
               Too High             About Right               Too Low                                    Yes            No


         Nearly 25% of reps feel their call quotas are too high compared to only 5% of the managers
         However, 35% of the reps believe call quotas interfere with their selling ability (are they
         right or are they complaining?)

Source: Pharma Sales Force 2006 Study                                                                                        GfK Market Measures
Q8: Are your call frequency quotas….
Q9: Do you think your call frequency quota interferes with your ability to sell your product?
GfK Market Measures       A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  SFE Research Key Findings
                                                                                               46

      The gap between physician/rep relationship and the promoted
      product is now closed in determining physician access (a concern
      as sales is relationship driven).
      Physician access appears to be stabilizing across most specialties as
      the majority of restrictions were put in place in previous years with
      PCPs being the last to follow in reducing rep access.
      Physicians are still looking for strong, tailored product knowledge
      coupled with efficient use of time as critical in defining rep value.
      Pfizer was rated one of the top forces and the top force despite a
      decline over last year with Forest, Lilly and AstraZeneca making
      gains with certain key specialties.
      e-Detailing is occurring among 23% of physicians with certain
      specialties being under-detailed based on their
      usefulness ratings for this medium.
                                                                          GfK Market Measures
GfK Market Measures      A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  SFE Research Key Findings            (cont’d.)

                                                                                              47


      When changes are noted at all, physicians are noticing the
      mechanical changes to the rep’s detail and not so much of the
      substantive changes at this point.
      Sales reps and/or district managers are out of synch with 9 of
      the behaviors that physicians consider important, by at least a
      25-point spread.




                                                                         GfK Market Measures
GfK Market Measures            A Member of The GfK U.S. Healthcare Companies         October 4, 2006




  Things to Consider…
                                                                                                       48
      It appears that physicians across specialties including PCPs are in
      greater agreement as to what they are looking for in a valuable rep.
      Many of the field force quality initiatives that companies are
      implementing are not markedly visible to the physicians yet.
      Physicians continue to emphasize the basics of every valuable
      sales interaction:
       ̶   Right-sized visits (right frequency, right time, right length & right content)
       ̶   Tailored clinical information (to the practice & to the amount of time)
       ̶   Credible and trusted source (balanced view with the facts with no bashing)
       ̶   Impeccable service and extension of our staff (follow-up from previous call,
           samples, patient education & formulary updates)
       ̶   “People smarts”

      It is critical for all company personnel to realize what the physicians
      expect from not only the sales rep but the company. How many home
      office personnel would have been in alignment with physicians on the
      critical behavioral attributes?
                                                                                GfK Market Measures
 GfK Market Measures        A Member of The GfK U.S. Healthcare Companies      October 4, 2006




   Sales Force Analysis Offer
                                                                                                 49

       GfK-MM is offering a follow-up study that will analyze your field
       forces’ understanding of their customers’ needs.
       GfK-MM will measure your sales force’s perceptions against those of
       the physicians they call on.
       We will present the data in an on-site presentation and also provide
       a hard copy report of the finding.
       The survey itself will be internet based, no more than 10-12 minutes
       long and will require the participation of your designated sales
       representatives and district managers.

If you are interested in participating in this study, please contact Raj Kuchibhatla
at rkuchibhatla@gfkmarketmeasures.com or your account manager.


                                                                            GfK Market Measures
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies      October 4, 2006




                                                                                           50




                                                                      GfK Market Measures
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Instructions for Q&A
                                                                                           51

  To Ask or Withdraw a Question…
  When the Q&A session begins the conference
  coordinator will give you these simple instructions.

  1. To ask a question—please press star (*) and one (1).

  2. To withdraw a question—please press pound (#).

  We will then take each question in order, until we are
  ready to conclude the conference.


                                                                      GfK Market Measures
GfK Market Measures       A Member of The GfK U.S. Healthcare Companies      October 4, 2006




  Contact Us…
                                                                                               52


   Maureen McLaughlin
   Chief Marketing Officer
   Practice Leader, Sales Force Effectiveness
   GfK Market Measures
   mmclaughlin@gfkmarketmeasures.com
   (973) 599-3683


   Stacy Vaughn
   Vice President, Detail Tracker
   GfK Market Measures
   svaughn@gfkmarketmeasures.com
   (973) 599-3631


                                                                          GfK Market Measures
GfK Market Measures   A Member of The GfK U.S. Healthcare Companies      October 4, 2006




                                                                                           53




                                                                      GfK Market Measures

				
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