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					Interaction Between Detailing
    & Journal Advertising
Interaction Between Detailing
& Journal Advertising
   Welcome comments from

                   Will Passano
         President-Medical/Dental Division
                   Ascend Media
   JOURNAL ADVERTISING
   Research results from ACNielsen HCI Study
   Joint effort by ABM/AMP
   Reason for this presentation
   Journal advertising is an effective ingredient in the
    overall pharma marketing mix
   Webinar provides clarity of voice – we all hear the
    same message, at the same time
   Industry coverage – all medical publishing sales
    members have been invited today
   Research data tends to be technical and sometime
    difficult to apply in day-to-day sales calls
   Past Communication efforts
   Journal ads
   Direct Mail
   AMP general meetings
   Today’s webinar
   Today’s Agenda
   Presentation < 60 minutes in length
   2 versions being presented
      Full length @ 25 minutes – Charlie Hunt – AMP

      Short version @ 8 minutes – Mark Rothman – ABM

   Q&A
      Submit questions electronically during presentation

      Will attempt to answer key questions at the end, time
       permitting
      All questions will be answered in 48 hours
   Summary
   Entire presentation and questions to be archived
    for 6 months
   Links to presentation will be on both the ABM
    and AMP websites
   Feel free to pass on to colleagues that couldn’t be
    here today
   Next Steps
   Want access to major Pharma marketing
    executives that would be responsive to this
    message
   Charlie Hunt can go with you on a qualified call to
    deliver the full presentation
    e-mail: Charles Hunt, cch35@cornell.edu
   More research being evaluated by AMP/ABM to
    further confirm value of professional advertising
        Interaction Between Detailing
            & Journal Advertising




Charles Hunt
cch35@cornell.edu
Agenda
   Background
   Vision
   Action Plan
   Measurement
   Results
          Promotional Mix - 2004
  12
                                       Estimated expenditures
  10
                                           Detailing, $11.3 billion
      8

      6
                                           DTC, $4.3 billion
      4
                                           PME, $2.9 billion
      2                                    Journal ads, $0.54 billion
      0
          DET   DTC   PME    JAD
                                       Trends
4.5                                        Detailing growth flat, but
 4
3.5
                                            spending at high level
 3                                         DTC growing fast
2.5
 2                                         PME, JAD growing slowly
1.5
 1
0.5
 0
      DTC   1999      2001   2003
Promotional Mix - 2005
   Detailing
       More reps spend less time with doctors
   Medical education
       In OIG-ACCME environment, concerns about value
   DTC
       Concerns whether safety information adequately
        presented
       Excesses bred political and clinician backlash
       Moves for voluntary restraint, with threat of legislative
        action
   Journal advertising
       The “safe and effective” modality
Current Climate
   Rare moment of opportunity to reconsider the mix
      Based on experience and new learnings

   Fundamental needs
      Educate healthcare professionals that prescribe
       or influence
      Inform patients to build awareness, increase
       adherence
   Professional advertising has been underutilized
   Not one or the other but rather, “what is the best
    mix?”
Proof of Performance

   Coalition PhRMA Study
      PhRMA Patient Assistance Program

   ROI Analysis of Pharmaceutical Promotion
      RAPP

   Analysis of ROI for Pharmaceutical Promotion
      ARPP

   Doctors of the World
   AMP/ABM Study
   ACNielsen HCI CTS
   Case Studies #1-3
Chronology of Recent
 Findings
    Dartmouth Marginal ROI Study, 2001
                 RAPP
   ROI Analysis of Pharmaceutical Promotion
       Truly landmark study used historical data for 1995-99
       391 drugs, 16,696 monthly observations
       Measured marginal ROI for DET, DTC, JAD, PME
       Examined how ROI differs by brand size, launch date
       For median brand, marginal ROI was:
          JAD, $5.00 +/- $0.88

          PME, $3.56 +/- $1.92

          DET, $1.72 +/- $0.19

          DTC, $0.19 +/- $0.52
          Yale Marginal ROI Study, 2002
                     ARPP
   Analysis of ROI for Pharmaceutical Promotion
       Steering committee included pharma researchers
       Historical data on spending in JAD, DET, DTC, PME
       Extended data 1995-2000; 21,436 monthly observations
       Used new brand revenue levels
       Explored ROI for specific therapeutic categories
       Examples of findings:
          $500M+/1998-2000: All tactics generate positive

            returns for average brand, but under spending on
            JAD and PME
       Added spend on JAD could have very positive returns
        for both small brands and large brands
ACNielsen HCI
Sources of Information Study - 2004
   80% of physicians rank journals as important
    source of information
      Highest percentage for any of 15 modalities
       measured
      Up 9% since previous study in 2001 (only
       information source with significant increase)
   Similar findings found by Accenture and AAFP
   Professional journals have a unique relationship of
    trust with America’s busy physicians
PhRMA Patient Assistance Program
Study 2004
                    PhRMA, CHC, AMP
                    Measured increase in MD
                     awareness of PAP directory
                    1-page ad; schedule targets
                     ONC, PUD, Psych, Neuro
                    203 insertions, >$1M value
                    Awareness rose by 89%
                    Awareness rose in line with
                     R&F in specialties studied
Vision
   Document the effect of promotion on New Rx’s
   Select products
   Plan multi-level media schedules
   Create - Test - Evaluate
   Arrive at Conclusions
“One Test Is Worth a Thousand
 Expert Opinions”
Action Items
   Select two products in major therapeutic areas
      No previous PCP promotion

      Patent-protected

      One year test period
Action Items (continued)
   Select Products:
      Gain Brand Management agreement

            Agree to Confidentiality
       Alan Fask, Ph.D designs study
            Consultation with brand teams
       Select AC Nielsen HCI to coordinate study
Methodology
   Four Cells of 16,000 PCP’s
      Control Group

      Low level of promotion

      Average level of promotion

      High level of promotion
Journal Insertions




              Insertions

            C T1 T2 T3
            0 66 168 325
Design
   Pretest each advertisement
   Launch Campaigns
   Six Month PosTest
      Ad Recognition

      Product Recall

      Correct Message Association

      New Rx’s

   New Rx Analysis
   Twelve Month Results
Process Responsibilities
   Medical Publishers
     Selected for schedules

          Agree to space and demographic splits
   Brand Teams
     Create Advertisement

     Report Detailing Activity to AC Nielsen HCI

     Report Monthly New Rx’s to AC Nielsen HCI
Process Responsibilities (continued)
   ACNielsen HCI
     Coordinated study

     Conduct campaign pretest

     PosTest campaign at six months

     Track monthly New Rx’s

   Alan Fask, Ph.D
     Model response metrics
Product “B”
Product “B”
   PreTest
      57% physicians unsure/negative

           too busy, too crowded, too much information
      Recommended to change ad size from 2 pages
       to 4 pages
      Not Done

   Subsequent change of detail message
 Product “B” Six Month PosTest
 Metrics did not change: Awareness Score
                Ad Recognition Product Recall

Control               46%              33%

Cell I                40%              30%

Cell II               48%              29%

Cell III              45%              34%
 Product “B” Six Month PosTest
 Metrics did not change: Awareness Score
                Ad Recognition Product Recall

Control               46%              33%

Cell I                40%              30%

Cell II               48%              29%

Cell III              45%              34%
Product “B” Six Month PosTest
Metrics did not change: Correct Message Association

      Control            51%

      Cell I             59%

      Cell II            51%

      Cell III           52%
Product “B” Six Month PosTest
Metrics did not change: First Choice Therapy

       48

       46

       44

Percent 42

       40

       38

       36
             Control   Cell 1   Cell 2   Cell 3
   Product “B” Six Month PosTest
   Metrics did not change: PCP NRx

              Mar-Aug ‘03 Mar-Aug ‘04   % Change

Control          5,707          8,287    45.2%

Cell I           5,438          7,845    44.3%

Cell II          5.946          8,718    46.5%

Cell III         6,713          9,650    43.8%
Product B Conclusions
   Pre-test scored below average
   Six month PosTest indicated that campaign had
    not increased awareness
      Message association did not improve

      First Choice therapy did not improve

   Sales did not increase

    Change Message or Discontinue the Campaign
Product “A”
Product “A”
   PreTest
      Good pretest acceptance

      Accepted visual elements

      Accepted headline

   Recommended message simplification
      adjusted
Campaign R&F Specifics
 90                                 89
                     78                  79
 80
 70                                           69
                          59
 60   56

 50                                                1x/mo
                               42                  2x/mo
 40        31
 30                                                3x/mo

 20
                13
 10                                                Office-Based
  0                                                Core
      Cell I         Cell II        Cell III
Six Month Metrics
Ad Recognition – six months

60                                           58

50                             45
                  44
40

30
        21
20

10

 0
     Control   Low Cell   Average Cell   High Cell
Product Recall – six months

45                                           44
40
35
30
25                             23
20                16
15      11
10
 5
 0
     Control   Low Cell   Average Cell   High Cell
Correct Message Association –
six months
                                             44
45
40
        32
35                 29
                                26
30
25
20
15
10
 5
 0
     Control   Low Cell   Average Cell   High Cell
     Perception of Detailing – six months

                                                         52%
           43%                         46%
                        38%

60
                      Physicians’ Perception

40                            41%        42%
     40%     40%

20               Company Records                               .
                                                     .
 0
Control    Low Cell     Average Cell     High Cell
Product “A” Six Month PosTest
First Choice Therapy
           40                                  38
           35
                    31                32
                             30
           30
           25
    Percent 20

           15
           10
            5
            0
                 Control   Cell 1   Cell 2   Cell 3
 Change in NRx

           12                          11.07
           10           9.79

            8
% change    6                                  Control

            4                                  High cell

            2
                  0.1            0.1
            0
                1st 6 Months   2nd 6 Months
Product “A” Observations
   Pre-test scored above average
   Six month PosTest indicated that campaign
    increased awareness
   Message association improved
   First Choice therapy improved
   Perception of detailing strengthened
Product “A” Conclusions
   Effective advertising increases awareness
   Effective publication planning increases awareness
      Reach/Frequency/Commitment

   Measure it to manage it
   Detailing alone does not insure growth
   Detailing and advertising increased New Rx share
   High Cell
     New Rx’s increased 10.47%
Post Promotion Observations
   Ad schedules were terminated after 12 months
   AMP commissioned Dr. Fask to monitor New Rx
    activity for an additional 8 months
Base Model
   Base Model Adjusted for Period 25
                     The REG Procedure
                      Model: MODEL1
             Dependent Variable: Product A_NRX Product A_NRX
              Number of Observations Read 1649966
              Number of Observations Used 1649966
                    Analysis of Variance
                         Sum of       Mean
   Source            DF      Squares     Square F Value Pr > F
   Model             15      165624      11042 18650.7 <.0001
   Error         1.65E6       976803     0.59202
   Corrected Total    1.65E6     1142427
           Root MSE          0.76943 R-Square 0.1450
           Dependent Mean       0.16957 Adj R-Sq 0.1450
           Coeff Var       453.75872
Base Model (cont’d)
   Parameter Estimates
                        Parameter Standard
   Variable Label         DF Estimate          Error t Value Pr > |t|
   Intercept Intercept 1 -0.13891            0.00276 -50.41 <.0001
   da               1 -0.00511          0.00360 -1.42 0.1559
   db               1      -0.02446     0.00360 -6.79 <.0001
   dc               1 -0.02725          0.00360 -7.58 <.0001
   pd13               1      0.03399     0.00343 9.91 <.0001
   pda               1 -0.00486         0.00545 -0.89 0.3725
   pdb               1      0.00332     0.00546 0.61 0.5436
   pdc               1      0.01744     0.00544 3.20 0.0014
   Detail_P1e Detail_P1e 1          0.34034     0.00219 155.38 <.0001
   Samples    Samples        1    0.02071 0.00011500 180.05 <.0001
   compnrx               1     0.02281 0.00006926 329.30 <.0001
   pperioda             1 -0.00004285 0.00028894 -0.15 0.8821
   pperiodb             1 0.00029129 0.00028978 1.01 0.3148
   pperiodc             1 -0.00022853 0.00028910 -0.79 0.4292
   period             1      0.00517 0.00022978 22.50 <.0001
   pd25               1     -0.04498     0.00246 -18.32 <.0001
Change in NRx

           11.5
                            11.07     11.16
            11

           10.5
% change
            10     9.79                           High cell
            9.5

             9
                   1st 6   2nd 6    Post Test
                  Months   Months    Period
                                     (8 months)
Observation:
   The promotional effect persists, even after the
    promotion has ended
Dr. Fask:
“Substantial post-promotion persistency is a
  common observation and is generally attributed to
  the known, high habitual behavior seen in
  physicians. That is, once a doctor becomes
  comfortable prescribing a medication, that doctor
  tends to continue that behavior.”
Dr. Fask:
   It appears that the effect of promotion C lingers after the
    promotion ended.
   The duration of this effect is difficult to assess, but seems
    to persist for the entire post promotional period.
   This result is important from a ROI viewpoint, since there
    is no added expenditure of funds during the post
    promotional period.
   The duration of the promotional effect for promotion C is
    unknown, but persists for at least eight months post
    promotion.
   It may very well represent a permanent change in
    market behavior.
In summary, this study strongly suggests
that journal advertising can be effective
in raising pharmaceutical sales.

				
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posted:10/6/2012
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