Jonathan by mikeholy


									            TAP Gynecology Lupron Depot®
                       EndoKnow RM Program
                       Topic and Messaging Plan

04/2004   Xolair ePRM Launch Requirements
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     This document provides:
         An overview of the EndoKnow communication plan for Segment C of the Lupron Depot ® PRM
         Recommendations for extending Segment C communications
         An opportunity to gain consensus regarding content and supporting materials

     When the EndoKnow program was initiated, Segment C enrollees were identified as the least
     impressionable segment. It was believed that the women in this segment seemed unaffected by their
     endometriosis-like symptoms, and that the side effects associated with Lupron Depot would offset any
     benefits of treatment.

     As a result communications were tailored to offer Segment C enrollees balanced information regarding
     the disease. DKI then monitored their behavior to determine their response to the program content.

     Since the launch of the program, data has suggested that Segment C may be more approachable and
     responsive than initially estimated, and it is likely these women would benefit from additional
     Specifically, reporting has uncovered:
         - Most enrollees in Segment C open at least one E-mail
         - Approximately 45% open two or more E-mails, indicating an active interest in their condition and
               the content provided
         -      Segment C enrollees also migrate to a higher segment and convert at higher rates than first

     It is important to note that approximately 80% of enrollees in this segment are undiagnosed or
     misdiagnosed. This presents TAP with an opportunity to increase awareness of Lupron Depot by
     providing harder hitting messages that inspire these enrollees to seek a proper diagnosis.

         Motivate EndoKnow Segment C enrollees to seek a definitive diagnosis, and when appropriate,
          treatment with Lupron Depot.

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     Communication Strategy:
     Move Segment C enrollees into Phase 3 messaging emphasis (e.g., inspire) by leveraging previously
     approved EndoKnow content from Segments A & B and extending the number of E-mails included in the
     communication stream, to enhance Segment C enrollees' information. When adapting content from
     Segments A and B a neutral tone (i.e., factually “upfront” and not overly emotional) will be used.

     Because Segment C communications are more neutral, it is important to add two elements that are likely
     to have minimal regulatory impact, and may help motivate enrollees to seek diagnosis:
         1. Action Plan
              A checklist/"to do" list to help enrollees focus on a definitive diagnosis for the cause of
              The checklist encourages enrollees to:
                         start and maintain their Pain Diary
                         discuss current/long-term symptoms with gynecologist
                         discuss possible ramifications of undiagnosed/misdiagnosed endometriosis with
                            their gynecologist (e.g., worsening symptoms over time, fertility/conception)
                         persist in the search for a diagnosis (e.g., according to a 1998 study, 47% of women
                            reported having to see a doctor 5 times before being diagnosed or referred)
                         update their profile so they may continue to receive E-mails tailored to their needs

          2. Lupron Depot Rebate
                Incorporate appropriate language in one of the E-mails to enable enrollees to link directly to
                  the approved Rebate
                Use this approach to test response and usage compared to stand-alone rebate sent earlier in
                  the cycle

     Key Insight:
         Women in Segment C are receptive to receiving information even after acknowledging their
          symptoms are not debilitating and that their current response to symptoms experienced is passive.
         Segment C enrollees need to be inspired to seek a diagnosis by offering balanced information that
          motivates discussions about symptoms with a doctor (e.g., endometriosis is a serious condition and
          you may not just be suffering from bad periods).

     Key Messages:
         Ask your gynecologist to establish a definitive diagnosis of your symptoms
         If the diagnosis proves to be endometriosis, ask your gynecologist about Lupron Depot

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we focus on results

     New E-mail Components:

     E-mail Message C1: Recognition (unbranded)
     Location in Communication Stream: Following “Welcome” E-mail
      Goal: Inform and inspire
         Increase enrollees' awareness regarding endometriosis by:
             Leveraging statistical content from "A Closer Look - Important Facts"
                      - 5.5 million women afflicted – helps enrollees recognize they are not alone
                      - 71-87% of chronic pelvic pain associated with condition – indicates the symptoms are
                       not something to be ignored or accepted as
             Providing information about different treatment options via the "Time and Effects of
                 Endometriosis" E-mail to offset possible preconceptions and further inform enrollees about
                 the importance of a definitive diagnosis
            Establishing a basic understanding of the biology of endometriosis using information from
            “Endometriosis - Looking at the Inside” without making the explanation too technical
         Introduce Action Plan
             Promote use of Pain Diary as item #1 in the Action Plan to motivate and reinforce the
                  enrollees' empowerment

     E-mail Message C4: Causes and Effects (branded)
     Location in Communication Stream: Following “Symptom Specific” E-mail
      Goal: Inform and inspire
         Further empower enrollees through information that helps facilitate doctor discussions by
            including previously approved content from the "Time and Effects of Endometriosis" E-mail to:
                Explain how regular use of the Pain Diary can help identify changes in symptoms and/or
                    their severity, which may inspire earlier recognition and action
                Build awareness and understanding about possible options if or when a diagnosis of
                     endometriosis is made, which in turn may inspire earlier discussions about treatment
         Understand how Lupron Depot has the ability to alleviate pain associated with endometriosis
            Include previously approved content from the "Endometriosis – Looking at the Inside" E-mail to:
                Inform enrollees about the medical aspects of endometriosis through brief explanations of
                      where growths may occur, and without the medical illustration
         Remind enrollee of other elements on the Action Plan in addition to the Pain Diary via
            appropriate language and links
         Acknowledge that a definitive diagnosis of endometriosis may require multiple discussions with a
         Present Lupron Depot fair balance

     E-mail Message C8: What Is Add-Back Therapy? (branded)
     Location in Communication Stream: Following “Treatment Options for Endometriosis” E-mail
      Goal: Inspire to seek treatment
         “What is Add-Back Therapy?” (as approved for Segment A and B) can be modified to match the
            style of Segment C

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     E-mail Message C10: Don't Give Up (branded)
     Location in Communication Stream: Following “Don’t Ignore Your Symptoms” E-mail
      Goal: Inspire to seek treatment and discuss Lupron Depot
         Reintroduce the Action Plan presented earlier in the communication stream
         Remind enrollee of items to be managed – including definitive diagnosis
         Encourage discussion with gynecologist about endometriosis
         Empower enrollees to continue to pursue additional avenues when initial efforts have not
            brought about a diagnosis
         Remind enrollee that endometriosis is a condition that may worsen over time and should not be
         Review benefits of Lupron Depot, as well as the use of add-back therapy to help alleviate side
         Provide a link to the Lupron Depot Rebate offer within the body of the E-mail
         Present Lupron Depot fair balance

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                         Current Contact Map
                         Messaging Emphasis

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                                                 Segmentation Drives
                                                 Messaging Emphasis

                       Phase #1                 Phase #2                      Phase #3                 Phase #4

                         #1                          #2                         #3                        #4
           Strategy:     Welcome                     Inform                     Inspire                    Empower
                                                                                 Updating your Pain        “Why Lupron may
                          Introduce DDG with          Establish Benchmarks:      Diary                     be right for you”
           Content:       Serious Disease, Serious    Pain Diary                 Testimonials              “Getting the
                          medicine theme              Offer support resources    “Seeking treatment”       treatment you need”

                                                                                                  Emphasis for segment A

                                                                         Emphasis for segment B

                                                     Emphasis for segment C

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