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The worst part of the Zika story we know so far, is that we do not know nearly enough to combat it in a meaningful way. First it was just an exotic STD from South America. Then it turns out to be a virus that could cause severe disability in newborns. As of August 2016, the CDC has reported that there are 2,722 Zika cases across the United States, another 14,110 in the US Territories (not counting the sexually transmitted cases), active mosquito-borne transmission in every country from Mexico, south through the Caribbean and Central America, to Ecuador, Colombia and Brazil in South America.  New studies indicate the virus is associated with brain disorders in adults, for example Guillain-Barré syndrome.  According to Florida State University researchers, the Zika virus directly targets the development of brain cells, in as little as three days after exposure, effectively stunting the cells' growth.

The United Nations Health Agency noted in its new warning on the virus that “the more we know, the worse things look,” while World Health Organization’s Director-General Dr. Margaret Chan said that in under a year, the status of Zika has changed from ‘a mild medical curiosity’ to a disease with severe public health implications. Meanwhile, the CDC reported just a few days ago that they are almost out of money to fight this growing epidemic, which is unfortunate for many states and Puerto Rico which heavily rely on Federal help.

We still do not know what type of global impact on the spread of Zika the past Olympic games will play, but with the fast approaching annual rainy season in South America we are in for a perfect storm of factors that could become the tipping point to spreading the virus globally, unless concrete steps are taken now.

Clinical trials to make vaccines are still in process, and won’t progress anytime soon for that matter, if the stock market is any indicator.  Companies like Sanofi (NYSE:SNY), Inovio Pharmaceuticals (NASDAQ:INO), Intrexon Corp (NYSE:XON), and others have announced Zika vaccines initiatives, but the investors are clearly not impressed.

That leaves us with the next most logical option: detection.  Making easy to use, rapid, reliable, and cost-effective testing tools widely available across the affected region will help slow the spread and is a key preventative measure for this global epidemic.

Dr. Yelena Budovskaya, Ph. D., whose company Xnsion is at the cutting edge of rapid testing development, explains the difficulty labs face when tackling the problem with traditional methods. According to Dr. Budovskaya, “Most new technologies target the development of an instrument or adapting already existing instruments to allow rapid detection of one or few potential causes of infection. These instruments are expensive and would require significant investments for a diagnostic lab to adapt and adopt these instruments for the detection of various disease and infections; and in this case – Zika. Combined with the high cost of tests and limited testing availabilities, very limited information is available about the epidemiology of Zika: from its geographic origin, patterns, down to the possibility of health impacts and studies regarding Zika co-infections with other mosquito- or tick-borne viruses. The other fundamental problem with current Zika testing technologies is that they heavily rely on antibodies against the Zika virus. However, the Zika virus is very similar to other mosquito-borne viruses which makes those test unspecific. “

Yet, while, companies like Xnsion do appear to have the answer, it has yet to reach the market. The stalemate seems to be in the partnership that should have been a fertile ground for growth and innovation: between the public and the private sectors. One is in the business of advancement of public health, while the other is in the business of offering effective solutions for a profit. Inertia of one, causes inertia in the other, and rightfully so.

Big corporations do exist for the ultimate goal of enriching their shareholders, and they simply cannot afford to invest into solutions that will not have the backing of the public sector. Right now the “best” (CDC recommended) test costs ~$20-25 per sample that makes it out of reach in many struggling economies, which also happens to be the countries most affected by the virus at the moment.

Public health experts say that a viable test should utilize standard molecular laboratory equipment, be simple enough to be performed by any laboratory technician without necessity for in-depth knowledge in molecular biology, and should cost below $10 per test.

I believe we could get there, and the price will be driven down by normative market laws of supply and demand through increased competition if the private sector sees a serious commitment from the Federal government here at home, the World Health Organization, and of course local governments across the region.

Combating the Zika virus falls out of the normative boundaries of global responsibility. It is not about more affluent countries providing aid to developing nations. The threat to global health is real, and is a joint responsibility of the leading nations and each individual government in the affected region to step up to the plate. One cannot expect the private sector to go at it alone, although one can expect them to deliver, if the other side does their job, as opposed to the ongoing jockeying currently happening in the US Congress, such as blocking President Obama’s request for the necessary funds.

It is easy to call out the pharma industry for being the bad guys. But maybe, now is the perfect opportunity for the public sector to show them what good guys look like, and help create the market conditions for an affordable, accurate, scalable, adaptable and, most importantly, rapid Zika diagnostics.

The theme of this month’s DTC in Focus newsletter is “From the Patient's POV”, so I want to start with a little experiment. Si escribo esta frase en español, va a entender?

Did you understand that? The Spanish sentence simply says, “If I write this sentence in Spanish, will you understand?” I’ll admit that I used Google’s translate tool to help with the translation, and yes, I’m aware that online translations are not always 100% accurate.

Unless you are fluent in Spanish, those nine words probably confused you. Did you try to figure them out? Did you get close? For many of the 58 million Hispanics¹ living in the United States, trying to translate isn’t just a nine-word experiment – it’s the everyday reality of living in a country where the majority of the health information is only available in a language different from the one they speak.

A Growing Market

The fact that many pharmaceutical and healthcare brands continue to ignore the Hispanic market is remarkable when you consider the numbers. According to research from Telemundo:

• 1 out of every 4 babies born in the United States is Hispanic (25%)¹
• Nearly 1 in 5 Americans will be Hispanic by 2020 (19%)¹
• Every 30 seconds, a Hispanic turns 18,²
• By 2020, Hispanics will account for more than 50% of the total U.S. population growth.¹

When you see these numbers presented this way, it’s staggering to realize the opportunity that lies within the growing Hispanic population. But don’t forget that as a brand marketer, you have to at least meet these consumers halfway. According to The Curve Report by NBCUniversal, 77% of Hispanics feel underserved and wished brands reached out more (versus 43% of non-Hispanics), meaning that they are waiting to hear from you.

The truth is that every brand will say that multicultural education and marketing is important to them, but when it comes time for budget cuts, Spanish-language marketing is the first to go. However, armed with the statistics above, you can make the case for implementing these programs into your existing plan and begin delivering results by reaching the Hispanic consumer at the point of care.

Myth Versus Reality

Even with the staggering statistics presented above, some brands are still reluctant to target the Hispanic consumer. It seems as if there are two prevailing myths that are clouding their judgments and a quick reality check might further reveal the tremendous opportunity with the Hispanic population.

MYTH: Hispanics prefer cost-saving generic drugs instead of the often more expensive name brands.

REALITY: Over a third of Hispanics (35%) are much more loyal toward companies that show appreciation for their culture by advertising in Spanish.³ Many immigrants who came to the United States support brands that are available/marketed in their home country, while Hispanics who were raised in the United States tend to trust the brands that their parents and grandparents relied on while establishing the family’s new roots.

MYTH: Healthcare products are a “luxury” that Hispanics are not willing to purchase.

REALITY: 44% of Hispanics are willing to pay anything when it concerns health versus 36% of non-Hispanics, according to Simmons One View research. And, according to one PatientPoint study, 48% of Hispanic patients (compared to 37% of non-Hispanics) responded saying they go to the pharmacy immediately after – when the brand their physician recommended is still top of mind.

By ignoring popular misconceptions and relying on the facts, marketers can tap into an underserved market that is seeking Spanish-language education materials and from brands that understand the cultural nuances to healthcare communication.

Opportunities Abound

Did you know that Hispanics suffer from more health issues than the general population? For example, Hispanic children are 40% more likely to die from asthma compared to Non-Hispanic whites, and Hispanic adults have the greatest prevalence of obesity and nearly 30% have diabetes. In one PatientPoint survey, a higher percentage of Hispanic women who participated – 32% – had never had a pap test compared to 6% of the Caucasian women and 4% of African American women.

These statistics underscore the desperate need for quality education customized for the Hispanic audience, including a more robust Spanish-language offering. At the rate the Hispanic population is growing, combined with the lack of healthcare education that has historically been available in Spanish, marketers will realize there is a tremendous opportunity to reach Hispanics now, and develop loyal customers for the future.

 References

1. Census 2014 National Population Projections

2. Pew Research Center as quoted in “Every 30 Seconds, a Latino Reaches Voting Age”, The Atlantic, 8/26/15.

3. New Simmons stat (Source: Simmons Winter 2016 NHCS Full Year Study, Hispanics A18+)

About the Authors

Linda Ruschau is the Chief Client Officer at PatientPoint, the trusted leader of patient and physician engagement solutions at the point of care. She brings nearly 25 years of experience in pharmaceutical marketing, point-of-care expertise, client service leadership and business acumen to the role. As one of its first employees, Ruschau helped PatientPoint pioneer the point-of-care industry in exam rooms, waiting rooms, clinical areas and throughout a patient’s hospital stay. She is now one of the company’s longest-tenured leaders. Ruschau can be reached by email at linda.ruschau@patientpoint.com or telephone at (513) 936-6819.

Ellen Falb-Newmark is the Vice President of Client Development at NBCU Hispanic Enterprises and as such serves as a personal consultant to clients on all things pertaining to the Hispanic consumer. With more than 25 years of Latino Marketing and Advertising experience, she utilizes consumer insights, research and custom data to demonstrate the value of this vibrant customer. Falb-Newmark represents all the company’s media assets including network, cable, digital, mobile, out-of-home, custom content and promotions. Falb-Newmark can be reached at ellen.falb-newmark@nbcuni.com or (212) 664-3503.

Nothing makes one better at their job as a healthcare marketing art director than actually experiencing healthcare firsthand. I’ve always been relatively healthy – doing my fair share of exercising physically and mentally, and eating “kinda” well. I rarely visited my doctor’s office, except for the usual appointments. More honestly, I steered clear of doctor visits almost entirely. I routinely even avoided taking ibuprofen for common aches and pains associated with running. As healthcare marketing creatives, we put ourselves in the shoes of patients to find out what messaging resonates with them. Pretty ironic stuff – here I am in this healthcare advertising world that I clearly try to avoid in my non-working world through my own preventive measures. I’ve gleaned a solid chunk of my healthcare knowledge purely from being surrounded by it for the past 10 years – concepting campaigns, learning about healthcare technology, reading statistics, focus groups, etc. You can gain a lot of information that way (and I have), but to experience healthcare firsthand was an area that I personally lacked.

To read the Deb Salzer's full article about “stepping into the role of a patient”, click here. This blog post has been shared with permission from HTK Marketing Communications.

Part 1: Testing And the Lancing Device

Editor's Note: Last month, DTC Perspectives' President & Chief Operating Officer, Scott Ehrlich, was diagnosed with diabetes. Join us in the multi-part series as he shares a first-hand account of his experiences as he moves along his treatment journey.

About a month ago, I went for a blood test and found out my A1C was over 10%. This, combined with an unexplained weight loss of about 30 pounds, led doctors to the obvious conclusion that I had joined the ranks of about 30 million Americans who had diabetes. At this point, the two major questions were which type of diabetes, and how can I treat it? Because it came on suddenly and quite severely, my doctors suspected type 1. I, knowing my diet and physical activity regime over the last 30 years, suspected type 2.

As diabetes is very complex, it's more than just taking medication every day to treat this disease; there is a great deal a patient has to know about diet, exercise, devices, drug interactions, dosing, and testing. As there was so much to take in, I decided to detail my experience as a newly diagnosed diabetic and the challenges I have faced, having spent so much of my time on the marketing side, to now be on the patient side. In this article, I detail with the lancing devices I have had to learn to use. My future articles will deal with the various monitors and medications available, and the overall consumer experience of being a newly diagnosed diabetic.

After going to my GP with my initial blood results, I went to an endocrinologist for a follow-up. After taking a quick and painful finger prick with the lancing device at the office, they quickly confirmed that I had diabetes, with a fasting blood sugar of 273mg/dL at that time. (A normal result for fasting blood glucose ranges from 70-110 mg/dL.) I was also told that the blood work, to determine which type of diabetes I had would take a week. However, because of how high my blood glucose was and that the doctor suspected type 1, he decided an aggressive course of treatment should be tried, well beyond diet and exercise. Being that I was deathly afraid of needles, this was awful news for me. I was told I needed to test my blood sugar at least four times a day and inject insulin into my stomach three times a day on a sliding scale depending on where my glucose was. After a very brief demo, the nurse sent me home with an Accu-Chek meter, a FastClix pen, and 100 units/mL of Humalog fast-acting insulin.

Testing with the Well-Knowns

The first thing to deal with was the testing. I had read, prior to this visit, that FastClix was one of the preferred pens of diabetics as far as reduced pain and ease of use was concerned. The FastClix device was small and came with a cartridge for lancing devices that held six lancets. When pushing the button, you never actually saw the needle, which was good for a needle-phobe like myself. After mustering up the courage to prick myself, I put it on the second lowest depth and proceeded to prick the side of my finger. The button to give the injection is like the button on the back of a pen, except you have to push pretty hard. I kept pushing and pushing, holding my breath, waiting for that stinging pain. Finally, after pushing down a good bit, it finally kicked into action, the lancet pricked me, a little blood bubble was drawn, and I had done my first test.

I was pleasantly surprised to see that this really didn’t hurt. However, I was not happy that it wasn’t comfortable and, the knowledge that I’d have to do this three to four times a day at least, every day, for possible the rest of my life, would leave my fingertips pretty torn up. This was confirmed by the fact that, by the end of the second or third day, and even though I would switch up fingers, they were pretty sore. There’s not a lot of places you can inject on the fingertips and, being useless with my left hand, there is really only one hand I could use for the pen. FastClix also isn’t meant for alternate site testing so I could see my index and middle fingers on my left hand were due for a rough ride. Still, for the price and ease of use, as well as the lack of any real pain (like briefly pricking your fingertip on a thorn at worst), it could have been a lot worse than the FastClix.

Trying an Alternative Device

Still, I was concerned about the frequency of the testing and the accumulated discomfort. Knowing I had to do this a lot, I tried to see if there were any devices that could be better and provide less discomfort or more choices as to where to do the testing. I came across an interesting device called Genteel, developed by an engineer. There weren’t a ton of reviews I could find on it and the price of $129 for a lancing device seemed a bit steep, compared to the $20 or far less most others would cost. Furthermore, most of the positive reviews I could find either came from the site itself or from people given a free sample for testing. The website featured a video of a sleeping child getting tested on their shoulder by a parent and not being woken, which also seemed hard to believe. Still, hating needles more than I hated parting with my money, I decided to order one and give it a try, as it's only available via online order.

When I received it a few days later, it was much bigger than the other device and came with a bunch of highly visible lancets. There are also some attachments you put on top to control the depth of the stick. It is certainly less intuitive than the FastClix, with a lot more moving parts, to start. I put on the one for the smallest stick, which is largely recommended for finger sticks, since body skin may be thicker. I set it up, put it on my shoulder as in the video, and pushed the button. At that point, the plunger pops up and you are supposed to hold the button for a few seconds before taking it off. Aside from the loud pop it makes when you push the button, I didn’t feel anything. No stick, no pressure like with the FastClix. I took it off and figured I’d need to put on the cap for a deeper stick on the arm when I looked down and saw a perfect blood droplet sitting there. I couldn’t believe it.

I tried the same thing on my finger. It wasn’t easy to find a spot on my fingertip that would fit the device at first due to its size, and also it needs a vacuum seal to work properly. However, once I lined it up right and did it, it was much the same result. Painless, and, unlike the FastClix, largely sensationless. You’d also usually draw more blood with each prick, even on the lowest depth, which could be very helpful in machines that require a good amount of blood for each test (more on these in the next article).

One of my only complaints about it is that, for the price, it's not the most durable device. I dropped it on the floor when trying to set the plunger and the back part fell off. While it is removable for cleaning, it was a pain to get back on and even when I did finally get it back on, the device didn’t work properly, either flying off when I tried to test or pricking way too deep leading to real pain. I was able to get it working again, however, in a few hours and I am certainly no engineer when it comes to fixing devices. I was also sent another device immediately after I said something to their customer service rep, who was available to be reached through an online chat, on a Sunday night no less. Their service is superb. My only other issue with this device is that it is a bit bulky compared to others, so carrying it in a pocket or a small carrying case, such as the one provided, along with my other diabetes supplies, isn’t easy. However, it’s a great device and I haven’t used my FastClix since I received it.

Factors Impacting Compliance

Testing is one of the most important things for a new diabetic to learn and compliance with testing is paramount, regardless of the type or severity of the disease. With the FastClix, I didn’t fear testing, but I certainly would not do it more than I had to; I sometimes had to talk myself into it. With Genteel, I had no trouble convincing myself to test. In fact, I was testing so frequently I ran out of my first month’s supply of testing strips in about a week. For someone like me that hates needles, doesn’t do well with pain, and likes to be able to vary their testing sites, Genteel has been a tremendous help in frequent testing, the first step in keeping my blood sugar numbers stable.

However, I am also a consumer that has both means and did a lot of research. Neither my endocrinologist or his assistant had ever heard of it. Most insurances won’t cover it. It doesn’t come with any glucose meter. There is no DTC behind it. It's not sold at pharmacies. So most consumers will be using something like the FastClix or the OneTouch Delica (which came included with my OneTouch Meter). These are good devices and I’m sure much better than what preceded them. They are cost effective (both of them were free for me) and get the job done. They both come with glucose meters, are widely available, and are backed by well-known and respected companies.

If testing was infrequent, cost was a major driver, or the patient was a bit tougher around needles than I was, I think both would be perfectly sufficient. However, if you were like I was, and building up the courage to do each and every single finger prick was a struggle, the Genteel was well worth it. And if my two-year-old son, for example, was the one who had diabetes instead of me, the Genteel is a no brainer. It has been a game changer for me in maintaining testing compliance, and pharma companies would do well to integrate it or a similar lancing device into their treatment packages. Because no matter the diabetes type, no matter the severity, no matter the treatment plan, regular and frequent testing is a necessity. That becomes much harder when the patient has any amount of fear of or dislike for their lancing device.