13 misbin 0002 binosto presentation w summary

INSIGHT FOR ACTIONJANUARY 9, 2014

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TODAY’S PURPOSE IS THREE-FOLD…

To present findings drawn from Franklyn MM insight activity which was dedicated to:

IDENTIFYING/UNDERSTANDING KEY ISSUES CONFRONTINGFIELD SALES RELATIVE TO BINOSTO MARKET GROWTH

IDENTIFYING ACTIONABLE BEHAVIOR THAT CAN ADVANCE THE STANDING OF BINOSTO IN THE MARKETPLACE AND

STRENGTHEN ITS VALUE TO THE MARKETPLACE

WHAT STRATEGIES AND TACTICS CAN BE DEPLOYED TO EMPOWERGREATER EFFECTIVENESS IN CURRENT AND FUTURE SALES EFFORTS?

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Copyright © FranklynHealthcom 2014. All rights reserved.

THE PURSUIT OF ACTIONABLE

INSIGHT…

VERBAL GOLD

3 Copyright © FranklynHealthcom 2014. All rights reserved.

The Sales Force, HCPs and their officestaffs believe that Binosto has a value greater than its copay

Value is synced with promotional platform

THE IDEAL

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MEDICARE(BINOSTO(in(preferred(posi7on(for(>50%(of(Medicare(Claims(

COMMERCIAL(80%(of(Commercial(Claims(covered(without(restric7on.(

I.  Improve)posi,on)while)preserving)profitability))

II.  Navigate)hurdles)to)access)&)affordability)

I.  Priori,ze)Top)Plan)Targets)

II.  Evaluate)2nd)Tier/Regional)Plans)

MEDICAID(Ac7vely(manage(&(monitor(Medicaid(posi7on,(especially(

at(District(Level(

I.  Iden,fy)top)priority)key)states)

II.  Target)key)states)to)put)BINOSTO)in)preferred)status)or)in)parity)with)brands.)

BINOSTO(will(be(an(accessible(and(affordable(treatment(op7on(for(osteoporosis(pa7ents.(

EDUCATION/COMMUNICATION(

Create(an(informed(&(empowered(Sales(Force(that(understand(MC(and(uses(tools(

to(op7mize(sales(in(their(territories.(

I.  Educa,on)via)Formal)Training)

))II.  Enhance)communica,on)

Minimize(Barriers( Preferred(Status( Focus(/(Target( Empowerment(

BINOSTO(S(Managed(Markets((2014(WorkSinSProgress(Revise)(

BINOSTO PLAN

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PLAN SEGMENTS

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MINIMIZEBARRIERS

PREFERREDSTATUS

DMALIGNMENT

EMPOWER FOCUS/TARGET

STRATEGICIMPERATIVES

SALES FORCE/AMs

PAYER MKT

HCP/PHARMACY

BUSINESS GOALS AND OBJECTIVES

Define KPIs…

Internal Customer Understanding• Intent• Motivation• Behavior

Market Capabilities & Analysis• Market/Trend Assessment• Opportunity Analysis• Competitive Analysis

MESSAGING CONTENTPLATFORM PRODUCTION

Content• Copywriting• Multi-platform assets

Visual Design• Branding• Creative Concepts

Technical Development• Code• System Architecture• Quality Assurance

User Experience• Information Architecture• Interaction Design• Usability

STAKEHOLDER ENGAGEMENT• Internal messages• External messages

INSIGHT & STRATEGY TACTICAL DEPLOYMENT MARKETING & TRAINING

OUR PROCESS

DEFINE VALUE PROPOSITION STRATEGIC PLAN TACTICAL

RECOMMENDATIONS & MEASUREMENTS

CUSTOMER EXPERIENCE

ONGOING OPTIMIZATION

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SOCIAL MEDIA

ONLINE AUDIT-WEBSITES

COMPETITIVE INFORMATION

MARKETING MATERIALS

1 EXECUTIVE

DIRECTOR OFFIELD SALES:

BRIAN CARD

2 DISTRICT

MANAGERS:KEISHA MCCAALESLIE PAINTER

4 TERRITORYMANAGERS:JONATHAN TISCHIOPATRICIA DEVINEANDREA METZA

JAMAAL CHAMBERS

7PARTICIPANTSCONDUCTED 12/12 - 12/19

1 ON 1 INTERVIEWS:

INSIGHT PHASE METHODOLOGY

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RESEARCH AUDIT:REVIEW OF PROVIDED

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ECONOMICS BASELINE

SWEET SPOT


WARREN BUFFET

“PRICE IS WHAT YOU PAY, VALUE IS WHAT YOU BUY.”

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X MARKS THE SWEET SPOT

REDUCETHE COST

THERE ARE TWO WAYSTO INCREASE SALES

INCREASE THE VALUE

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UNDERSTANDING WHAT MM IS AND WHEN, WHYAND HOW IT MATTERS

DIFFERENTIATING BETWEEN AN OBJECTION AND A SMOKESCREEN

OVERCOMING COST OBJECTIONS BY LOWERING THE PERCEIVED PRICE AND BARRIERS

CORE OBSTACLES BLOCKING ATTAINMENT

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OVERCOMING COST OBJECTIONSBY RAISING PERCEIVED VALUE

CONFIDENCE AND ACCOUNTABILITY

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INSIGHT

KEY FINDINGS


"A nurse said that a pharmacist called to switch Binosto to a Gx,

and said that Binosto wasn't covered and would cost a lot."

“I don't know what to say when an HCPtells me that we're not covered on a plan,

and we're not covered on that plan.”

“A doctor said he can only write generics now.”

"A doctor told me his patients won't pay any more than $15."

“A lot of times HCPs just launch right into our poor Medicare coverage beforeI can even say anything.”

“The doctors ask me, ‘why’? Just because Binosto has a different

delivery system, that's why you want me to write this product and deal with all your cost and coverage problems?”

"I keep losing switches even with Apricot. The office only realizes there's paperwork

necessary to be completed after the patient goesto the pharmacy and the pharmacist calls trying to switch. At that point, they forget that Apricot

is available to them, or they don't feellike dealing with it at that point."

"A doctor told me that he wrote Binosto, but the patient

reported back after going to thepharmacy that the copay wasmore than she could afford."

DIFFERENTIATING BETWEEN ANOBJECTION AND A SMOKESCREEN

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If a doctor immediately keys in on mgdc, then:it's like any shopper who immediately keys in on the cost ... they don't understand why the product with worth that price. ORthey're using the oldest trick in the book to clear a rep out of their office. (they probably talk about it over cocktails ... what plan do you bring up?)It is a worthless conversation ... say that after a huge conversation, you get the doc to agree that the price is not $400, it's $45. If he understand the cost but not the value, the doc is still not going to write it.

The only "real" mgdc objections are the ones from doctors who have committed to write the product, and who have encountered a patient for whom the price was too high.


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“I don't know anythingabout EHR systems, really.

Except that most of mydoctors have them now.”

“Oh right. It didn't occur to me that thereason a patient might not be covered isthat they have a PBM for their pharmacy

benefits and a plan for their medical benefits.”

“MM has been such a silo for us. I don't understand how it all fits together.”

“PCMH? ACO? What the who?”

“Sometimes I just don't get why the terms matter. Like how

does the donut hole affectBinosto prescribing?”

“Our biggest problem is coverage.”

“I think many reps have trouble taking control of the conversation. They can't

transition when the doctor starts ranting about problems bigger than Binosto.”

“It's difficult to hard-sell a brand when thedoctors I'm dealing with are just tired and angryin general. I need a compelling reason for them

to overcome their instant fear of writing a brand.”


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“It is interesting to me to think of mm as a cost objection. I know cost objections. I know how to deal with cost

objections. To consider myself a professional in sales, it's my responsibility to address cost objections.”

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“I target based on physician decile. PCPs write 14 million Gx scripts. Yes, when we walk in

all we hear about is medi/medi, but all those scripts are our biggest opportunity.”

“It's about the value. Docs don't see where this drug fits into the options.

If the patient can't swallow a pill, they get them an injection.”

“We need to be a resource for osteo, not a pill pusher. It undermines our

credibility and our ability to construct our overall argument in a compelling way when all we do is hard-sell the drug.”

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“This product is a 'me too.' There is nothing different between Binosto and Gx

besides the delivery.”

“I need to be relevant. My customers needto know I've heard their concerns and have a

solution that can help them solve their problems. Their problem with writing a brand is thatthey are penalized for doing so. I need a

reason for them to do it anyway.”

"I know that attitude is everything. Customers will pick up on it if I don't

truly and passionately believe what I say."

"This is not a prenatal vitamin. Some reps haven't come to terms with that yet. They don't prepare,they don't know how to make a clinical sale or

how to handle a true cost objection."

"Reps have to do the work. They can't have everything handed to them. We can only do and educate so much and educate so much.

Reps need to review those materials andif you don't know the info, then you can't

fault anyone but yourself." 05


"We often go in and we think that the doc isn't going to write it because

there's a Gx and it is cheaper."

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"Reps that are more successful are the ones that aren't letting these little

challenges get in their way."

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GET READY

OVERCOMING CORE OBSTACLES



DIFFERENTIATING BETWEEN AN OBJECTION AND A SMOKESCREEN


CORE OBSTACLES BLOCKING ATTAINMENT

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SOLUTIONS

STRATEGIC IMPERATIVES

SMOKESCREEN MM MATTERS PERCEIVED PRICE PERCEIVED VALUE CONFIDENCE

LOSE SIGHT, LOSE FIGHT COWBOY UP BE RELEVANT

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LOSE SIGHT, LOSE FIGHTTHE MM PATIENT ENDGAME: • Prove the value of Binosto is greater than the cost

• Just like L'Oreal, We're Worth It. As soon as welose the confidence to say that with passion, oursales pitch will become inauthentic. Letting theconversation drift into no-win areas

• We are not a me-too. Binosto could be thedifference between living and dying

THE MM POPULATION ENDGAME: • Our concern is ensuring that 100% of your

patients are cared for. Our aim is to savethe lives of your patients who can't chokedown a sizable pill

THE PROCESS ENDGAME: • Understanding how MM fits into the continuum

of the sale enables the reps to clearly see theircompetition and employ all their sales materials toarticulate their point, not just their mm ones

• Right now they are fighting shadows


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HOW WILL WE KEEP SIGHT, WIN FIGHT?REFRAME THE SALES APPROACH TO INTERLACE MM BASIC PRINCIPLES• See smokescreens for what they are

• Transmit best practices to handle true cost objections

• For doctors battered by MM, frame the conversation into MM, population-level terms

• Believe in the product

• Effective targeting. High decile docs arenot always the best prospects if the bulkof their patients will abandon the Rx inthe pharmacy for cost reasons


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COWBOY UP• We're sales professionals. The fundamental

skill of a sales professional is to comeout on top in a "cost vs worth" discussion

• Let's be accountable for that


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HOW WILL WE COWBOY UPTOUGH LOVE TRAINING AND MOTIVATION: • Recognize and acknowledge the challenging

marketplace, but remind the reps that their job is no more or less difficult than mostother pharma reps out there right now

PERSONAL RESPONSIBILITY:

• A high price will axiomatically lower demand,but what is the core skill of a sales professional? To raise the value of a product to be greater than the cost-this is their accountability

JUST DO IT ATTITUDE:

• Let's be nimble, let's be smart, let's be creative. How are we going to defeat our circumstances?

• Collaborative Camaraderie: Provide the baseline information and forum, and encouragement tomake that information actionable


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The lowest priced product on the market doesn't require a sales professional. It requires a magazine ad and a UPS driver.

Only one view of the truth matters, namely the customer's. We must find the communication “truth-space” where what customers believe aligns with what we are saying. It is in this common ground that we can begin to connect with skeptics. Source: Mike Maslanski: The Language of Trust

BE RELEVANT"PEOPLE DON'T BUY A DRILL,

THEY BUY A HOLE."


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Little things make a big differenceIDENTIFY TRUTH-SPACES TO ENABLE THE REPS TO BEGIN EVERY CALL WITH:

"Since we talked last time, I've looked at what we talked about from not only my perspective, but also from your perspective. And I think we have some things that we can discuss today that will help both of us." Source: Rob Lambert - world - renowned negotiator

HOW WILL WE BE RELEVANT?


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ACTION

CONNECTING STRATEGIES TO TACTICS


CONNECTING STRATEGIES TO TACTICS

Pearl of the week Pearl of the week Pearl of the week Pearl of the week Pearl of the week

Sampling Program Effective targeting Apricot Positioning PCMH Program Prevalence Sheet

Prevalence Sheet Resource Library Effective targeting Sampling Program Effective targeting

Resource Library Resource Library Prevalence Sheet Resource Library

CareLoop


Resource Library Resource Library Apricot Positioning Resource Library Effective targeting

Effective targeting Resource Library


Sampling Program Resource Library Apricot Positioning PCMH Program PCMH Program

Resource Library Sampling Program Sampling Program Prevalence Sheet

Resource Library Prevalence Sheet Resource Library

CareLoop

SMOKESCREEN MM MATTERS PERCEIVED PRICE

PERCEIVED VALUE CONFIDENCE

LOSE SIGHT, LOSE FIGHT

BE RELEVANT

COWBOY UP

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“PEARL OF THE WEEK”

Program Elements

• The object is to crowd-source by involvingas many reps and DMs in the writing and recording of the pearls as possible

• For example, one DM could interview another DM or rep about how they overcome a certain objection. After each communication, DMs decide how to reinforce the communication within their teams

• Every 1-2 weeks, email out a pearl to the Sales Force

• Pearls could be simply emailed words, or a video, deck or podcast "talk show"


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DMs or reps who are consistently negative, orwho haven’t come to terms with today’s market environment as a whole, need to hear from their peers that their expectations are unrealistic.Not us.

Make sure the reward and recognize those that exhibit the empowering behavior that we seek. We want solution-oriented individuals who are able to recognize a legitimate problem and then collaborate toward the best solution.

• Crowd-source best responses to common objections

“PEARL OF THE WEEK”, CONTINUED

?SMOKESCREEN MM MATTERS PERCEIVED PRICE PERCEIVED VALUE CONFIDENCE

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CUMULATIVELY COVER:

• What MM tools are available and where? What support can people within the organization provide? Suggestions to most effectively use these tools (eg "Top 7 References to keep in your Car")

• When are MM concepts relevant? (eg PBMs and pharmacy coverage)

• Understanding MM as a cost objection –"cost vs value"

• Success takes personal accountability...what does that look like? In a managed market environment, what is withinand without the rep's responsibility?

• Best practices to address pharmacy switching

• How to recognize and mitigate a smokescreen • How to take best advantage of

the new strategies like focusing on population health/PCMH entities, targeting, sampling, etc

• The impact and opportunity of EHRand eRx systems

• Controlling the conversation, probing, transitioning, objection handling

• Total Office Call

• Finding the "truth-space"• Understanding the MM pressures faced by HCPs

Make sure the reward and recognize those that exhibit the empowering behavior that we seek. We want solution-oriented individuals who are able to recognize a legitimate problem and then collaborate toward the best solution.

RESOURCE LIBRARY

PROGRAM ELEMENTS:STEP 1

• Perform a complete inventory of all available MM resources

• Identify gaps/needs• Streamline and reduce redundancy• Optimize content to meet current

strategic thinking

TO ENHANCE SALES FORCE EFFECTIVENESS IN THE PURSUIT OF ESTABLISHING VALUE - ENABLE ACCESS TO EXISTING EDUCATION RESOURCES

STEP 2• Assemble all resources in a digital library• Develop a resource training guide/reference to

enable SF to be educated on each resource andhow each piece should be used in the field

• Rep can download or order as needed


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HOW WILL WE BE RELEVANT?DEFINE THE PROBLEM:• Raise the Value of Binosto

• Show the consequences of untreated osteoporosis, compare against the current standard of care, show thegaps, show that Binosto fills those gaps

• Take stats from the payer deck that are appropriate. Show the life/death implications of patients who don'ttake their drugs

• Motivate reps (this is not a me-too)

PROGRAM ELEMENTS• Use at lunch ‘n’ learns

• Total Office Calls

• Direct mail

• Co-promote w/plans or other entitiesto get them to distribute to their HCPs


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As many as 22% of adults aged 50+ suffer from dysphagia1

A high number of patients unable to maintain pill regimen!

Dysphagia is present in 30% to 75% of patients in nursing homes1

In addition to clinical dysphagia, 40% of American adults have experienced difficulty swallowing pills, even though most have had no problems with food or liquid2

APPROACH:

• Get Reps more aggressive in using existing program elements• Ask nurses to include a sample/voucher for Binosto with every Gx• Document failure (Include the apricot form in the sample bag)

ADVANTAGES:• Easier to create a habit• Faster, don't have to wait for failure, don't have to

keep reminding docs to ask if patient can swallow

PROGRAM ELEMENTS:• Rep: Population health info (dysphagia stats, etc)

reference guide• HCP: Patient ed to include w/the sample kit about

the importance of taking a med, and describing theBinosto difference + dialoguing with the pharmacistif pressured to take a Gx

SAMPLING & PATIENT ED PROGRAMTransform patients into learned advocates - now they are awareof what they are not getting if they let a pharmacist switch them,they understand the value of what they are paying for.


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PCMH PARTNERSHIP INITIATIVEPatient Centered Medical Homes (PCMHs) have avested interest in patient outcomes. Sometimesas much reimbursement is riding on outcomesas on Gx incentives.

PROGRAM ELEMENTS:STEP 1• Research how Binosto can help PCMHs

achieve top reimbursement• Educate representatives on PCMH and EHR systems

and the incentives that HCPs have around them• Create a Q&A on the resources Binosto offers which

may assist the PCMH to achieve their goals• Target PCMH practices

STEP 2• Extend effort to educate HCPs and patients• Research done for this project may also be

used to augment the payer deck


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CARELOOP FOR PROVIDERS, PAYERS AND PHARMACISTS

Demonstrate Mission's commitment to better patient outcomes by offeringa service to help patients get the most out of their osteoporosis medication• Consider positioning as an epidemiologic trial

PROGRAM ELEMENTS• Via SMS and/or email, select a population intervention including

reminders and education• Since metrics are tracked, consider testing with Gx patients to see

if we can capture non-adherence fast and get doctors to understandwhy orals may not be sufficient

REP EDUCATION• Program Definition• Program Development• Training and Sales Tools

EXTEND• Program Execution with Customers

• Consider making available to all target stakeholders...HCPs, MGs, ACOs, payers and pharmacies


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APRICOT POSITIONINGApricot will not work unlessit's within the clinical workflow

Consideration - RELAUNCH:

1.Strategic Review and formulate a Solution

2.Working with JR and Team to execute solution


PROGRAM ELEMENTS:• Follow-up Training

• Tools: eg; FAQ

• Success can be as simple as - Form Completions

EXECUTE THE SOLUTION

• Hand out forms w/the samples.

• Consider whether patients can fill out the form themselves or get physicians to fill out the top of the form (the rep can even bring a filled out form to local pharmacies)

• Goal for the pharmacist - make it easy

• If the rep encounters an HCP that is experiencing call backs, then the Rep can tell the doctor which pharmacies accepted the form

• Consider other leverage points within the patient journey

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MULTI-FACTORIAL TARGETINGThe goal of targeting is to hit doctors where thereis the highest Rx potential. However, if the abandonment threshold is $X copay, and if most of a high prescribing physician's patients would pay over that threshold, then this doctor is actually not a great prospect.

PROGRAM ELEMENTS:• Mission data analyst

• Ascertains the copay threshold• Ascertains NRx volume and branded prescribing

and factors this into targeting if not alreadydone so. (RRx is not a great metric)

• Work with DMs and maybe reps using theirFTF data to assess optimal HCP call-plan

• Mission works internally to determine iforthopedic surgeons or other specialtiesare more advantageous targets


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2014 Next StepsJAN MAR APRIL MAY JUNE JULY AUG SEPT OCT NOV DECFEB

“PEARL OF THE WEEK” PODCAST

PODCAST

PODCAST

Gather Pearls

RESOURCE LIBRARY

Site launchInventory / Gap solutions

HOW WILL WE BE RELEVANT?

Rep Training Rep Training

L&L Tools L&L Tools

SAMPLING & PATIENT ED PROGRAM

Reference Guide

Development

CARELOOP

Roll-outTraining

MESSAGE PLATFORM

Development Test


[email protected] x105

[email protected] x128

13 misbin 0002 binosto presentation w summary

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