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Year in Preview
Communicating with Patients
Opportunities abound for marketers who begin to embrace a new paradigm with patient-directed communications. The biggest breakthrough opportunity in healthcare could very well be in the realm of communications, says Matt Giegerich, president and CEO of CommonHealth. “With health awareness, disease diagnosis, therapy compliance, and persistency still at alarming lows, there remains much to be done to turn audience insights into meaningful and enduring behavior changes,” he says. “The challenges the communications industry faces are small in relation to this opportunity, but we need visionary champions and bold chargers — on both sides — to elevate the differentiating power of communications in an increasingly pressurized and procured environment.” Typically, the larger the problem, the greater the opportunity, says Matt Coe, VP at PharmaDesign Inc. For Mr. Coe, one of the most troubling issues is the noncompliance crisis, which adds huge costs to the healthcare system. “The biggest challenge is to get pharmaceutical companies to view compliance marketing not as an expense but as an investment,” he says. “Often we are dealing with corporate purchasing departments that are more concerned with cutting costs than getting a return on their investment. It is our job to demonstrate that just a small shift in this area will result in a large improvement to a company’s bottom line.” Kathleen Case, executive VP of Columbia MedCom Group, believes pharmaceutical companies have a tremendous opportunity to use their consumer marketing funds, combined with the creative expertise of their agency partners, to motivate consumers to take charge of their health and seek solutions to their conditions by focusing on health and vitality instead of encouraging consumers to demand specific drugs from their physicians. This opportunity also extends to improving health literacy and raising the cultural awareness of healthcare providers. “The next generation of patient-directed communications should be more about raising awareness about specific medical conditions, the importance of seeking diagnosis, and the benefits of treatment and less about persuading patients that a particular product is the best,” she says. To DTC or Not to DTC Controversy surrounding the effectiveness and purpose of DTC advertising continues to wage despite recent guidelines, cutbacks in spending, and enhanced compliance. A MedPanel Inc. survey found that, among a group of 1,360 physicians surveyed, 80% favor a moratorium on DTC advertising for new drug therapies. The survey demonstrates that practicing physicians concur with the Institute of Medicine and the American Medical Association on the issue. “The crux of the DTC advertising debate comes down to preserving the balance and inviolability of patient-physician relationships,” says Will Febbo, CEO of MedPanel. “We think it’s important to give individual physicians the opportunity to weigh in on the matter.” Three clear themes emerged in the responses to the MedPanel survey. Physicians who favor a moratorium tended to cite the benefit of additional time to become familiar with a drug through experience and/or scientific data before patients are influenced by advertising. The next most frequently cited reasons were the desire to maintain control of the physician-patient relationship without interference from advertising and a lack of trust in pharmaceutical companies. According to Mr. Febbo, of the 20% who oppose a moratorium, the reasons most commonly cited were the beneficial nature of, and right to, healthcare information. These respondents believe that consumer drug advertising educates patients and encourages them to seek treatment, as well as forces physicians to stay up to date with new treatment options. At the same time, a study led by the Medical University of South Carolina (MUSC) that looked at DTC for COX-2 inhibitor drugs supports the theory that DTC advertising encourages patients to seek medical care. “One conclusion we drew is that DTC may not be the universally pernicious practice that people are worried it is,” says W. David Bradford, Ph.D., director of MUSC’s Center for Health Economic and Policy Studies and lead author of the study. “DTC does get patients to their doctors and, once there, we saw mixed results in prescribing.” Dr. Bradford’s team reported on two drugs, Merck’s Vioxx and Pfizer’s Celebrex, in a study that sought to determine whether pharmaceutical companies can influence physician and patient decisions about adopting pharmaceutical therapy. Researchers analyzed monthly clinical information from 57 primary-care practices during the 2000 to 2002 period, matched to monthly brand-specific advertising data for local and network television. “We found that for both Vioxx and Celebrex, DTC tended to increase visits by patients with osteoarthritis to their physicians,” Dr. Bradford says. “Once the patients got to the doctor’s office, advertising was not the biggest factor affecting prescribing.” As the DTC advertising debate wages on, pharmaceutical marketers are looking to make the shift from traditional to more innovative tactics, says Richard Pascoe, VP and chief commercial officer at Ariad Pharmaceuticals Inc. This shift is being driven by the need to offset patent expirations on major brands, slow-moving development pipelines, and margin compression. “These factors will underscore the industry’s realization that it must change the game to succeed,” he says. “I believe brand teams will begin investing more in meaningful patient interactions and less on traditional DTC advertising. I also see an emerging trend in primary care where the role of the field representative is being reexamined and redefined. The successful brand manager will continue to evaluate the use of technology in lieu of headcount to increase their brand’s share of voice, as well as its profitability.” Capitalizing on Opportunities According to Rick Rhyner, president of Rhycom, the greatest opportunity lies in the ability to develop brands that transcend the product or service category and represent value in customers’ minds. “Achieving this goal has many challenges: increasing advertising messages, media fragmentation, and emerging nontraditional media such as blogs, RSS, and Web-banner advertising,” Mr. Rhyner says. “These factors make it more difficult to communicate a consistent and congruent brand message to the audience.” But he says it’s important to track ROI, whether through qualitative means, such as RFPs (requests and conversions); customer satisfaction surveys; revenue and profitability; customer response by tactics; or Website tracking. According to Cutting Edge Information, in the first year a new pharmaceutical product is available, a company may spend anywhere from $1 million to $50 million on marketing. And according to the company’s analysts, often the variability in the spend depends on the potential sales of the product. Cutting Edge examined marketing budgets for nine drug brands in their first, second, and third years on the market. The data show that companies spend more on larger products than drugs with modest revenue goals. The spending on potential blockbusters, for example, was more than $150 million over the three-year span. The spending on smaller niche products, however, was less than $30 million. According to the study’s lead author, Eric Bolesh, such trends are not surprising. “Everyone expects a larger brand to spend big bucks,” Mr. Bolesh says. “The important thing is to understand the underlying factors that contribute to each product’s budgeting. Teams allocate their dollars in very different ways.” One first-in-class brand, for example, allocated 24% of its promotional budget to advertising in medical journals and another 40% to medical education as a way to teach the market about its new product. On the other hand, another brand team dedicated 64% of its budget to sampling, since it knew it had to get samples of the drug into the hands of doctors and patients if it wanted to drive sales. PharmaVOICE welcomes comments. E-mail us at firstname.lastname@example.org. I believe that the next generation of patient-directed communications will be less about persuading patients that a particular product is the “best” and more about raising awareness about specific medical conditions, the importance of seeking diagnosis, and the benefits of treatment. Kathleen Case Columbia MedCom Group One conclusion we drew is that DTC may not be the universally pernicious practice that people are worried it is. Dr. W. David Bradford Medical University of South Carolina’s Center for Health Economic and Policy Studies The greatest opportunity lies in the ability to develop brands that transcend the product or service category and represent value in the customers’ minds. Rick Rhyner Rhycom Strategic Advertising I believe pharmaceutical company brand teams will begin investing more in meaningful interactions and less on traditional DTC advertising. Richard Pascoe Ariad Pharmaceuticals The biggest challenge is to get our clients to view compliance marketing not as an expense but as an investment. Matt Coe PharmaDesign Outlook: Patient Communication Trends and Opportunities PharmaVOICE asked experts involved in healthcare marketing and advertising to evaluate the current state of promotion and Predict what they believe will be the biggest trends in the near future. Kathleen Case Columbia MedCom In the sector of promotional education, I envision the biggest challenge to be relevance. Several forward-thinking pharmaceutical companies are already exploring the value proposition of using the promotional environment to provide educational opportunities that are less focused on product specifics and more focused on physician-to-patient dialogue and health-literacy issues. Healthcare providers have clearly communicated that the traditional dinner program with product-focused content is no longer appealing. Matt Coe PharmaDesign Drug companies need to be able to better identify the appropriate consumers for their products. There is a 50% chance that the prescription will not be taken correctly and an 85% chance that the prescription will not be refilled. This is often due to a lack of understanding of what the medication does and the reason the medication needs to be taken. Matt Giegerich CommonHealth We are organizing the full network of our creative talent around the principles of “reality-based marketing,” which is a unique approach that highlights real brand drivers across patient, provider, and payer dynamics. We are approaching all assignments from an integrated, idea-centric, and media-neutral perspective. Also, we are leveraging technology and the basic tenets of permission-based marketing across all audiences. Richard Pascoe Ariad Pharmaceuticals Compliance management will continue to impact sales and marketing in 2007. The industry has moved beyond the days when simply following the OIG and PDMA guidelines constituted a compliance program. Compliance programs must be embedded in commercial operating plans at every level and must include the proper training, internal controls, and management oversight to satisfy the growing number of regulatory requirements being placed upon commercial organizations. Rick Rhyner Rhycom We view marketing from a 360-degree perspective; we analyze all customer touch points, and we develop strategies that most effectively meet the pharmaceutical companies’ needs. To optimize efficiency, we strive to align clients’ advertising with measurable long- and short-term strategic goals. The biggest breakthrough opportunity in healthcare could very well be in the realm of communications. Matt Giegerich, CommonHealth To access a FREE Podcast on this topic, featuring Richard Pascoe, go to pharmavoice.com/podcasts. Eric Bolesh. Research Team Leader, Cutting Edge Information, Durham, N.C.; Cutting Edge Information’s mission is to provide innovative, implementable research and consulting to the pharmaceutical, biotechnology, and devices industries. For more information, visit cuttingedgeinfo.com. W. David Bradford, Ph.D. Director, The Center for Health Economic and Policy Studies, the Medical University of South Carolina, Charleston, S.C.; The Center for Health Economic and Policy Studies has extensive experience in designing and implementing cost benefit and other health economic and policy analyses. For more information, visit musc.edu/cheps. Kathleen Case. Executive VP, Columbia MedCom Group, Columbia, Md.; Columbia MedCom Group is one of the largest independent medical communications networks and the only employee-owned medical communications firm in the country. For more information, visit columbiamedcomgroup.com. Matt Coe. VP, PharmaDesign Inc., Warren, N.J.; PharmaDesign designs and manufactures compliance aids and compliance packaging for the pharmaceutical industry. For more information, visit pharmadesign.com. Will Febbo. CEO and Cofounder, MedPanel Inc., Cambridge, Mass.; MedPanel offers an online research platform providing clients greater strategic direction for healthcare and medical investment decisions, product development, and marketing. For more information, visit medpanel.com. Matt Giegerich. CEO and President, CommonHealth, Parsippany, N.J.; CommonHealth is a leading healthcare communications resource and a WPP Group company. For more information, visit commonhealth.com. Richard W. Pascoe. VP and Chief Commercial Officer, Ariad Pharmaceuticals Inc., Cambridge, Mass.; Ariad is developing medicines that regulate cell-signaling pathways implicated in cancer. For more information, visit ariad.com. Rick Rhyner. President, Rhycom Strategic Advertising, Overland Park, Kan.; Rhycom is a full-service, integrated marketing communications agency. For more information, visit rhycom.com.