Oct14

Learning From a Physician First Hand

Kareem Blog ImageMy name is Kareem Royes and I just completed my first year in medical school. I’ve had the opportunity to return to OCHWW Planning this past summer. Over the past year, I have worked very closely with different physicians in the hospital setting, which has allowed me to gather some new insights that I am happy to share about one of OCHWW’s biggest customers, the healthcare professional (HCP). These insights can drive tactics that will not only improve our customers’ experience, but also maximize our clients’ ROI.

Insight 1: Physicians have an inherent distrust of sale reps

One key insight medical planners and marketers frequently do not consider is that physicians have distrust for the information provided to them by drug sales reps. HCPs do not think sales reps have the medical education and years of clinical practice to tell them how to use a drug. Physicians almost unanimously prefer to obtain information from other physicians who are experts and researchers in the therapeutic area of interest. As such, there is a tremendous opportunity to improve our clients’ penetration into these practices by leveraging more physician experts, also known as “thought leaders” or “key opinion leaders,” to provide detail through webinars to physicians who are not open to speaking with sales reps.

Insight 2: The whole is more important than the individual part

We are currently in the era of using apps to enhance our day-to-day experience and interactions. This is no different for HCPs, most of whom also use smart devices. In tactical planning, we often pitch ideas around creating apps that educate physicians about a drug, or a disease, or help them follow up with care for a patient with only one disease. The flip side to this is that on average, each physician will have 2,000 patients in his or her practice and will treat over a 100 diseases. Therefore, our challenge is to convince physicians that using an app that is niched to provide care for only one disease or patient will add value to their experience. Again there is a tremendous opportunity for agencies to work with their clients to create apps that provide a more holistic experience for the physician. Physicians are more likely to engage and frequently use an app if it will cover multiple therapeutic areas and drugs, or can accommodate a significant portion of the patients in their practice.

Insights 3: Always vow to do no harm

The healthcare industry is currently transitioning to the use of electronic medical records (EMRs). The ultimate goal is to increase proper recordkeeping, increase the efficiency of the healthcare system, and facilitate physicians’ communicating better within different specialties when caring for patients. One of the frequent asks we get from our clients is, how can we penetrate EMRs to keep our products top of mind for physicians? Well there is no simple answer to this question. The technology is relatively new but it has a lot of potential to keep our clients’ brands top of mind. Opportunities exist to provide “pop-up” alerts about a drug when certain information is entered into the EMR. This can certainly help keep our clients’ drugs top of mind when a physician is filling out a patient’s chart. However, because physicians sometimes consider EMRs to be burdensome to their practice, agencies’ penetration into this space should be seamless, without adding any burden to physician practices.

Recently I was able to integrate these findings into the brand plan for a drug in the oncology space. Our client tasked us with developing three big ideas that would drive their business, considering a strong competitive landscape with increases in the barriers to accessing physicians. To address this, we proposed:

  1. Physician expert videos that could be leveraged on the drug website and on a YouTube channel where physicians could learn from experts about the drug. This allows physicians to hear from experts on their own time without adding significant burden to their workday.
  2. Leveraging EMR alerts to inform drug sales rep when a doctor has a new patient. This allows reps to detail physicians about drugs when it is immediately relevant in practices that are amenable to rep visits.
  3. And finally, to help differentiate the drug from its competitor, we proposed an unbranded platform which leverages the use of an app to provide all the relevant information about treating the cancer and all the drugs available for this cancer. This provides a more robust app that physicians are more likely to engage with and use repeatedly.

Overall our ideas were well received, and we are currently in the processing of fine-tuning the ideas to determine feasibility for next year. Stay tuned!

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May20

Bringing Sexy Back…to Science

disease managementThank God for The Big Bang Theory. They’ve made it cool to be a nerd again.

While traditional brand attributes (efficacy, safety, dosing, etc) will always be of key importance, the last few years have seen a renaissance of scientific enlightenment as physicians across disciplines take a closer look at not only how well a drug works, but why it works.

With the advent of new targeted agents in oncology and virology, mechanism of action quickly went from a dirty little secret buried in the PI to front page news. There are now numerous products that have built their entire value proposition on mechanism of action.

In oncology in particular, where clinical improvement between new and old drugs is often measured in teaspoons, the science behind the brand can often stand as a key differentiator. Avastin—one of the most successful drugs in oncology—created a simple scientific rationale for its use: stop cancer cells from creating new blood vessels and “starve the tumor.” With three simple words they took a complex process of tumor growth and development and created a unique opportunity in oncology that they have effectively owned since its launch in 2004.

Science Sells

The ongoing race toward “scientific innovation” is redefining how we market specialty brands.

  • Have a good pick-up line: In specialty marketing an entirely new nomenclature has spawned, significantly impacting our ability to change physicians’ perceptions of our brand. Simple terms to describe the science have now become synonymous with clinical attributes we could otherwise never say in a branded way. “Targeted” or “selective” now means safe and well-tolerated, “multi-functional” equals efficacious. Understanding how one simple word can affect how physicians view your brand is now key, requiring comprehensive research and knowledge of the market.
  • Be yourself and if that doesn’t work be someone better: No longer content to be classified under traditional terms, products have been using science to create entire “new” drug classes. Avastin rebranded themselves from a VEGF inhibitor to an “anti-angiogenic,” and DDP-4 was redefined as an “incretin degradation inhibitor” in type 2 diabetes.
  • Dress to impress: Where once MOA materials were simply required to be informative, now visually dynamic and digitally distinct tactical initiatives have quickly become a cost of entry for products seeking to separate themselves from the competition.

And while I can say with absolute certainty that an in-depth knowledge of molecular drivers of cancer will not help you talk to girls at parties, understanding the science behind the brands and their competitors is now crucial to opening up new doors for creative exploration, messaging and differentiation in specialty marketing.

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Also posted in behavior change, Content Strategy, copywriting, Creativity, Data, Efficacy, Healthcare Communications, Learning, Marketing, Medicine, Pharmaceutical, positioning, Science, Strategy | Tagged , , , , , | 1 Response
Mar27

What the WWE Taught Me About Persona Development

I grew up watching WWF (now WWE) wrestling. Every Saturday morning I would rush through my morning breakfast with excitement to see all of my larger-than-life heroes. The sights of Hulk Hogan, “Macho Man” Randy Savage, The Ultimate Warrior, and Ricky “The Dragon” Steamboat enthralled me to a point where I was lost in appearance and personality.

Years later the characters are still there—I’m still a fan, and the audience of young kids appears to be stronger than ever. But how did the WWE keep me interested for the last 20 years? I take this thought and apply it to one of my everyday on-the-job questions: why do our targets—doctors—stop engaging with us after years of product loyalty, and what can we do about it?

With the WWE, it started with there being a 1-900 number that I called. I was overly excited as a kid to dial that number and think that Hulk Hogan was actually talking to me. The data/marketing method of the 1-900 number was very simple: associate numeric to selections on your phone to what you prefer and continue marketing to the contact in the way they want to be marketed to.

For example:  the 1-900 number asked me my age group, I choose #1 for 10-15 years old (type of message to give me); for favorite wrestler, I choose #3 for Hulk Hogan (message specific to my needs); and for the key question—if I would allow them to follow up with me via phone with updates—I choose #1 for yes (continued CRM communication).

Just like that, the 1-900 number captured all my information and knew exactly how to speak to me. To the present day, the WWE still sends me information. The below text is a screen shot of my present day phone and is proof that they remember me and my likes. This was a text sent to me just this past Sunday:

AngeloCampano_WWE
They still know I like the Hulk and they know what appeals to the 30-something me.

Clearly they created a digital persona of me and through all the years of technology used what they learned from me 20 years ago to keep my interests (especially the Hulkster).

The hypothesis that is commonly thought of is that we tend to try looking at our targets in the same way, capture what they like and what they know. We as pharma marketers spend a lot of time chasing the doctor when the doctor doesn’t respond to messages we give him or her.

Looking at a standard CRM program (delivered through multi-channel), those who spend some time targeting the office staff for the first communication have 52% more success reaching the doctor in the second and third communication than those who don’t. Much like the WWE did, we need to take the time to understand our audience, who is REALLY making us money, and how.

As marketing continues to evolve, so do the exercises marketers have been doing for decades. Persona development is not exempt from this trend. Traditional persona development is still a powerful tool for marketers to use. However, targeting these personas with traditional means will prove less and less effective and profitable over time. In order to create and leverage digital persona profiles, marketers must rely on technology to both capture Big Data and use it effectively. The goal of which is to get as close to one-to-one marketing as possible by delivering the right content to the correct person at the best time with the channel they prefer.

As a result, tracking and understanding a person’s digital qualities, digital movement, click data, sales funnel and preferences are important considerations for effectively identifying and building outlying digital personas. The WWE was way ahead of its time for this process.

Marketers who can best leverage digital persona development, content personalization, context marketing and Big Data will be best suited to thrive in the near future. The newer the generation, the greater the expectation is for one-on-one marketing. We can all learn a thing or two from the WWE; their model works and isn’t hard to duplicate (we have already come close to mastering it).

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Mar25

SXSW 2014: True Potential of Social Media in Healthcare Is Still Ahead of Us

sxsw logoOver a single-week period, SXSW Interactive hosts hundreds of presentations and panels. What was interesting to note this year, compared to the last few, is that a large percentage of healthcare discussions were now hosted on the stages of the two main convention centers, alongside all major celebrity keynotes.

Among many trends and ideas that were discussed, two concepts mentioned at the “What Happens When Tech and Healthcare Meet” panel were quite memorable. Although these are just mere single examples, each testified to a number of current trends in healthcare.

Concept: DermLink—a social network-based platform that allows patients to digitally share skin conditions with dermatologists and receive real-time responses.

Why this is important: This is especially relevant to those outside major metropolitan areas, where a wait to see the local dermatologist can exceed a few weeks. We’ve all heard success stories of doctors tapping into a broad pool of peers via Twitter and Facebook. But this platform is among the first controlled, social, care-specific environments that could potentially redefine the approach and expectations for doctor-patient interaction.

Bottom line: Regardless of the success of this platform, the mere fact that this platform is gaining momentum is an indicator that the true potential of social media in healthcare is still ahead of us.

Concept: Covered—a platform that helps applicants select the most appropriate health insurance by posing a series of qualifying questions in a standard, conversational language.

Why this is important: Although standard applications have been around for quite some time, we’re starting to see a shift in the way even insurance companies need to structure their communications. Over the past decade, we’ve witnessed a similar shift in practically every single aspect of marketing communication etiquette due to social media. A simple, well-timed response to a tweet can gain greater consumer loyalty than a multimillion-dollar Super Bowl ad.

Bottom line: Consumers no longer want to be talked at. They want to be spoken with. This is no longer breaking news…rather, a well-known fact. But at last it is finally beginning to change the insurance companies’ tone of interaction with potential applicants.

SXSW Series:

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Mar20

The Best of SXSW 2014

sxsw logoI could give you a top 10 list or a top 5 list of what was best at SXSW. That would be great if I were trying to convince you of why attending SXSW is an amazing learning experience. However, what I’d like to provide is the best single thing I learned, and get into some actionable details.

So, I was ready to get into what seemed to be a great talk. I was on line waiting, about a dozen people away from the door, when I heard, “Sorry, this session is full.” So with that news I went next door and found a talk titled, “Let’s Get Physical—Design + Embodied Cognition,” by Michael Hendrix, Partner and Creative Director at IDEO. By chance, I’d just found what was to me the best talk of SXSW.

Embodied cognition is the theory that the human mind is largely determined by the form of the human body. To simplify, the mind is experiencing the world through all our senses. The more senses that are stimulated, the more powerful the experience.

The really interesting part of this is that our minds cannot really differentiate a real experience from an imagined one. For example, when we go to the movies and experience an action-packed film, we are experiencing intense visual and aural senses. Our reaction to this fabricated experience is that we may be sitting forward in our seat, our heart rate may increase and the palms of our hands may even sweat. Our minds are telling our bodies to react to the imaginary experience as though it’s real. This is powerful stuff. The more senses we engage in an experience, the more our minds take that experience in and make it memorable.

Brands are already using this principle to design their products to convey a certain aesthetic to potential buyers. One example provided at the SXSW session was that BMW makes the hinges on their car doors heavier to convey quality and safety. People who are looking to buy a car will place a premium on a safe, well-built car.

So how does this apply to our world of marketing? Well, let’s say we are creating an iPad piece for sales reps to detail to doctors. It is common for these to include some basic ways of swiping or tapping to navigate to content. Additionally, it is the sales rep who is usually using the device. However, if we want to make this experience memorable for doctors, we should put the device in their hands and tap into more of their senses. We should think about including interesting visual and audio content. Additionally, we can use the interactive capabilities of the iPad to engage even more of the senses. For example, the iPad will recognize with its built-in gyroscope if it’s tilted or moved in a three-dimensional space, with its motion sensor if it’s shaken, or with its multi-touch screen if it’s touched with multiple fingers.

This may sound like fun and games or interaction for interaction’s sake but there is real scientific research that backs up communicating this way. The more we can tap into human senses when we communicate, the more powerful and memorable the communication will be. And remember, that goes for real and imagined experiences. This is an idea that can breathe new life into the way we think about our clients’ needs.

SXSW Series:

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Feb26

Digital Trends Impacting US Healthcare – Infographic

In the past year, digital innovations have brought about new markets and channels for digital health interactions. This infographic is a visual mapping of the technologies and innovations which are already playing a key role in shaping the future of healthcare and the experiences and journeys which surround it.

Of course the ACA is affecting healthcare coverage, but it is also affecting our healthcare experiences by placing increased importance on and driving more frequent interactions with NPs, PAs, and Pharmacists. Additionally, more priority has shifted to consumers to educate themselves and take responsibility for their own health, especially when combined with our growing culture of social media and trust networks, and recent draft guidance from the FDA. Video remains hot, but the trending has shifted to the length of videos patients are consuming, increasing its relevance to pharmaceutical marketers. Mobile and tablets continue to grow rapidly, with and quantified self driving deeper engagement though apps, not just web. Last, but certainly not least, EHR is poised to enter the next phase of meaningful use, setting the stage for a platform shake-out as certification requirements evolve to provide more and deeper data sets to systems of connected health as providers continue to on-board.

Infographic of important technologies that impact digital healthcare marketing.

Infographic of important technologies that impact digital healthcare marketing.

Technology is evolving fast, and healthcare, believe it or not, is keeping pace and even leading the charge on many fronts. Spurred on by government mandates and initiatives, innovative organizations ranging from Google and Apple to Silicon Valley startups like Practice Fusion are quickly carrying the ball forward, sometimes struggling to keep pace with consumer expectations of today’s technology. It’s these digital healthcare innovations which have set the trends affecting us today, and will carry us forward to tomorrow.

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Jan23

LIVING THE BRAND—Awakening the Senses at Congress

conventionIt seems that the time has passed when having more sales reps and a bigger booth at a major congress was enough to attract physicians to learn more about your brand. Beyond the financial and compliance challenges that the industry has encountered in the past decade, leading in part to decreasing attendance from physicians, clients as much as agencies are continuously looking for new ways to catch physicians’ attention.

What if physicians were just like us: curious and playful

At times, new data just doesn’t make the cut in the clutter of a congress…and let’s not mention when there is no new data to present. Of course, physicians are interested in learning more about a new product, indication or technique. However, in today’s reality, it just doesn’t seem to be enough. Having physicians engage with the brand in a fun and truly unique way can actually set the ground for a deeper relationship and more memorable experience.  What if detailing on touch screens, offering games or iPad quizzes, to name a few, were already not enough in this rush for new things? What if physicians were just simply looking to (re)connect with brands whilst having fun?

Success lies in the story you tell and how you tell it

Going beyond the usual techniques to drive interest at congress requires us to take a step back and look to the core of what the company, brand or product stands for. What it means for your client and physicians. After all, congresses are a great opportunity to reach a maximum of physicians while bringing your vision to life. The booth and activities around it, including symposia, then are used to articulate this story.

But how to define the story you want to tell? One way to do so is to look at the company or brand ambition. What they want to change or bring in this world, where they make a difference. Another way is to leverage the unique features of the product (eg, physical properties, MOA, mode of administration, unique manufacturing process, etc).

What do you do once you have a clear story? You offer physicians a sensory experience. This is when curiosity and playfulness come into place. Perceiving, feeling and doing will create a true brand experience. Knowledge is only one part of a person’s understanding.

Two client cases can help illustrate how senses can create emotional connections. An ophthalmic pharmaceutical company, living by the vision of “leading a brighter future,” and whose main products are hydrating eye drops, articulated their booth activity around a water light graffiti. As physicians were writing on the wall with water, the surface of the wall made of thousands of LEDs was illuminating. The client got their main message across: water is essential for the eyes to properly function, and light is an important medium for sight.  Another client, a leading dermatology company, developed a full sensory experience to differentiate its new dermal-filler range at launch and demonstrate that each product was customized to fit physicians’ needs. During a major industry event, physicians were welcomed into an experiential room. They were able to walk around and visit various custom-made “tools” to feel and see the products (eg, an injection bar,  a gel texture tool to touch the products, and a visual tool  to play with product elasticity). Both cases were based on the core of the brand vision and did create a memorable journey for physicians.

What will experiential activities do for physicians and your clients?

Physicians are keen to interact with their peers and such activities will make them want to share and tell. Word of mouth will not only drive traffic to your activities but also create brand awareness. Physicians will remember your client’s brand and the experience they had with it. They will probably want to engage with it after the event. Creative executions will also differentiate your client and position them as innovative and bold.

Brand experience is about going back to the basics: our senses

OCH Paris won a 2013 Global Award in the category Art & Technique: User Experience (click here to access the Global Awards website http://www.theglobalawards.com/winners/2013/index.php).

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Jan7

The Great Migration

Wildebeest Migration
Physicians: Owners to Employees

In the animal kingdom migration is natural and instinctual, a relatively long-distance movement of individuals as a group, as defined in the dictionary. It is found in all major animal species. The trigger for the migration may be climate, availability of food, the season of the year, or a major habitat change or disruption. Whatever it is, migration means survival!

So if birds, fish, butterflies, and elk do it, just to name a few, why are physicians doing it? The answer is adaptation for survival due to environmental shifts.

The Facts

There are approximately 100,000 (or 1/3) fewer doctors in an ownership private practice setting today than in 2000.

Accenture researchers analyzed data from the American Medical Association and MGMA-ACMPE to determine trends in physician independence and practice ownership. Physicians were defined as independent if they owned at least part of a practice.

Table

 

 

 

 

 

 

 

 

 

**Projected.

Source: “Clinical Transformation: New Business Models for a New Era in Healthcare,” Accenture accessed 11/25/2013.

The Why

Top concerns prompting physicians to consider employment

Several issues are persuading doctors to think seriously about leaving independent practice. Accenture researchers surveyed 204 specialty and primary care physicians in May to identify the most pressing concerns.

87% cited business expenses.

61% named the prevalence of managed care.

53% were concerned about EHR requirements.

53% mentioned maintaining and managing staff.

39% cited the number of patients required to break even.

Source: “Clinical Transformation: New Business Models for a New Era in Healthcare,” Accenture, accessed 11/25/2013.

More and more physicians are facing excessive business costs as employers in private practice and decide the price of autonomy just isn’t worth it anymore.

The type of practice setting doctors choose is a decision affecting everything from their salary, practice relationships, and the hours they work. What’s more, given the changes taking place in the healthcare arena, selecting a practice model is no longer a simple decision made in one’s final year of residency. Managed care reimbursement for services and formulary protocols and practices restrictions have increasingly changed the healthcare delivery landscape, financial pressures, government regulation, and technological as well as administrative demands from payers— i.e., commercial health plans, GPOs, hospitals, Medicare, and Medicaid are influencing physicians of all ages and stages in their careers to reevaluate their practice decisions just to make a living. “Where is the doctor-patient relationship in all this?” many doctors have asked me over the past few years.

Many physicians after paying all their monthly expenses and staff salaries have little or nothing to pay themselves and turn to market research and advisory opportunities to supplement their income. Many physicians find this increasingly frustrating and start looking for other options like migration.

Migration takes many forms: just walking away and becoming a chief, retiring, teaching/academia, and physician concierge. One doctor I know walked away and just opened a bar. The answer for many physicians is migration to more of an employee type setting.

Let’s just focus on institutional practice and what that means to manufactures and marketers. The physician has moved from employer to employee—a big communications game changer.

Being part of a hospital or institutional setting relieves physicians of many of the financial and administrative burdens of owning/running a practice. It gives them retirement plans and also support services they may not have had before, and enables them to offer their staff better benefits. Doctors I have interviewed have followed colleagues in this migration of selling their practices, and liked the results.

The Implications

Autonomy is compromised in the new payer-centric environment for survival, and the opportunity for manufactures to have the traditional access to communicate, educate and cultivate relationships is now forever changed.

The implications are profound and we need to adapt traditional forms of communications, and find new and meaningful ways to communicate. We need to take a more critical view of some of the more recent options we tend to look toward, like websites. “No, not another website! We are already pulling down ones that are doing nothing for us!” many manufacturers say. I have heard that more times over the past few years than I can count. Today, a new website or iPad detail aid will not do it. We need to fully understand how physicians today want and need to be communicated to in their new environment; it is not one size fits all anymore.  We need to look at institutional barriers to access and develop business-to-business value propositions to gain access. And it doesn’t stop there. We need to look at multiple or customized  value propositions by HCP specialties, gender, age, cultural diversity, as well as regional differences to optimize brand opportunities for growth in the brief moments in time we have to communicate. Think of it this way: a 29-year-old female internist in Texas most likely looks through a different lens for communications, information, and decision-making than a 62-year-old male internist in Vermont. What do they have in common? Most likely today they are in an institutional setting, they want to help keep or get their patients well, and they have no time to talk to you in their growing payer-centric institutional environment.

The Way to Adapt

The answer for manufacturers and marketers is that we need to change. Look to nature and migrate how we think and constantly adapt what we do to survive.

The question is, how are you going to activate your migration?

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Dec3

In the Ring

in the ringThere is a Spanish expression that goes: It is not the same to speak of bulls as it is to be in the bull ring. I’ve always liked it, because it seems to capture quite fundamentally the difference between being a spectator and a participant, an observer and an actor. I have paid my money and taken my seat at any number of events, sporting and otherwise; the few times I’ve been the one in the ring, literally or metaphorically, it was a considerably greater investment of self at that moment, and it occupied a lot more of my attention.

Often, I believe that the truth in this phrase applies to our line of work, medical communications, most clearly in the case of patients. We can argue or opine or assume what is best for someone facing difficult medical decisions, based on what we know and see, but until we are facing the same or similar situations and choices, it’s all just theory. Debating a hip replacement, or putting a child on therapy for ADHD? It’s easy to have an opinion, but much harder to know that it’s your choice to make, and your consequences to live with if you choose wrong.

This is why fellow patients are such critical sources of information for patient-centered decision making; it is the value of “experience by proxy,” of hearing from someone who faced the same challenges and choices that you did, and who is now living with those choices, that makes YouTube one of the most important channels for health information.

But what of the healthcare professional? Are they not, too, bullfighters in their own right, making decisions that deal with death and life, in big ways and small, every single day? I find myself in too many meetings in which we deliberate over the patient journey and decline to do the same for the physician, reducing them to a sentence or two, a professional epigraph and no more: “Neurologists like puzzles; psychiatrists don’t like touching patients; oncologists are like chefs.” These basic insights are helpful, up to a point, but I don’t believe that they capture what it’s really like to diagnose a patient with Alzheimer’s disease, bipolar disorder, or prostate cancer, not once, but many times a month, a week, or even a day. I’ve never done it, but as a field researcher have been an observer to many intricate, challenging moments that take place in hospitals and offices, and more than once, as a translator, have been asked directly, “What would you do?” The answer is never easy, and with the fourth wall down, you find yourself wondering if you are capable of making the right call.

It is these moments that most stick with me, as bringing home the gravity of the daily work of healthcare professionals. And I often try to remind myself of these feelings when discussing how best to reach a professional audience, to help them or to change the way they see a specific disease, or treatment, or test. We can make recommendations, but they have to live with the consequences of success or failure if they follow them. If we want to communicate effectively with our professional audiences, it is worth remembering that they face bulls every day; mostly, we just talk about them.

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Nov22

Payer Marketing—What Happened to the Good Old Days?

prescription padLife was easy in the early days of payer marketing: create a formulary kit, negotiate a market share agreement with tier 2 status, and pull it through with some fancy formulary status flashcards. Yes, life was good back then. Did I say formulary kit? Yep, those have changed as well. The executive summary of AMCP’s Format for Formulary Submissions 3.0 states that it must include a “value statement of the pharmaceutical or biologic agent being discussed.” What does that mean? Is it about pricing? Dollars saved? Rebates? Historically, rebates have been used to gain preferred formulary position with reduced member out-of-pockets. But with over 70% of prescriptions written today being generic, that marketing approach falls apart. Things are further complicated by the fact that payers are much more willing to use step edits (required failure on a preferred agent prior to use of another agent) and prior authorizations to drive use of preferred therapies, as opposed to relying only on formulary positioning differences.

The value proposition is now the most important story a manufacturer needs to craft in the launch of a new brand—so much so that more forward-thinking manufacturers are designing arms of clinical trials that integrate economic and comparative measures to support the value proposition they feel will be needed to gain support from the payer community (traditionally health plans, employers, pharmacy benefit managers) at launch. And the payer audience is expanding as well. It now includes ACOs and other emerging health care provider models with responsibility for populations. Furthermore, the stakeholders at each account matter more than ever. It is imperative to go broader and deeper into an account beyond just the Pharmacy or Medical Director. New stakeholders are emerging such as the Quality Director, Case Management and others who are weighing in on formulary and coverage decisions.

It isn’t tough to see the link between the growing influence of payers and the dramatic drop-off of new product approvals in the past 10 years. When products are not strongly differentiated, payers worry less about depriving patients of choices. Now more than ever, payer marketing is about differentiation and “pill plus.” It’s about developing business-to-business relationships. It’s no longer fee-for-service—it’s fee-for-value. Gone are the days of disease management; today it’s about disease prevention. It’s no longer good enough that a drug works and is FDA-approved. That alone no longer guarantees access. It’s now about outcomes—in trials and in the real world. It’s about costs—costs per member per month, per quality-adjusted life year, medical cost offsets, productivity, absenteeism. This is what now needs to be communicated to the payer audience in ways that are clear and impactful.

When communicating to payers, pharmaceutical manufacturers cannot approach the next 10 years using the time-worn marketing methods of the past 10 years. Pharma pipelines are filled with specialty products, and the use of traditional and new utilization management techniques will only intensify in the coming years. In a post-Obamacare world, pharma’s priority is to develop ways of engaging payers that are customer-centric and that support patient outcomes. Only then will the payer audience listen.

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