What separates them from the rest? I would not be able to comprehensively and categorically say I know what exactly differentiates them but I do know that they follow a few rules.
Rule 1.
Research your keywords. Qualify your traffic. You need to start off with a huge selection of keywords and slowly wither down to the most cost effective and relevant one. Say you promote widgets. You cannot just go biding on the keyword widgets as it is bound to have loads of competition. What you can do is expanding on it, drilling down going deeper. Buy blue and cheap widgets. You may not get loads of searches but you know that it is very targeted and it is cheap.
Rule 2.
If you are selling something, make sure you weed out those who are looking for free stuff. One way of doing this is to include a -free in your campaign so essentially all surfers searching for free + your keyword will not get to see your ad. Also you can include your price in your ad. True, it will reduce click through rate but you know that those who do click are more likely to convert.
Rule 3.
Include your keywords in your ad. Say you bid on the word big black hairy wig selling wigs....