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December 2, 2019 0

 

Your parents are the ones who always take care of you.  Mom kissed your knee when you fell on the playground, and Dad drove you to the hospital when you needed to get your tonsils out.  Your parents kept you healthy and safe.  They were your rock and knew all the answers and just what to do.

Time passes.  You’re in your thirties and somehow in an instant the role of caregiver has flipped.  This was the case for me.  Nothing could prepare me for the moment I learned my mom, my rock, was diagnosed with a form of non-Hodgkin’s lymphoma.  I recall googling “NHL” only to be served hockey statistics; I was frustrated and scared.  Every time we went to see her oncologist or when I accompanied her to chemo, I would get hit with a wall of anxiety.  Each time we stepped into the hospital, what my mom and I truly needed most was support.

As a caregiver and patient, I understand the emotional moments that can happen at the point of care.  As a healthcare marketer, I also understand the value of this space as a channel, and I’ve been fortunate to see it evolve over the tenure of my career.  Today, pharmaceutical brands and healthcare and lifestyle advocacy groups push messages at these point of care (POC) settings, hoping to educate patients about therapy options.

But POC as a marketing channel needs to be treated both similarly and differently from other marketing strategies if a marketer wants to appear relevant and connect in a meaningful and useful way.  The reality of distracted, concerned patients and worried caregivers means brands that want to engage with patients at the POC need to approach them with greater empathy and understanding, with content that resonates emotionally and rationally with this audience.

But what makes POC unique anyway?

The POC channel supports the patient at critical moments of their health journey. 

From acute illness to more chronic or prolonged conditions, important milestones of the health journey happen at the point of care.  Through a recent survey collaboration between Outcome Health and Nielsen, we learned that the wait times within the rooms of point of care are substantial, with patients waiting on average up to 38 minutes in the waiting room and then another 36 minutes in the exam room.  These wait times represent a huge opportunity to communicate with and impact patients, caregivers and physicians all at the same time — essentially turning a “captive” audience into a “captivated” and educated one.

Inventory is finite if POC content is done right.

POC differs from other digital ad channels because inventory is specific, targeted, and limited.  Think about it.  There are only so many rheumatologists in the United States, and there are only so many brands that treat or support patients who see a rheumatologist.  Factor in the attention span of the average person today, include the other places they can get content in the doctor’s office (like magazines, posters, pamphlets), as well as the fact that we are all walking around with smart devices that can deliver content that we ask it anytime, anywhere, and you realize how critical it is to provide content that is aligned with why a patient may be in that rheumatologist’s office in the first place.  This content (continuing with the Rheumatology example) could include anything from signs and symptoms of Lupus, to managing rheumatoid arthritis through diet, exercise, and lifestyle choices, to understanding how to best support a loved one who has osteoporosis — this is just the short list of potential content that may be pertinent to patients or caregivers seeing rheumatologists.  The funnel of dependencies leading to the opportunity to message a patient who is seeing their provider for an ailment and being able to support that patient on their journey means that there are finite opportunities like this, which makes messaging at the POC more sophisticated and challenging in the same breath.

The point of care is the final touchpoint of the marketing message. 

On many occasions, I’ve heard pharma marketers muse, “What if we could hold hands with patients when they have those important conversations with their provider?”  In the POC channel, you can.  Unlike TV, print, and digital that serve to create awareness for new therapies or reach patients before they reach the office, POC holds their hand in the office, moments before and during time with their physician.

POC drives patients to take action.

Messaging at the POC has been proven to impact and shift patient behaviors.  In a study by ZS Associates, patient behavior was measured after being exposed to digital signage at their provider’s office.  Of those exposed, 84% were more likely to ask their doctor about an ad they saw, 68% asked their doctor for a specific medication, 31% were more likely to fill their prescription, and 34% were more likely to take their medication as prescribed.

Where does POC marketing fit in alongside DTC and traditional channels?  The point of care should serve as a complement to your brand’s other marketing and sales efforts, with specificity and context for patients waiting to see their doctors, moving them forward towards treatment.  POC marketing can be leveraged as a digital tool, as a TV alternative, and even as a patient engagement solution to share benefits like co-pay assistance programs.  Because your ad is now in the room with patients and their physician, messaging must be tailored for this space; simply dropping your TV spot onto an exam room screen isn’t likely to cut it with patients who are waiting to see their doctor.  Advertisers should welcome the opportunity to become more deeply integrated into the patient-doctor experience and develop content that can be integrated into the clinical setting.

Because there’s such a range of experiences (and emotions) that happen at POC, it’s important that any content (sponsored or not) intended for this space is sensitive to that.  You can’t create effective content without considering the patient’s mindset.  Content must be curated and contextualized for each touchpoint of the point of care experience.  Videos should be relevant for that clinic’s specialty and help to facilitate physician-patient conversations.  When you’re at the doctor’s office, sitting in a gown (or in the passenger seat supporting an ill parent), wouldn’t you prefer fact-based, custom information that’s helpful and supportive of the conversation you’re about to have with your physician?

On the other hand, there are also moments of the health journey when patients don’t want to dig further into their treatment plan or condition and prefer access to content that simply entertains or distracts them.  We as marketers need to take into account the range of experiences that happen within the point of care and provide content that aligns with and supports these unique moments.

The most important thing to remember is that patient needs vary within the POC environment, and you can’t take a “one size fits all” approach with your messages within each channel.  The diversity of needs and experiences is prompting the space to evolve beyond just awareness.  New trends within the space include patient education, adherence, support group registration, and more.  The channel is poised for continued growth and we, as healthcare marketers, need to continue to innovate so that everyone entering the POC space can feel informed, inspired, entertained, and renewed during the most critical moments of care.

 

Matt McNally

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September 5, 2018 0

The Senate recently passed an amendment to a larger health care bill that requires drug prices be disclosed in DTC Ads. The Durbin amendment was adopted with bipartisan support. It really just gives HHS a million dollars to study a way to require the disclosure. What is clear is this idea has strong support from President Trump, Congress, HHS Secretary Azar, and the American Medical Association. So, like it or not, the drug advertisers may be forced to add some price information to ads.

Bob Ehrlich
“Drug makers may be forced to add… price information to ads.”
-Bob Ehrlich

On the surface, that list price disclosure seems reasonable. We see MSRP in car ads, so we know whether it is a premium or economy car. Not that we don’t know that already but it is not unreasonable. For cars, we know we will likely pay somewhat less than MSRP but we do know the range a Mercedes will cost us. Congress thinks consumers deserve to know the price of drugs they see advertised. To Congress that seems like it would help consumers decide if this advertised drug should be considered.

Drug pricing is not like car pricing. Consumers pay much less than the list price and sometimes pay nothing for the $50000 drug for cancer. Admittedly, drug pricing is a Byzantine process that confounds most of us. Each insurance company, PBM, and government payer negotiates prices. Each consumer depending on their insurance pays a different price no way near the list price. Sometimes the consumer would pay out of pocket more for their OTC cough medicine than the $50000 cancer drug.

So how should drug companies disclose drug prices? If the list price is not anywhere near what consumers pay, then how does disclosing it help them? It does not. It helps insurance companies in making DTC more difficult for drug companies to execute. The knowledgeable legislators know that if they force drug makers to talk about price that may discourage them from doing DTC Ads for expensive drugs. Drug makers advertising the $100000 cancer drug may decide that DTC is not worth trying to explain the complexities of drug pricing or face the barrage of criticism for having a sticker shock price.

I think this is the real reason for this amendment. Embarrassing drug companies they hope will put a chill on DTC for cancer drugs, biologics for arthritis, Crohn’s, and other new premium drugs. Of course, all drugs will face a guidance on how pricing needs to be discussed. Somehow FDA will make disclosure a time consuming step in a DTC ad. That will add 10-15 seconds to the ad and may make them difficult to execute. Their hope is to get drug companies to stop doing DTC.

So the good news is it will take FDA a while to study and draft guidance for disclosing price. This lag may allow the powerful advertising lobby to show how impractical this disclosure requirement will be. My guess is we may have some compromise that speaks in terms of ranges of price. That is something like “most patients will pay much less than the price listed depending on your insurance coverage.” Or, drug makers may be able to say “the average price paid by consumers is x.”

It may be illegal to require drug makers to disclose price under commercial free speech grounds. I am sure the advertising lobby will argue this inhibits commercial speech. They would have a strong case based on precedent.

My advice to the agencies is to be ready to deal with adding some price statement but I am sure it will be a few years before FDA can figure out how best to do this. They research everything they do and that will take a long time to study. DTC price disclosure sounds great but is just a bad idea that will not help patients.

Bob Ehrlich

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February 10, 2017 0

Merck’s cancer drug Keytruda recently began its DTC campaign competing with Bristol Myers’ Opdivo. What is significant is that highly targeted drug categories continue to invest heavily in DTC. Keytruda is a biologic injection that has indications for non small cell lung cancer, advanced melanoma and head and neck cancer.

Bob Ehrlich
“Keytruda has done an excellent job in its DTC ad.”
-Bob Ehrlich

The market is small by size compared to mega categories like diabetes and cholesterol where sufferers are in the tens of millions. Lung cancer cases number about 200,000 newly diagnosed annually. Of course, when the treatment price is around $100,000 per year for biologic lung cancer treatment versus less than a thousand for cholesterol drugs; the DTC payback is certainly achievable.

Roughly the numbers show a $50 million ad campaign for Opdivo and Keytruda need only gain 500 new patients from DTC to break even on a revenue basis. While consumers are the DTC apparent target, these ads also reach oncologists. Once an oncologist knows patients are seeing the DTC and will ask about the drugs, it clearly provides the motivation to consider using them.

The Keytruda ad is very different from Opdivo. While Opdivo used a headline dramatic announcement approach, Keytruda chose an individual patient story. Using an actor portrayal Keytruda showed a 60ish age woman named Sharon telling her story in a tv production studio. Sharon says she learned her type of lung cancer could be treated with an alternative to chemo. She tells how she was given only months to live but a year later after treatment she is still there with her family.

The commercial is filmed in black and white which adds to the seriousness of the presentation. Sharon’s story in this 90 second ad is told very well. It is very informative and understandable using Sharon and supers emphasizing the key benefits. What is interesting is that they are showing Sharon in the production studio both telling her story and in the makeup room preparing to be filmed. Her family is also at the studio watching her being filmed telling her success story.

The sell portion of the ad is about 30 seconds with fair balance risks and warnings in the last minute. Clearly the ad is technical in terms of disclaimers about who can take the drug and one wonders if patients who have non small cell cancer are aware of their biomarkers and gene types mentioned in the ad.

Given the high prices for treatment stock analysts see Keytruda generating revenue in the billions. A DTC campaign costing $50-100 million for a drug bringing in billions is a small risk for Merck. Opdivo had been criticized by some doctors for advertising to patients in an area best left for oncologists. This is a fair question but advertising breakthrough therapies does help potential patients become aware of their options. It also puts pressure on insurance companies to cover the large expense.

Keytruda has done an excellent job in its DTC ad. This campaign will get attention and is very different in executional style from Opdivo, an ad I also think is very good. The broader concern is whether advertising $100,000 drugs to consumers causes Congress to look more critically at both drug prices and DTC ads. While individual patients get extra months and in some cases years longer to live, government payers and insurance companies are paying a lot for that life extension. While no one wants to put a price on those months, unfortunately it is a calculation needed to be considered by policy makers.

Bob Ehrlich