Co-Pay Card “Played Out”: Manufacturer Belief, Not Patients’

I have had the opportunity through our Level of Evidence (LOE) appraisal service to examine more than a dozen third-party developed DTC/DTP ROI models that outline the business case behind the investment. Over the years, I’ve noticed a consistent pattern to all the ROI models examined. . . no, it’s not that the company creating the model has a significant stake in the model proving a positive ROI for DTC/DTP. That could be a whole other blog post!

It’s that two essential ingredients for the DTC/DTP ROI Model are missing all together:

1. Relationship between Reach and Investment – The number of potential patients you’re able to reach via media execution is inextricably linked your investment levels, unless you really only have one media outlet. The practice of using a general DTC reach average or an even more general percent of the disease prevalence as the reach number in your DTC model ignores the fact that your media investment level has a profound impact on the number of patients you can reach. A sure sign of this is crazy large reach assumptions like ~ 50% of the market within the first year with a modest DTC budget. It not only doesn’t pass the red-faced test, but it also invites senior management to question the need for additional DTC after Year 2 when you’ve saturated the market based on your model.
2. Impact of Creative Execution – Several key variables that may already be in your model – unaided awareness, aided awareness, likelihood to take action, branded request, etc. – are dependent on the power of your creative execution. Most ROI models, even those developed by the consumer agency, all but ignore the impact of the creative execution. Market research companies, such as IPSOS, Millward Brown, and Phoenix Marketing International, have DTC/DTP creative norms that can be and should be leveraged to look at the elasticity of your model depending on an average creative execution versus an above average creative execution.

It’s clear to me that Clients responsible for evaluating the DTC marketing opportunity get worn down by just collecting all the basic data points to put together the business case. Seeking counsel from an objective, external party to gut check the assumptions and corresponding numbers could not only re-energize the DTC marketer, but also ensure all the right ingredients are accounted for in the final model.

More and more, Clients are developing robust patient segmentation schemes to pinpoint, not only segment(s) who are most likely to positively respond to marketing efforts, but also to avoid the segment(s) least likely to respond to said marketing. The marketing application of these insights has proved difficult for some; especially in the area of media plan development. Despite the robust patient insights delivered, we still see media plans that feel more like digital disease-focused billboards versus highly focused plans designed to reach clearly defined target patients.

Here are 5 recommendations Clients need to consider when trying to actualize their patient segmentation through media plan development:

1. Chase Quality, Not Quantity – You undertook segmentation to focus on the subset of customers most likely to respond to your Brand. Don’t let your media agency lose sight of the goal – reaching your high-value segment.
2. Build Bottoms Up, Not Top Down – Start your base media plan development with sites that have a high concentration of your high-value segment versus just buying a ‘disease center’ on a more general health site. In today’s resource constrained environment, prioritization of media properties based on concentration of high-value segments allows you to quickly respond to media cuts or incremental funding with a strong rationale.
3. Focus on Mindset, Not Location – You have a rich portrait of your high-value segment and you need to put it to good use. If your target segment consists primarily of disease ‘veterans’ seeking more specific and sophisticated information, buying the first impression on a general health site will likely be an incredibly wasteful investment. The media agency needs to understand the media implications of the segment mindset and be able to play those implications back to you before ever starting to put the plan together.
4. Embrace Goals, Not Impressions – Vast majority of media placements have a specific goal in mind and regularly the goals get lost in a sea of meaningless numbers – impressions, clicks, visitors. In general, the goal is to reach the high-value segment wherever they are and direct them to the messaging or resource that you know will make them most amenable to your product. This is what you need to measure and ultimately report on!
5. Prioritize Tracking, Not Reporting – Spend time with your market research colleagues and the vendor that completed your segmentation to set up an independent tracking plan to objectively assess the utility of the media plan. Too much time is spent producing beautiful looking media reports that provide no managerially-relevant information. Simultaneously approve the tracking plan and the media plan to ensure your team understands what is expected.

Focusing on the 5 recommendations above not only yields far superior media plans, but it also allows marketers to establish clear measures of success and accountability with their planning agency. With new levels of accountability in place, we’re sure you will see greater pull through and performance from your plan.

Let’s be honest, creating patient demand for a product is much sexier than converting existing patient demand. Designing a patient intervention that starts at the top of the consumer decision-making process – problem recognition – is more intellectually fulfilling than simply informing the evaluation of alternatives stage. Yet for many of our specialty care pharmaceutical and rare disease biotechnology Clients converting demand is much more prudent and impactful to the bottom line.

Let’s face it, the level of evidence required for patient marketing investments is exponentially higher than those placed on professional marketing investments. The payback period for patient marketing investments is measured in months, not years, and converting patient demand, regardless of the media source, is infinitely cheaper. In fact, our normative data shows that average per patient costs for demand generation hover around $125/patient versus ~$5/patient for demand conversion.

So, you’re convinced… but how do you begin to find existing patient demand to convert? We recommend you start with Google.

• What’s the monthly volume for key disease state phrases associated with your category?
• How much does it cost to intercept those patients that have been driven down the funnel through the ‘information search’ and ‘evaluation of alternatives’ stages?
• Who else covets these patients? The list of bidders will give you a hint.

The knock on demand conversion will always be the ability to scale your efforts to reach large volumes of people. At a minimum, we’re seeing Clients who embrace evidence-based marketing use the result of their patient conversion efforts to inform and refine the subsequent patient demand generation phase.  When weeks and months matter, you need the most efficient strategy to ensure patient marketing success.

Of all the predictive questions one faces in launching a new biologic or pharmaceutical product, the ceiling of your product’s adherence curve may be one of the easiest to tackle with a high degree of accuracy. The answer to this question is buried within your clinical study report(s).

The fact is that the ceiling for your adherence curve is revealed by carefully examining the ITT (intent to treat) analysis by time increment, preferably monthly for most brands. Once you’ve plotted this curve, you can safely assure your Senior Management that it won’t get any better after launch.

But wait, why can’t your adherence curve get any better?

• HCP (i.e., $) and patient (i.e., free quality medical care) financial incentives for trial adherence are not repeatable in the real world
• Interventions (e.g., personalized patient follow up by the practice) employed are generally not scalable for use with the general disease population
• Patient population careful culled to maximize trial completion does not reflect your real world patient pool

While it may not be possible to recreate the adherence curve from the Pivotal trial(s) in the real world, an in-depth understanding of the adherence data, challenges and adherence-enhancing interventions from the Pivotal trial(s) is your first step in building a validated adherence framework for your brand.

What next? Pick up the phone and introduce yourself to the clinical study coordinator for the site that had the best percent completion for your Pivotal. I’m confident you might learn a few things!