“Pharmacist diagnosis and OTC treatment is not a bad alternative.” -Bob Ehrlich

In a move causing significant debate and emotion, the FDA is considering making more Rx drugs available. FDA held a hearing March 22-23 on the subject. They have the comment period running through this week. The goal of FDA is to review chronic categories where OTC availability may make it easier to start therapy because a doctor visit would not be needed.

The FDA believes that increasing access might be worth the risk of approving more OTC drugs. It is clear they know that our current medical system cannot handle the diagnosis and treatment of all the sufferers of chronic disease such as high BP or high cholesterol. Having a different way of getting the drugs may help those patients who do not see a doctor get those drugs.

The usual arguments were made at the hearing. The physician side warns that it is dangerous to diagnosis these conditions without the skilled physician interpreting the BP or blood lipid diagnosis. Pharmacists argue that they can do simple diagnostic procedures and counsel patients on how to take the drugs and follow lifestyle changes.

In the ideal world all people would get to see a doctor and have continued follow-up care. In our world that is not the case. Millions of people suffer undiagnosed or untreated hyperlipidemia and high blood pressure. The public policy question is will OTC status and more pharmacist involvement lead to healthier people? Physicians argue that some underlying conditions will be missed or that a more urgent serious problem is behind a high blood pressure or cholesterol number.

I think we need to deal with the real world of limited access. These newly insured under Obamacare have problems getting to see a doctor. If they can visit a pharmacist to have blood sugar, blood pressure and lipid profiles done and then buy some OTC meds, we may see better outcomes. We need to be realistic how a doctor treats most patients. They do not do a deep analysis of test results. If BP is higher than 140/90 they are likely to suggest a mild diuretic or something stronger. If blood sugar is over 120 they may suggest diet and eventually an oral pill. My point is most doctors do not discover some deep seeded issue under the test numbers. They do not connect all the unseen dots like Dr. House.

A pharmacist could do basic testing and counseling faster and cheaper. At least having OTC’s makes the chance of getting treatment easier. The patient dilemma is that once a drug goes OTC, insurance companies may no longer cover it. In the case of more OTC’s, patients may pay more for drugs. On the other hand competition will drive down prices and store brands will undoubtedly be offered at cheap prices. More OTC’s may keep our insurance premiums in line as payers would have less drug payments.

The problem of whether to allow more OTC’s largely depends on the risk/benefit. While it would be nice for everyone to see a physician, we may not be able to make that happen. For common chronic conditions pharmacist diagnosis and OTC treatment is not a bad alternative. People generally like their pharmacist and they have access to one easily. So I hope FDA is aggressive in looking at new ways to diagnose and treat Americans who have trouble seeing a doctor. I see a lot more benefit than risk in opening up more drug categories to OTC status.

Bob Ehrlich, Chairman

DTC Perspectives, Inc.

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“I prefer a private system to squeeze costs…” -Bob Ehrlich

Yes, I know Obamacare is not the name of the health reform act. I was reminded of that by one of the speakers supporting the law. That being acknowledged I will continue to use the term throughout this column and probably in many future columns. It is Obama’s law, pushed through by him so why not give him full credit.

Despite my opposition to the law for lack of cost control, experts at the conference seemed to believe it is a net positive for the drug companies. This is based on the addition of at least 30 million new customers who will get insurance under the law. New customers mean more profits, even if the prices are reduced through the deal brokered by the drug lobby.

“Good for the drug industry” is something that can be debated. It is good if these new covered patients get branded drugs. Many of these patients will be covered under Medicaid so I am not sure that there will be a flood of new branded scripts written. There will be some but it is not so clear to me how low income people will be a boon for branded drugs.

Is it good that government will play the role of effectiveness judge? Many drug companies may get some bad news if these panels decide older drugs are much more cost effective than new brands. Their findings will be widely disseminated and this may cause current users to be switched by private plans.

The experts we had discussing Obamacare said our current system was not sustainable. I totally agree that our fee for service system encourages over-reliance on excess tests, procedures, and other treatment. The issue is not whether the system needs to be changed but how it can be changed. What more government involvement means is more bureaucracy, mostly well meaning but usually inefficient and inept.

None of us really have any control over Obamacare at this point. It is likely in the hands of one Supreme Court Justice. That is Kennedy, who is the swing vote. If it is upheld, then the drug industry will live with it. Perhaps effectiveness panels will provide extra motivation to research more breakthrough drugs and that would be a good thing. On the other hand, all the experts agreed that the future of healthcare will be on cost control whether or not Obamacare remains the law of the land. Private markets will also be forced to squeeze cost out of the system.

For drug makers, they will see the squeeze in either system. That means drug companies are going to need to provide added value both in their drugs and in their follow up care. Consumers love branded drugs as long as someone else pays for most of the cost. That is changing through higher co-pays and that trend will continue.

My conclusion is I prefer a private market system to squeeze costs and increase coverage. If we have Obamacare I fear huge cost overruns. After all, government run programs rarely cost less than expected. These bureaucrats are not generally good business people and I have zero confidence that Obamacare can work financially. Many on the left hope that we evolve to a government single payer system. If Obamacare does not control costs, then there will be a push to nationalize healthcare. My cynical nature tells me this is the real plan. Full government control will mean less innovation and slower progress fighting disease. We will end up with adequate care for all. America can do better if we allow the free market to work. We will know in a few months.

Bob Ehrlich, Chairman

DTC Perspectives, Inc.

“Consumer product advantages need to be considered early on…” -Bob Ehrlich

The economy has not surprisingly impacted consumer spending behavior on healthcare. IMS released some interesting data in their report on use of medicines in the United States. While spending in 2011 rose 3.7% to $320 billion, it was only up 0.5% without inflation. Branded spending was up only 2.2% and basically zero in real terms.

Consumer visits to physician offices dropped 4.7%, apparently a reflection of a desire to save on co-pays. Seniors reduced their prescription drug use by 3.1% in 2011. It is apparent that payers are requiring consumers to pick up more of the branded cost, as those drugs averaged a $40 co-pay.

What all these data show is a consumer squeezed by a weak economy and rising prices in things they cannot afford to do without like food, health insurance and gasoline. If consumers are paying $40 dollar co-pays for branded drugs versus a few dollars for generics, the pressure is on drug companies to justify the premiums.

We can expect the future to be even worse in terms of consumers taking on more of the cost burden. Drug makers are going to need to better differentiate the product advantages to get new users and do more coddling of existing users. The bombardment of physicians by detail reps is showing diminishing returns. Drug companies have cut back on freebies and physicians are more leery of taking those consulting fees and trips.

I admire Pfizer’s approach on Lipitor. They are essentially willing to sell the branded product at a generic price because some profit is better than no profit. I expect other brands to do the same when the generic alternatives appear. Keeping the brand alive is a good strategy while an RX to OTC switch is in the works. Other opportunities exist for branded drugs on patent to offer more dosing alternatives, easier to swallow pills, more non-pill options, innovative packaging, and other product enhancements.

Clearly the biggest opportunity is in after care for current users. While many drug companies have tried to have retention programs, the results are mixed at best. Consumers usually do not sign up and the offerings that are not particularly innovative. Most retention efforts offer the same health information found easily elsewhere. What we need are real consumer benefits that add value to the branded drug. I think most drug companies offer what they think the consumer needs, not what they really want. For example, a drug company selling a statin might create a custom recipe guide for healthy eating when the consumer would be happier with an off the shelf best selling cookbook.

Drug companies have to face the fact that their customers are equally consumers as they are physicians. Consumers are going to decide whether to pay $40 dollar co-pays. That means when generic alternatives exist, consumers are paying a lot more to buy a brand. That makes them more discerning buyers who expect real advantages. Even when no generic exists, there will always be OTC, dietary, and supplement alternatives. If drug companies are to thrive they better have a robust consumer marketing department that reminds the R&D and manufacturing groups that more is required that consumers can easily see, taste and feel in those products. That needs to be part of the advertising strategy and particularly highlighted in the DTC ads. Remember basic efficacy is only a starting point, so brand advantages need to be more than that and offer consumers other reasons to pay more. That is not easy in a heavily regulated environment where change is slow and approval process is long. That is why all the consumer product advantages need to be considered early on and consumer specialists brought in the early stages of drug development. Too often consumer specialists are brought in after the product is in phase 3 or near final approval. That is a mistake made by most drug companies. I hope that will change as consumers are more involved in the final drug selection due largely to their out of pocket contributions.

Bob Ehrlich, Chairman DTC Perspectives, Inc.

“DTC is an easy to execute alternative option to offer information.” -Bob Ehrlich

The trend is clear. Drug companies have dramatically cut detailing and sampling in the past 5 years. According to ZS Associates, reps totaled 102,000 in 2007 and are projected to be at 75,000 in 2012. TNS Healthcare says for every 100 rep visits only 20 involve actually seeing a doctor. Sampling is down from 2007 as well. Drug companies spent $8.4 billion on samples 2007 and down to $6.3 in 2011 according to Cegedim.

Drug companies are also seeing more resistance to detailing as the number of physicians who refuse to see reps increases. This is related to time crunch as well as policy to avoid undue influence. The greatest resistance to seeing reps comes from larger practices and hospitals. About 14% of small practices refuse to see reps but that number in 10 or more group practices jumps to 44% according to SK&A Information Services.

The negative trend in the medical promotion area makes DTC an important reach alternative. Doctors are consumers too so any DTC reaches doctors. Consumer requests on advertised drugs give physicians the motivation to learn about new drugs, even if they refuse to see detail reps. While DTC will never replace detailing, at least it is an information path that doctors cannot stop. DTC will remain particularly important for lifestyle and weight loss drugs. These categories may be seen by physicians as relatively less important than disease treating drugs. To consumers however, erectile dysfunction and weight loss may be equally important to them as reducing blood pressure or blood sugar.

In a health care system that will be increasingly focused on cost control, drug companies will need to be increasingly concerned about provider and payer actions to influence patients away from branded alternatives. In many cases, generics will do the job effectively but in others the branded drug has significant advantages. The patients need a way to hear about these advantages and at least have providers understand those benefits.

The bottom line is drug companies have a right to commercial speech to sell their products. Without these outlets to promote new products, there will be less incentive to research and develop new products. Advertising may have some negatives in convincing people to buy what they do not really need. It also has the positive effect to make products better by creating comparative claims.

DTC is not perfect, and is by definition biased towards having the drug positively portrayed overall. There are plenty of critics who can also provide the public information on why a drug should not be used. Consumers have the right to hear about those choices and physicians have the obligation to prescribe what they think does the best job. Cost will be an increasing factor in their prescribing behavior. As detailing and sampling decline, DTC is an easy to execute alternative option to offer information to consumers and health care providers. That information system in a free market can be messy but would we have government prevent a free flow of information? FDA regulates it now and requires it to be factually accurate per the approved label. DTC is a valuable tool and will remain so as drug companies scale back detailing and sampling.

Bob Ehrlich, Chairman DTC Perspectives, Inc.

“Open and transparent cost information will drive prices down.” -Bob Ehrlich

Today consumers have a wealth of online price information on almost everything they buy. If you want the best price, a little research can get you the tools to negotiate well. You can compare costs across a multitude of suppliers and ask fellow consumers what they paid. We all know how many car and electronics comparison sites exist and most of us use them. So how come none of us really know the cost of our healthcare products and services?

Of course doctors and hospitals are reluctant to tell us. Even if they did, most of the cost is covered and many of us would not care what the bill is. We generally trust our doctors and would not comparison shop based on price. If we need to go to the hospital in a non-emergency, we go where our doctor or surgeon tells us to go. We eventually get a bill for some absurd amount but we only really care about the co-pay which might be 10-20%.

Looking to the future, costs will be controlled because they have to. No matter what system eventually dominates in America, either government or market forces will eventually bring costs down. To do that, cost information will need to be readily available and understandable to consumers. If we have a government run system, prices will be controlled by reducing services and capping reimbursement to
both providers and patients. In a private system, consumers will be paying higher co-pays and getting limited government support through tax credits.

If that happens, then we will see rampant price competition and transparent advertised prices for services. With less money to spend and the end of “someone else” pays, consumers will comparison shop on price and quality. Web sites will be available to tell us doctor and hospital fees and consumer ratings for those providers. While some ratings are available now on some sites, they are few and prices are not readily available.

The era of consumer driven medicine is close. DTC has helped consumers hear about drugs and hospitals
advertise their specialties. To date, however, price remains a mystery to most of us. As we pay more of the bill directly, and we will, consumers will expect transparent price information before they are treated. We will find a lot of wiggle room for negotiation with doctors and hospitals as prices get published. As unseemly as it sounds, we will look for price/value and buy medical services like we do other things. It is already happening in dentistry. Ads are common telling us how much a crown or implant costs.

Health care has been very secretive in disclosing prices. We used not to care and left price negotiation to our payer insurance company. In a few years I expect that role will be taken up more by consumers who will demand to know what things costs and what cheaper alternatives exist. Co-pays will rise, perhaps from 20% to 50%, as employers shift the cost burden to employees. None of us will then be so willing to do anything our doctor tells us to do if it involves expensive tests or procedures. Price lists will be demanded and we will see more price competition as web sites show us where the same service can be done cheaper. Just as we do it now for cars and televisions, we will comparison shop for our medical services. Open and transparent cost information will drive prices down. That will be good for both our personal and government budgets.

Bob Ehrlich, Chairman DTC Perspectives, Inc

“We’re excited to celebrate effective marketing campaigns at DTC National this year,” said Jorge Daboub, VP Client Development Group/Healthcare at Univision. “We’re also excited to bring focus to a valuable consumer segment that represents a $12 billion growth opportunity for pharma marketers – U.S. Hispanics. Brands that engage with this consumer can drive demand and establish first mover advantage.”

“OptumInsight is pleased to co-sponsor the DTC National Advertising Awards in 2012 along with our partner Univision,” said Louis Brooks, Vice President Marketing Analytics at OptumInsight. “This is a great opportunity to recognize the creativity and consumer insights displayed by this year’s nominees. OptumInsight shares this passion for connection with consumers and patients.”

Don’t miss this opportunity to congratulate the Gold, Silver and Bronze winners in person. Finalists for each category are listed below, with the winners to be revealed during the Advertising Awards dinner on April 11th. An independent panel of market research experts and the DTC Perspectives team determined all of the finalists, as well as the Gold, Silver and Bronze winners in eight categories.

“Delegates attending the DTC National Conference will help select the winners for both the Best Branded TV and Best Branded Print campaign awards,” explained Bob Ehrlich, CEO of DTC Perspectives and DTC National Conference Chairman. Using an interactive voting system, the delegates’ scores will be combined with the judges’ scores to determine the winners.

This year’s judging panel included: Mark Einhorn of MarketView Research, Monique Levy of Manhattan Research, Fariba Zamaniyan of TRA Global, Deborah Dick-Rath of SymphonyAM, Fred Church of Ipsos, Frank Chipman of Lieberman Research Worldwide and Jon Swallen of Kantar Media.

The Summer issue of DTC Perspectives Magazine will feature coverage of the DTC National Conference and profile each of the DTC National Advertising Award winners.

The finalists are (listed alphabetically)…

Congratulations and best of luck to the finalists. All Gold, Silver and Bronze winners will be announced at the DTC National Advertising Awards Dinner on April 11th. Be there in person to salute the winners or receive recognition for a job well done.

To register for the DTC National Conference, click here. For tickets to the Ad Awards cocktail party & dinner only or for more details about the event or Advertising Awards, visit the Conference section of our website, www.dtcperspectives.com, or contact the DTC Perspectives office at 973-239-2051.

About
OptumInsight combines unparalleled data assets, online tools, and scientific expertise with innovative market intelligence to provide pharmaceutical, biotechnology, and medical device companies with a full range of integrated services and solutions that support sales and marketing activities. We can help you go to market more quickly, efficiently, and cost effectively while helping you make gains in market share, competitive advantage, and return on investment with our exclusive patient level information database of millions of individuals. Look to OptumInsight for information that can help you formulate the strategies that are essential to realizing the full potential of your brands.

About
Univision is the leading media company serving Hispanic America. Our portfolio includes 2 national TV networks: Univision, one of the top 5 networks in the country, and TeleFutura. We also offer 7 cable networks, more than 130 local TV and radio stations and Univision.com, the most visited Spanish-language website. On the consulting side, we work with clients and agencies to develop and execute their strategies to drive sales with Hispanics. We serve healthcare marketers in the areas of Strategy, Research and Consumer Insights, Marketing and Media Services and Measurement and have worked with brands including Cymbalta, Diovan, Exelon Patch.

About the DTC National Conference
The DTC National has become the industry leading annual DTC event by delivering top quality content and unprecedented networking opportunities to its delegates. This year’s DTC National will be held April 10 – 12, 2012 at the JW Marriott Hotel Washington DC. Hotel space is limited, early reservations and registrations are encouraged. Click here for more information about the DTC National Conference.

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For more information about the DTC National Advertising Awards, contact Christine Franklin, VP of Marketing & Sales, DTC Perspectives at 973-457-5774 or Christine@dtcperspectives.com.

For information about attending the DTC National or Advertising Awards dinner, visit our website, www.dtcperspectives.com, or call the DTC Perspectives office at 973-239-2051.

“I do not see this guidance as a big deal.” -Bob Ehrlich

FDA just issued its draft guidance on pre-submitting DTC television ads at least 45 days in advance of airing. This is to ensure that FDA gets to see ads before they air for brands they feel might pose a risk if the information is incorrect. You may recall that critics say that once misinformation is public and by the time FDA takes action, the ad has already done damage. This 45 day rule helps FDA catch the problems
before the public sees it.

Not all ads will have to deal with the 45 day requirement. Most will, however, because FDA has a fairly broad requirement for categories of ads that must meet the 45 day rule. They include new products, new claims, highly risky drug categories, ads where a prior warning letter was sent, and anything else FDA might determine poses risk. So is this new requirement a burden to drug companies? Will it change the way DTC is done?

I do not see this guidance as a big deal. Most drug companies pre-clear anyway well in advance of airing. After all, no one wants to produce an expensive finished ad and have FDA kill it. Therefore at the storyboard or animatic stage ads are usually sent in for an advisory opinion. The new guidance seems reasonable and as long as FDA is not unreasonable in what they find objectionable, it seems like a benign requirement.

Drug companies will need to develop ads early enough to make sure they can send ads in well in advance so any FDA changes can be incorporated prior to airing. The practical effect is that ads will need to be submitted 90-120 days in advance of air date. FDA will usually suggest changes so a brand team needs plenty of time to re-record voiceovers, fair balance reading, supers, etc.

The old regulations did not require advance looks at ads. They needed to be sent concurrent with air date. The problem of course was violative ads actually aired. This new requirement should prevent this from happening. That would help FDA, the public and drug companies who would avoid embarrassing warning letters and the critics’ inevitable outcries.

I know the advertising industry may see this as a slippery slope. Today 45 days, maybe 90 days in a year, 180 days next year. They also fear outright pre-clearance which would require official FDA approval. I am not concerned about this problem. Whether one calls it pre-submission, pre-clearance, pre-approval it is the same thing in practice. Drug companies need to show FDA the ad in advance and make changes that FDA asks for whatever it is called officially. Drug companies that try to go around FDA have historically been hit with warnings and penalties. So, I urge drug companies to start the copy development early enough so they do not face the dilemma of hoping they have time to make changes.

DTC copy development should start about 18-24 months prior to expected air date. That will help with FDA review but also makes good business sense as numerous refinements based on consumer feedback takes time. In the average 60 second ad you may have 25-35 seconds of sell copy and every second counts. Too many drug companies wait way too long before selecting the DTC brand team and agency. Layering on this new FDA requirement should incent drug companies to start sooner and that is a good thing.

Bob Ehrlich, Chairman DTC Perspectives, Inc

This year’s class, sponsored by PARADE Magazine, includes representatives from 15 different manufacturing companies, with a broad range of DTC responsibilities, from brand marketing to media planning to consumer engagement. “PARADE is pleased to join DTC Perspectives in recognizing this year’s Top 25 DTC Marketers,” says PARADE Group Publisher, Brett Wilson. “These leaders are setting the benchmark in the industry and driving innovation in their field.”

The Top 25 DTC Marketers of the Year for 2012 are…

Bob Allen, Director, Digital Marketing, AstraZeneca

Melissa Bojorquez, Associate Director eChannel Marketing, Boehringer Ingelheim US

Jennifer Borgmann, Promotion Manager, Global Marketing Communications, ISENTRESS, Merck & Co., Inc.

Vladimir A. Castillo, U.S. Oncology, Yervoy Marketing, Bristol-Myers Squibb

Julia Deves, Senior Product Manager, Tafamidis, Pfizer

Ken Haener, Media Director, Team Leader, Pfizer

Susan Harris, Sr. Director, Insulins Marketing, Sanofi US

Scott Hazelton, Director, Consumer Marketing BPH Franchise, Jalyn, GlaxoSmithKline

Stacee Jones, Senior Product Manager, Primary Care Marketing, Novartis Pharmaceuticals

Todd Kolm, Director, Emerging Channel Strategy, Consumer Center of Expertise, US Primary Care Marketing, Pfizer Inc

Laura Y. Kolodjeski, Senior Manager, Patient Solutions, US Diabetes Division, Sanofi US

Brian Lange, Product Director – Cardiovascular and Urology, LOVAZA, LEVITRA & STAXYN, GlaxoSmithKline

Carolyn Leighton, Product Manager, XIAFLEX, Auxilium Pharmaceuticals

Christopher Leonardi, Associate Director, Tasigna, Novartis Pharmaceuticals Corporation

Meredith S. Manning, Senior Director, Marketing, Vertex Pharmaceuticals, Inc.

Shruti Parekh, Product Manager, II, AndroGel, Abbott Laboratories

Jessica Pieters, Brand Marketing Leader, Seroquel XR/Nexium, AstraZeneca

Lisa Romero, Product Director, OraPharma

Jennifer E. Ryan, Team Leader, Global Contraceptives, GMC and CS, Merck & Co., Inc.

Jeremy Shepler, Associate Brand Director, Marketing, Novo Nordisk

Laura Stamper, Product Manager, Neurodegenerative Diseases, EMD Serono

Lisa Tollman, Director Marketing, DTC, Prolia®(denosumab), Amgen Inc.

Brian Walsh, Senior Product Manager, EGRIFTA®, EMD Serono, Inc.

Michael A. Wishingrad, Gardasil Franchise Team Leader, Merck & Co., Inc.

Justin Zandri, Associate Director, Spiriva, Boehringer Ingelheim Pharmaceuticals

“These elite pharmaceutical marketing professionals are this year’s top contributors to the advancement of patient outcomes via direct-to-consumer pharmaceutical education and marketing,” added Robert Ehrlich, DTC Perspectives chairman. “We would like to recognize the faces behind prominent DTC campaigns, because their hard work and dedication to fostering the industry is often not recognized. The awardees were selected from many worthy candidates.”

The Top 25 DTC Marketers will be honored with this prestigious award during a special luncheon (April 12), immediately following the close of the DTC National Conference. The DTC National will be held April 10-12 at the JW Marriott Hotel in Washington, DC. This year’s luncheon will be a private event; those wishing to attend should contact the DTC Perspectives offices at 973-239-2051 for more details about how to receive an invitation.

About PARADE

PARADE Publications is a multi-brand media company that provides entertainment, information and inspirational human interest stories to millions of Americans. It includes PARADE, America’s most widely read magazine, which reaches 65 million readers each Sunday through over 640 of the nation’s finest newspapers. PARADE Digital is a unique content and advertising partnership that combines the company’s digital assets with over 500 newspaper partner websites, reaching 50 million unique monthly visitors. Dash, the new food brand created in collaboration with Condé Nast titles Bon Appétit, Epicurious.com and Gourmet, aims to help busy moms prepare simple, fast and delicious meals every day. Dash magazine is distributed monthly in more than 113 newspapers with a circulation of 8.5 million and a web audience of over 7 million monthly unique visitors.  In addition, the dash food brand will expand in 2012 with “Dash:  Around the Table,” a local food event program.

About DTC Perspectives Magazine
DTC Perspectives Magazine, a quarterly resource for DTC thought leaders, has been read by industry leaders for more than a decade. As the industry’s only magazine devoted exclusively to DTC marketing, DTC Perspectives is well positioned to serve as the platform for the industry to recognize and honor the leading marketers, campaigns and companies in consumer marketing. The Summer 2012 issue will feature profiles of the Top 25 DTC Marketers.

About the ‘Top 25 DTC Marketers of the Year’ Award
The annual “Top 25 DTC Marketers of the Year” was established in 2001 to recognize extraordinary DTC marketers who drive innovation and work towards better patient health outcomes. Pharmaceutical companies, their agencies and supplier partners were invited to submit nominations in an industry-wide process. The list is then rigorously examined to arrive at the final Top 25.

For more information about the Top 25 DTC Marketers of the Year awards, contact Jennifer Haug, Director of Publishing & Content, DTC Perspectives at 973-457-5718 or Jennifer@dtcperspectives.com.

For information about attending the Top 25 luncheon, call the DTC Perspectives office at 973-239-2051. To register for the DTC National Conference, click here or call our office.