PM360 asked experts within point of care how the space is evolving and what might change in 2019 and beyond, including:
- What has been the result of increased transparency and audited reporting after the controversy over inflated numbers in previous years? How are companies ensuring they get what they pay for?
- What are the best ways to measure the success of POC marketing campaigns? What metrics are the most important to look at?
- What new technologies, methods, or strategies should marketers pay the closest attention to in 2019 in terms of POC marketing?
- What are some of the biggest pain points marketers face in the POC space? How can they overcome them in 2019?
The past 12 months have afforded point of care (POC) a critical opportunity to demonstrate a commitment to transparency and audited reporting—restoring confidence and accelerating investment in the channel. The PoC3 has been a driving voice in this effort, establishing verification and validation guidelines and assembling an Industry Advisory Council comprised of senior leadership across agencies and pharmaceutical companies to build on the association guidelines published in 2018.
Under PoC3 guidance, third-party auditing companies have been engaged to help ensure buyers that they are indeed getting what they paid for, and PoC3 urges all POC media providers to conduct regular and thorough audits with these companies. The effort to create and maintain universal verification and validation standards that will advance the industry remains an important focus for PoC3 in the future. At the same time, the key trends toward healthcare consumerism and value-based care are broadening the scope of point of care, allowing brands and agencies to further realize the abundant opportunity POC provides. The future of POC is a bright one.
Transparency is achieved through people, partnerships, and processes. As advertisers have come to expect audited reporting for POC marketing, there is demand for the industry to provide advertisers with the confidence they require to increase utilization of this critical patient touchpoint. Organizations such as the PoC3 are working to align the industry in developing much-needed standards.
At Outcome Health, we’ve seen tremendous value in building more sophisticated systems that can capture, preserve, and track campaign scoping and delivery data. Make sure you work with companies that have implemented third-party independent auditing by BPA and can provide analytical reports and audits on a regular basis for each campaign that you run with them. Other ways to ensure you are getting what is promised is to work with companies that partner with a physical auditing firm to add an additional layer of qualification; collaborate with Nielsen to quantify and qualify audiences, data, and analytics; and use best-in-class data sources to map target physicians to physical office spaces in order to get even more rigorous data.
Enhanced auditing standards, frequent verification, and heightened scrutiny on POC marketing will now allow the channel to fully demonstrate its efficacy. By demystifying the available platforms and clarifying reach for each tactic, partners can speak openly about campaign objectives and performance. In doing so, buyers and providers can align to determine the best methods to reach patients and consumers.
This collaboration will lead to stronger ROI and greater value, since programs are grounded in verified, trusted channels and touchpoints. Most importantly, by improving communication and transparency, both parties gain a better understanding of the capabilities and challenges of POC.
For marketers, significant challenges remain in finding effective, efficient programs that meet regulatory guidelines at POC. It is incumbent upon media providers to assist marketers in understanding the POC channel and the vehicles that will carry their messaging. Concurrently, providers and buyers must work together to clarify regulatory objections to ensure campaigns are effective. Too often, POC is used solely for its proximity to the patient, without truly understanding how to use that distance in a meaningful way. The true power of POC is unlocked once dynamic campaigns are executed with a clear, compliant message.
TRx lifts are not always the measure of success of POC marketing campaigns. The key is to develop a solid ROI methodology by following these guidelines:
- Proper program evaluation and execution: The definition of program objectives is critical to your ability to measure program impact and what metric determines your ROI analysis. For example, a clinical messaging POC campaign might focus on patient education/support opportunities. Therefore, the ROI should be based on how the campaign impacted enrollment not TRx.
- Data access: A physician-centered program such as a patients’ savings coupon program/notification to the HCP in the EHR at the point of prescription should be able to capture at least the NPI information about the physician that can enable you to segment or isolate the physicians reached. If not, you will not be able to distinguish between the test and control HCP population and it will be almost impossible to measure ROI.
- Program data analysis: ROI can be calculated from the measurement methodology and you can also identify and analyze the non-monetary benefits of the program. Meanwhile, the length of the program will determine what methodology to use (time series regression analysis or a test/control analysis ROI methodology).
A patient-centric approach to measuring POC marketing is critical for capturing two key performance factors: A campaign’s impact on consumer behavior and how it interacts with marketing efforts across other channels.
A successful direct-to-consumer campaign is one that influences consumer behavior. This is best measured by observing relevant clinical events (testing, diagnosis, treatment) to quantify a campaign’s impact on actual patient health outcomes. These patient-centric metrics capture impact that HCP-level measurement may miss. For example, a patient may see a campaign in one HCP’s office but actually receive treatment in another office where the campaign was not running.
POC marketing sometimes gets credit for behaviors that would have occurred without POC exposure because it reaches consumers at a key moment in their treatment journey. This makes it essential for marketers to isolate impact using a test/control methodology and to account for the influence of concurrent exposure to other marketing channels. Finding performance synergies across channels can show how POC messaging amplifies the impact of TV, digital, and print campaigns and highlights opportunities to optimize by further unifying audiences across channels.
A pharmaceutical marketer’s ability to measure the success of any campaign—point of care included—demands the use of reliable quantitative metrics. Expectations for valid measurement can be even higher in the point of care realm versus other media settings since most POC communications are focused on reaching the patient at actionable decision points.
Matched Panel Experimental Design is the preferred analytical methodology because it allows for isolation of only the variable (in this case, the point of care marketing tactic) and compares rate-of-change in a test panel versus a control panel. The best metric to evaluate by far is the program’s effect on actual Rx sales volume.
Other commonly used metrics such as intent, website visits, and brand awareness are all nice to have and help marketers tailor current and future campaigns. However, they are directional only and don’t paint the real performance picture. Sales impact and return on investment are the ultimate metrics to provide an unequivocal assessment of marketing effectiveness.
Marketers must refresh their mindset about POC in 2019. The term itself is from a different era when the primary venue for care delivery was a physician’s office. So much has changed in the past few years that even “points of care” is insufficient, and many of the tactics deployed by marketers simply don’t work in this new environment in which care can be accessed from nearly anywhere via smartphones and telemedicine platforms.
POC marketing traditionally relied on a captive audience—meaning patients without smartphones—stuck in waiting rooms or exam rooms with time enough to leaf through ad-filled magazines and glance at whatever sponsored program was on the TV. The consumerization of healthcare means a better-informed patient with more options who cannot be easily pinned down into predictable patterns of behavior and easily swayed by traditional pharma brand advertising.
In addition, competition from alternatives to prescription medications has intensified in care venues such as Walmart and clinics in retail pharmacies stocked with store-brand OTC remedies. Finally, since POC today is wherever the patient is, smartphones are the gateway for marketers to activate patients using tactics like programmatic mobile ads, paid search, geotargeting, email, and social media.
The biggest challenge at point of care is that the configuration of EHR software is done locally at the practice or health system level rather than centrally by the EHR vendor. This means that implementing new treatments within the EHR requires practice staff to champion the change across the practice or health system’s medical and administrative staff.
To address this challenge, marketers must create material to assist customer-facing teams with resources and education to help practices optimize their EHR for treatments and documentation needed to support prior authorization (PA) from payers.
Also coming to the point of care, in a major move, are payers who are participating more and more in drug decision making. Payers are encouraging EHR automation to support PA. Automating the physician side of PA requires added clinical discreet documentation in the EHR. To lower the burden on physicians, marketers should help practices understand the data that needs to be added to discreet fields to support PA approvals, such as the number of symptomatic patient days per month or a decline in physical or cognitive ability. Helping practices update standard documentation practices advances their ability to systematically identify approvable patients for a therapy.
Patients are showing keen interest in using voice search for health. According to DRG’s ePharma Consumer 2018 Study, 23% of U.S. patients said they are likely to use a voice assistant skill/app provided by a pharma company. Given that a quarter of patients have reported trying to access treatment information via these devices, pharma brands need to think about ways they can capture this new inbound flow of treatment info-seekers on this platform. While utilization is still low, brands have a chance to establish themselves in a relatively, uncluttered channel. Smart brands will seize the opportunity of this coming trend and develop for the interface of the future.
In addition, voice technology is on the rise for POC marketing. One in four U.S. patients who have researched health information online while at the hospital say that voice assistants are influential in treatment decision making (26%)—indicating the growing usage and importance of voice tech. These patients are mostly searching for treatment info specifically via voice—how to take their treatment (48%), medication reminders (47%), and side effects (46%). Consider partnering with voice technology providers to increase your patient reach at one of the key decision-making moments along the patient journey.
Lack of access. It is difficult to reach a meaningful number of practices nationally across fragmented POC media provider networks. Some have sizable networks. Others are strong regionally or within certain medical specialties. But few cover the majority of key offices and providers. An understanding of all the various POC media providers will help you coordinate a plan that reaches the widest, yet most targeted audience.
Lack of control. It’s impossible to ensure that all TVs and digital wallboards in all offices are always on and placed so they can be seen and heard in the waiting area or exam room. It’s equally difficult to ensure tablets are always charged, accessible, and sanitary. A diverse mix of POC tactics—digital, print, and experiential—will ensure that you connect with patients throughout their time in the office.
Lack of influence. If providers aren’t advocating for your brand when patients ask about it—or worse, when it is actually the right treatment—you must make sure you are part of the conversation. When you put together your marketing mix, make sure to include POC marketing companies that can measurably influence provider behavior and offer physician education and feedback as well.
Federal, state, and industry regulations governing how and when pharma companies identify and communicate with HCPs have become stricter and will likely be reviewed and tightened in 2019. Brands have been able to use EHR systems for a targeted communication with specific physicians during critical points within a patient’s journey at the POC. But as the guidelines evolve, many EHR systems have begun to regulate how brands communicate within their platforms, with some of the larger systems prohibiting brand-level advertising altogether.
In 2019, it’s time to look outside of healthcare marketing and apply strategies and technologies that have proven successful in other industries. Account-Based Marketing (ABM) is one such strategy, which leverages a historically B2B strategy by identifying specific customers (either on the institution or physician level) and treating them like their very own market segment, allowing brands to customize content for these specific “markets.”
ABM is not intended to replace offline, digital, or EHR marketing initiatives. Rather, ABM is the next level of marketing to help brands communicate with physicians within this highly regulated marketplace, domestically and globally. A strong ABM program will provide marketers an additional channel to build brand equity through personalized campaigns targeted toward their target audiences.
Measuring success via Rx lift for rare disease brands. Obtaining strong sample sizes to represent either pre/post or test/control segments is difficult for any brand with hyper-focused patient populations. If population size and/or budget make it difficult for market research to construct statistically significant studies, marketers may have to elevate the value of anecdotal findings such as “awareness,” “intent,” or “change of behavior” in order to gain confidence in the performance of some POC programs.
Obtaining high reach even with multiple suppliers and unduplicated coverage. Based on 2018 KANTAR Sources & Interactions studies, more than half of physicians believe educational/disease maintenance material “provides patient with instructional or background information (they) do not have time to supply,” while less than half say they have website, TV, or video information in their practice. POC TV/video suppliers should feel encouraged to partner with advertisers in recruitment programs to expand their network while offering ground-level access.
Hospital-based presence. Beyond waiting areas/rooms and lounges, the advancements in geo-fencing and beacon targeting show promise, but improvements are still needed in use of more health-endemic apps/sites and opt-in personal ID information to learn more about the traffic coming in and out of these target zones.