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Assessing and Predicting Patient Behavior to Maximize Direct-to-Consumer Effectiveness Direct-to-consumer advertising has been demonstrated to be effective in bringing diagnosed patients into doctors’ offices but less so in driving undiagnosed patients to see their physicians. This represents an untapped opportunity for pharmaceutical marketers — if they can figure out how to motivate this patient segment. Understanding patient behavior, and the attitudes that drive it, is becoming increasingly important to pharmaceutical marketers. View on Patient Behavior In an exclusive to PharmaVOICE, Market Measures/Cozint’s Suzanne Ramspacher, senior VP, and Alan Steinberg, senior research director, discuss why pharmaceutical marketers need to better understand the consumers who do — and don’t — respond to DTC advertising. Alan Steinberg Those who tend to respond to DTC ads have a medical basis for doing so; they are more likely to have condition-related and treatment-related concerns. That is no surprise. They have greater sensitivity to their condition. Suzanne Ramspacher There is definitely an opportunity to to first better understand what the differences are in terms of motivational factors between the undiagnosed and the diagnosed audiences as well as between the DTC nonresponder versus the responder audience. While the lion’s share of pharmaceutical brand management and marketing-research budgets have historically been, and still are, allocated to physician programs, expenditures, and attention spent on promoting to, understanding, and impacting patient behavior are clearly on the rise. Last year alone, pharmaceutical companies spent more than $2.6 billion on programs designed to reach and influence the critical patient audience, according to Competitive Media Reporting. Clearly, the pharmaceutical community widely acknowledges and accepts the central role patients now play in the healthcare-decision process. Direct-to-consumer advertising has been demonstrated to be effective in creating awareness of drugs and disorders within the consumer population and in driving patients into physicians’ offices to seek diagnosis and treatment. Doctor contact rates resulting from DTC exposure increased to 22% last year, up from 18%, according to Market Measures/Cozint’s DTC Monitor 2002. To date, however, DTC advertising has been less effective in driving undiagnosed patients into doctors’ offices. In many of the high incidence, chronic disease categories, it is estimated that about half of sufferers remain undiagnosed and untreated. These patients represent a tremendous untapped opportunity for pharmaceutical manufacturers. “There is definitely an opportunity to first better understand what the differences are in terms of motivational factors between the undiagnosed and the diagnosed audience as well as between the DTC nonresponder versus the responder audience,” Ms. Ramspacher says. “Once we have a better understanding of those differences, then pharmaceutical companies can craft specific, targeted messages to motivate and affect behavior of those different audiences.” To turn undiagnosed, untreated consumers into diagnosed and treated patients, pharmaceutical marketers need to identify the motivational factors that drive patient behavior. Marketers need to understand consumers on a personal, emotional, and behavioral basis to create value-based messages that effectively demonstrate patient outcomes and benefits. “It’s been a long-standing challenge not only to the pharmaceutical industry but also to the healthcare industry to motivate those who know they’re suffering from some illness to see a physician for treatment,” Mr. Steinberg says. “This is a challenge that goes beyond DTC. Pharmaceutical marketers have to have a better understanding of patient attitudinal and behavioral factors to address whatever might be impeding this patient segment to seek treatment.” Ultimately, the goal is to create targeted, disease-specific claims and messages that resonate with consumers and patients. To do that, pharmaceutical marketers must understand the drivers behind patient behavior, including: • What motivates some consumers to seek treatment? What factors dissuade others? • How are consumers who respond to DTC ads attitudinally and behaviorally different from nonresponders? • What are the drivers and what are the barriers to DTC response? Research by Mr. Steinberg and Ms. Ramspacher has attempted to answer such questions. “The research that we’ve done in this area spans a number of different conditions and we were looking for general relationships between those who are likely to respond to a DTC ad versus those who do not respond to a consumer ad,” Mr. Steinberg says. “This information can be translated into effective messages for a category-specific audience. Marketers can delve into the issues or potential barriers that surround that particular category, whether it be high cholesterol, osteoporosis, or migraine.” Consumer Awareness Increases “Over the course of our research, we have seen a steady increase in consumer awareness of DTC ads, with 75% of consumers surveyed now aware of DTC advertising,” Mr. Steinberg says. This increase in awareness can, to a certain extent, be attributed to DTC marketers becoming more adept at creating ads that effectively communicate information and catch consumers’ attention. It is probably also due to cumulative exposure and the increased concentration of spending — more dollars behind fewer products. Mr. Steinberg and Ms. Ramspacher dug deeper into Market Measures/Cozint’s DTC research to assess consumers’ perceptions of ads, their treatment characteristics, and their health attitudes and orientation so that marketers can make further improvements to ensure that the best consumer segments are being targeted and communicated to with the most effective messages. Mr. Steinberg and Ms. Ramspacher found that among various patient segments there are response predictors to DTC related to contacting a doctor, including consumer perceptions/reactions to DTC ads’ believability and informativeness. The two also evaluated consumers in relation to their health attitudes and orientation, emotional and behavioral characteristics, information-seeking behavior and degree of knowledge about a condition, and treatment and condition-related characteristics. Their findings are based on in-depth telephone interviews with more than 6,000 self-reported sufferers across more than 25 conditions from DTC Monitor 2002 and the Response Drivers Study, both of which are Market Measures/Cozint products. The study covers virtually every print and broadcast ad aimed at the consumer audience. “Certainly we’ve found some differences between those who respond to DTC ads — visit a doctor — and those who don’t respond,” Mr. Steinberg says. “Those who tend to respond to DTC ads have a medical basis for doing so; they are more likely to have condition-related and treatment-related concerns. That is no surprise. They have greater sensitivity to their condition, more difficulty in controlling their symptoms, and report that they are less satisfied with their medication.” He says responders differ from nonresponders on key health-related behaviors, their attitudes, and health orientation. “For example, responders express a vulnerability and anxiety about their health more so than nonresponders,” he says. “We found that to be an important discovery.” Mr. Steinberg says when it comes to DTC ads that speak to a health condition and specific prescription product, consumers are more likely to inquire about a particular brand. DTC responders’ health orientation lends itself to DTC ad discussions. They are more likely to feel vulnerable about their health, are comfortable telling their doctors which treatments they want to try, and rate themselves as being less healthy. Responders also tend to worry more about their health than their non-responder counterparts. In addition, responders are more likely to characterize their conditions as moderate or severe, and they indicate that their problem is somewhat controlled, poorly controlled, or not controlled at all. They experience more health-related vulnerability and anxiety, and these feelings serve as motivators rather than barriers for DTC response. Responders are less resilient when it comes to illness and health-related setbacks, and their conditions are more likely to interfere with their everyday lives. They make more visits to the doctor and assume a “take charge” approach to their healthcare. They perceive themselves as being able to influence their physicians’ decisions regarding their healthcare. Although they tend to be taking prescription medication already, they are less than satisfied with their current therapy. Nonresponders, on the other hand, are more likely to characterize their conditions as mild and either completely or well controlled. They make fewer doctor visits and actually try to avoid seeing the doctor unless they are very sick. They tend not to take prescription medication, but those who do are satisfied with their current treatment and prefer to stick with familiar remedies. Providing New Information is Key Among the factors Mr. Steinberg and Ms. Ramspacher analyzed to understand consumers’ perceptions were ad “likeability,” ad “believability,” and the extent to which ads provided new information. They looked at each factor individually to determine the variation in scores across therapeutic categories and then compared them with each other. “Our analysis reveals some interesting findings to help marketers in creating more effective ads,” Mr. Steinberg says. “On average, 36% of consumers liked (liked very much or liked somewhat) the ads they saw or heard. On a therapeutic category basis, likeability scores ranged from a high of 51% for the chemotherapy supportive-care category to a low of 25% for the migraine category.” More important than the number of consumers who liked the ads, however, are the number who rated the ads as neutral. “We found, essentially, that consumers disliking DTC ads is not an issue,” Ms. Ramspacher says. “Only 5% said they disliked DTC ads. But the highest percentage of consumers, 53%, rated the ads as neutral. Consumers who rate ads as neutral tend not to take action based upon them. This implies there is an opportunity to shift a greater number into the like category.” The second measure they looked at, ad believability, shows substantially higher marks than likeability. The all-condition average, at 84%, bodes well for consumers’ perceptions of ad credibility. Clearly, the vast majority of consumers trust the information pharmaceutical companies are conveying in DTC ads. When they looked at the third measure of consumer perceptions — the extent to which ads provided new information — they found that only 27% of respondents across all categories think DTC ads provide new information. The analysts then evaluated which of the three factors has the greatest influence on motivating a consumer to contact his or her physician as a result of DTC ad exposure. Their results show that providing new information has the greatest impact on motivating consumers to contact their doctors. Respondents who said ads provided them with new information about treating their conditions were significantly more likely than those who did not to contact their doctors (39% vs. 16%). “What we have found consistently — across a number of years through the DTC Monitor and across all conditions — is that new information seems to motivate consumers to seek additional information about a particular brand or available treatment for their condition,” Mr. Steinberg says. The benefit of motivating consumers to contact their physician is significant. Of those who contact their physicians and request a specific medication, 71% receive a prescription. More importantly, the prescription they receive tends to be for the advertised brand they discussed. “This finding is even more significant when considering that patients are more compliant when they receive a drug they requested themselves,” Ms. Ramspacher says. “So, it’s in everyone’s best interest to motivate consumers to seek treatment.” More Effective DTC Campaigns To strengthen patient interest and motivate/modify behavior, pharmaceutical marketers must begin to better understand — and take action based upon — factors that differentiate consumers who respond to DTC advertising from those who do not. By doing so, they will be able to craft more effective and more targeted advertising strategies. Marketers also will benefit from developing a deeper understanding of undiagnosed, untreated sufferers, who tend not to respond to DTC ads. Identifying what does motivate this group will aid in developing advertising strategies specifically designed to break down barriers to care, promote appropriate doctor visits, and initiate brand discussions. Crafting messages that resonate with specific consumer segments — rather than simply sending mass broadcast messages — should help pharmaceutical marketers achieve their objectives: to motivate patients to seek specific treatment and improve ROI on DTC spend. PharmaVoice welcomes comments about this article. E-mail us at email@example.com. October 2003