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SALES, MARKETING, AND R&D TRENDS AFFECTING THE HEALTHCARE INDUSTRY
NestEggz Survey Suggests PATIENTS WHO SAVE ON PRESCRIPTIONS TAKE THEIR MEDICATION Almost 90% of cholesterol patients enrolled in NestEggz were found to take their medication daily, almost double the national average.NestEggz,a loyal ty and relationshipmarketing program for the phar maceutical industry, was created by Nuvisio Corp. The survey was conducted among a segment of the 600,000 NestEggz users who were prescribed a cholesterol medication during a fivemonth period. The results are in sharp contrast to the national aver age, which indicate that dropout rates for choles terollowering products are as high as 50% after three months, and approach 90% by the end of the first year. The survey also shows that 98% of NestEggz par ticipants requested follow up offers, citing price as a significant motivator. Sur vey results revealed that 26% of the participants were lapsed patients who were motivated by the NestEggz program to reengage in cholesterol therapy. Among these patients, 93% indicated that they had taken the medication at least 26 of the past 30 days. “Our survey findings validate the NestEggz con cept,”says Jason Eisner,VP of business development of Nuvisio. “The combination of education and sav ings packaged in an optin customer relationship program,does indeed motivate patients to stay on their prescribed medication and to stay healthy.” The NestEggz program works by motivating, educating, and supporting patients to stay on their prescribed medication.The program’s printathome coupons can be used at 55,000 retail pharmacies nationwide. Patients who optin to NestEggz may receive followup educational information, reminders,and offers from the sponsoring manufac turers, which may feature free trial samples,electron ic rebates,or hurdlerate programs (savings provided after a multiple of refills are filled). Pharmaceutical PACKAGING MARKET EXPECTEDTO GROW A report by Drug & Market Development Publi cations predicts that pharmaceutical companies will place more significance on the packaging of their products to effectively position them within the industry, remain competitive,and increase the viabil ity of the products. Key trends affecting packaging include:an aging population; focus on decreasing medication errors; increasing number of biological drugs; intensified competition and consolidation in the pharmaceuti cal industry; international harmonization and increased regulatory scrutiny; and changes in U.S. Medicare reimbursement. The complexity of packaging design is expected to increase throughout the decade due to new forces that are pressuring packagers for additional safety and compliance features; expanded regulato ry reporting and documentation;and costeffective ness. New enduser needs, legislation and regula tions, and the intensely competitive pharmaceutical industry environment have intensified the pressure. Later in the decade, as pharmaceutical companies begin to create personalized drugs for use by small er population segments, packag ing companies will be challenged to respond, perhaps by providing highly specialized packaging sys tems in smaller quantities. According to the report, the $15 billion worldwide pharma ceutical packaging industry has historically delivered slow growth. Throughout the decade, however, changes in the types of drugs and their concomitant packaging requirements will offer new opportunities for expansion. Opportunities will include con tainers and components made of new materials; coatings; packaging systems that improve compliance and reduce errors such as blis ter packs; total biological formulation/packaging solutions; and combined diagnostic/drug packag ing. Also expected is increasing consolidation to cre ate more global packaging companies that are capable of delivering both lowcost worldwide packaging as well as niche market drug packaging that will be needed for future pharmacogenomic generated biological products. Study Links PATIENTS’ INABILITY TO UNDERSTAND MEDICAL INFORMATION To Poor Health Outcomes More than 75% of patients, physicians, and phar macists say the inability to understand information about prescription medica tions contributes to poor health outcomes, according to survey results from Rop erASW.Onethird of patients and twothirds of physicians polled say they know of someone who has had health problems because they did not understand how to take a prescription medication correctly. This limited understanding, referred to as low health lit eracy,affects thehealthof90 million Americans and is estimated to cost the healthcare system tens of billions of dollars annually. THE COMPLEXITY OF PACKAGING DESIGN IS EXPECTEDTO INCREASE THROUGHOUTTHE DECADE DUETONEW FORCESTHATARE PRESSURING PACKAGERS FORADDITIONAL SAFETY AND COMPLIANCE FEATURES. “It is the responsibility of everyone involved in healthcare to offer medical information to patients in a way that is clear, understandable, and truly accessible,” says Dr. Barbara DeBuono. Among the elderly, 40% of patients taking cholesterol medications are nonadherent after three months, and 56% are nonadherent after six months — Journal of American Medical Asso ciation. 10% to 20% of initial prescriptions are never filled and 30% to 85% of patients do not get their refills. Noncompliance contributes to more than 125,000 deaths annually in the U.S. and 10% to 25% of hospital and nursing home admissions — Consumer Health Infor mation Corp. 22% of patients did not fill at least one pre scription during the previous year because of cost; 14% also reported taking a prescription drug in smaller doses, and 16% reported tak ing medication less frequently to save money — Harris Interactive. MEDICATION COMPLIANCE STATS PharmaVOICE PHARMA trax Results of the survey, conducted on behalf of Pfizer Inc., also show that twothirds of physicians and pharmacists regularly or occasionally encounter patients who don’t understand their prescription medication instructions. Nine of 10 physicians and pharmacists say most patients have had an experi ence in which they thought they understood instructions regarding prescription medication, but later had trouble remembering or knowing what they should do. “When it comes to medical information,one size doesn’t fit all,” says Dr. James Curran,from the Rollins School of Public Health of Emory University.“Medical language often comes across as jargon to the lay person.We need to continue to look for ways to pre sent health information in a way that is clear to the patient, relevant to his or her individual needs, and culturally sensitive.” Low health literacy can have an impact on any one, regardless of age, race, education, or income level. Patients who have difficulty understanding health information,however, are at a higher risk for poor health outcomes. Research shows these patients make more mistakes with their medicines and are less able to comply with treatment. Patients who have difficulty reading are at a 52% higher risk for hospitalization. “Our business is to develop innovative medicines,and we recognize our obligation to make information about those medicines and the diseases they treat easier for patients to understand,”says Bar bara DeBuono,M.D.,MPH, senior medical director of public health at Pfizer.“It is the responsibility of every one involved in healthcare to offer medical informa tion to patients in a way that is clear,understandable, and truly accessible.” Many patients feel intimidated or vulnerable in a medical setting often inhibiting their ability to admit they may not understand the information provided by their healthcare professionals. This may lead to patients’ lack of compliance with physician instruc tions or not seeking medical care altogether and, ultimately, negative health outcomes. In the RoperASW survey, 79% of patients polled say that “other people”have felt awkward communi cating their lack of understanding with medical pro fessionals, while only 14% of patients say they have felt awkward admitting that they did not under stand healthcare information.This “transfer of blame” may be a sign of the shame many patients feel in admitting that they need help with understanding healthcare information. Ultimately, if patients are able to increase their understanding of health information,experts believe that there will be many benefits including: better health outcomes, better provider/patient relation ships, improved preventive care, and cost savings to the healthcare system. The RoperASW telephone survey was commis sioned by Pfizer and is a representative sample of 666 patients, 150 primarycare physicians, and 151 pharmacists.Patients were defined as adults 18 years old or older taking a prescription medication and who had seen a physician in the past six months who had prescribed medication. AFRICANAMERICAN HEALTHCARE in the Spotlight The healthcare industry has been paying partic ular attention to the specialized healthcare needs of the AfricanAmerican population. One recent initia tive is a survey of AfricanAmerican views on DTC advertising. A survey has found that directtoconsumer ads empower AfricanAmerican patients by building awareness of medical conditions that impact them and by motivating them to seek medical treatment. The survey of AfricanAmerican patients and their views on DTC advertising of prescription drugs was partially funded by the Coshar Foundation and an unrestricted educational grant from Pfizer Inc.as part of an ongoing research effort into the physician/patient relationship. The patient survey was conducted by practicing AfricanAmerican physicians from across the U.S. and is based on more than 1,000 patient interviews con ducted in physician offices. Each physician was given a brief questionnaire about the role DTC may have played in the surveyed patient’s visit. ONLINE ADVERTISING SHOWNTO BE COST EFFECTIVE to Driving Incremental Sales for Prescription Drugs A case study conducted on behalf of a prescrip tion allergy drug brand has revealed that while televi sion was the biggest driver of incremental sales due to the mix of budget allocated to the medium, online advertising was the most costeffective advertising medium at driving incremental sales. The Media Mix Modeling Case Study, which was commissioned by DoubleClick Inc. and conducted by the research divi sion of Beyond Interactive, used econometric model ing to determine the relative impact that marketing activities have on incremental sales.Weekly marketing and sales data over five quarters for this major phar maceutical brand were examined. The model attributes 78% of the allergy drug prescriptions to baseline sales and seasonality. The incremental 22% is attributed to marketing activity, comprised of television (12%), detailing or calls on doctors (6%), print (3%), and online (1%). The model revealed that print advertising was almost twice as effective as television in driving incre mental sales for this allergy drug, while online adver tising was more than three times moreeffective than television at driving incremental sales. In examining the relative responsiveness of each medium, televi sion makes up 85% of total impressions, yet drives 73% of mediadriven prescriptions, whereas online advertising accounts for only 3%of total impressions, yet drives 7% of mediadriven prescriptions. Print and online advertising also were more cost effective than television advertising for this allergy drug. Despite higher cost per thousand impressions than either television or print, due to the targeted media purchased, online was more efficient at driv ing incremental prescriptions. The relative cost per incremental prescription generated from television advertising was almost 30% higher than print and 50% higher than online. Print advertising was almost 20% higher than online on a relative cost per incre mental prescription. Media mix modeling enables companies to sim ulate the impact of alternate marketing allocation scenarios.Using the model developed for this allergy drug, if the television budget was decreased by 3.1% andonline was increased by 50%,with the samedol lar total,prescriptions would have increased by 0.1% over the five quarters analyzed. CRMTOOLS Cultivate LongTerm Relationships In light of challenges facing the pharmaceutical industry, a new report from Cutting Edge Informa tion has found that forwardthinking executives are forging a new path toward continued growth by maximizing each customer’s lifetime value to a com pany. This thinking deemphasizes pharma’s tradi tional product focus in favor of longterm relation ships with the industry’s customers — and extends the role of marketing past initial brand recognition and customer acquisition to one that drives ongoing customer dialog, conversion, and retention. According to the report, Lifetime CustomerValue in the Pharmaceutical Industry,Webbased tools that enable direct patient communication encourage pharma companies to build longterm,lucrative rela tionships with consumers. 58% of physicians discuss specific medication with their patients, yet only 29% prescribe the requested medication 50% of patients seek additional health information because of DTC ads 48% of patients reported DTC ads help them make better decisions and/or keep them more informed about their health 23% of patients state they are more likely to take the prescription if they see or hear it advertised 6% of patients make appointments with their physicians after seeing or hearing DTC ads SURVEY OF AFRICANAMERICAN PATIENTS REVEALS DTCWORKS PHARMA trax PharmaVOICE Metrics and business practices from companies such as Pfizer,Merck,Aventis,GlaxoSmithKline,Bristol Myers Squibb, Novartis, and Eli Lilly & Co., were gath ered to form this report.The companies were found to employ disease management programs,ehealth tools, and emerging CRM technologies to drive brand awareness and encourage compliance. Five principles uncovered in the study include: build customer relationships through diseaseman agement programs;cultivate relationships with non patient customers via healthmanagement tools and educational resources;provide medical resources to develop nonsales relationships with physicians;build customerfocused corporate culture; and launch and measure lifetime customer value capabilities. The report also found that diseasemanagement programs position companies to learn more about patients, drive compliance, and ultimately build longterm consumer relationships. “In the threeyear period ending in 2001, cus tomer management spending increased by more than 200% across all industries,” says Jason Richard son,president of Cutting Edge Information.“To max imize each customer’s lifetime value, pharma com panies refocus their corporate priorities. Industry leaders now exchange productfirst thinking for cus tomerfocused thinking — on strategic, cultural,and tactical levels.” NEEDTO SHARE PATIENT DATA Spurs Implementation of Electronic Health Records Motivations for implementing electronic health records have risen substantially in the past four years, according to a study compiled by Medical Records Institute and sponsored by Snomed International. The need to share patient data was cited by 75% of those surveyed as the primary management/ administrative motivating factor, and by 90% of respondents as the top clinical motivating factor for implementing electronic health records. Improving patient care and safety, reducing costs, and meeting legal/regulatory requirements also were key motiva tors for electronic health records adoption. “The driving forces to implement electronic health records have shown broad and steady growth over the last four years as healthcare providers seek to integrate clinical viewpoints and facilitate the sharing of patient data,”says Jeff Blair,VP of Medical Records Institute.“As a result,providers are turning to more advanced clinical applications and services in their search for the right electronic health record solution.” The fourth annual survey of electronic health record trends and usage also found that electronic health record applications with the greatest oppor tunity for growth are physician order entry forms with clinical decision sup port, clinical data reposito ries that also support clinical codes, and clinical data repositories that also sup port clinical images. The number of respondents using basic repository capa bilities of storing data, text, and reimbursement codes is projected to grow from 37% to 67% during the next four years. The survey analyzes responses from 761 health care providers in three major categories — IT man agers and analysts, physicians and nurses, and nonIT management. More than half the respondents work in hospitals,with the remain ing employed in ambulatory settings and integrated healthdelivery service orga nizations; 90% of respon dents have some role in the electronic health record decisionmaking process. Additional key findings include strong growth pro jections for Webbased electronic health record applications and email services, as well as mobile applications and a major shift in growth opportuni ties in mobile health solutions, with order entry replacing Internet access as the most widely used application. COSHAR MEDICAL INC., Lanhama, Md., is a multispecialty medical group dedicated to providing primary care to its patients and the community it serves.The research arm conducts medical research outside of the traditional academic setting and in partnership with other similar practices around the country. For more information, visit cosharmedical.com. CUTTING EDGE INFORMATION,Durham, N.C., is a business intelligence firm providing primary and secondary research reports on a wide range of business subjects. For more information,visit cuttingedgeinfo.com. DOUBLECLICK INC.,NewYork, is a provider of tools for advertisers, direct marketers,and Web publishers to plan, execute,and analyze their marketing programs.For more information,visit doubleclick.net. DRUG&MARKETDEVELOPMENT PUBLICATIONS,Westborough,Mass.,is part of Informa Group Plc. and publishes D&MDNewsletter and Bioprocess News, in addition to its line of D&MD Reports. For more information,visit drugandmarket.com. MEDICAL RECORDS INSTITUTE,Newton, Mass., is committed to promoting the development and acceptance of electronic healthcare,and has pursued this mission on a national and internation al basis by hosting educational programs. For more information,visit medrecinst.com. NUVISIO CORP.,New York,enables companies to use the Internet to effectively advertise and promote their brands through proprietary technology that provides marketers with powerful tools to motivate consumer behavior, drive product trial and loyalty, and generate incremental sales. For more information,visit nuvisio.com. PFIZER INC., NewYork,discovers, develops, manufactures, and markets leading prescription medicines for humans and animals as well as consumer brands.For more information,visit pfizer.com. ROPERASW,NewYork,delivers timely, insightful market intelligence to optimize every aspect of a company’s performance. RoperASW is part of NOPWorld,a global group of highgrowth marketing intelligence leaders. For more information, visit roperasw.com. SNOMED INTERNATIONAL,Northfield, Ill., a division of the College of American Pathologists, is committed to the excellence of patient care through the development of a scientifically validated reference terminology that enables clinicians, researchers,and patients to share common concepts worldwide,across clinical specialties and sites of care. For more information, visit snomed.org. Follow up 75% say it is primary manage ment/administrative motivating fac tor. 90% of respondents state it to be top clinical motivating factor for imple menting electronic health records. THE NEEDTO SHAREPATIENTDATA