A lively group of PM360 Brand Champions and Marketer of the Year finalists gathered the day before the 2019 Trailblazer Awards Gala to discuss insights into point of care opportunities and how these can be used to improve communications with HCPs and patients. These individuals offered keen insights in a discussion moderated by Croom Lawrence, Client Strategy, Merkle. Read on to learn how you can more effectively use point of care in your marketing efforts. Participants included:
We would like to thank Health Monitor Network (HMN) for sponsoring this event.
Fabrizio Gambino, Senior Sales Director
Chris O’Toole, Senior Vice President, Alliance and Partnerships
Laura Prichard, Sales Director
Cynthia L. Walsh, Sales Director
Rodnell Workman, Chief Marketing Officer
Croom Lawrence: Good morning, everyone. The first topic we’ll discuss will be about defining the point of care. Debra, how do you define the point of care, and then what makes it different this year versus last year?
Debra D’Amico: As a new brand, we really felt it was important to ensure the patient understood the disease and then understood that this was a different treatment for atopic dermatitis—after 15 years without any innovation in the space. The topicals available didn’t provide the best results. Dupixent is very different. So point of care became very important. We’re educating physicians in their offices, and that patient also has that opportunity to learn about not just the disease, but a new biologic treatment unheard of in this category. So for us, it was the right strategy. Make sure you’re going where your patients are.
Croom Lawrence: Tywana. For IBD, where is the point of care?
Tywana Johnson: Entyvio is a specialty product, so for the most part, our point of care is in the physician’s office. This year we began following the patient journey. Our treatment is not necessarily the first treatment patients will go to because it’s for those experiencing moderate to severe symptoms. So we try to get that patient at the first point of failure. This year, we started to focus on retail to see when patients are failing steroids or other conventional therapies to get an understanding of when patients are ready for this treatment. So we also looked at pharmacy as a point of care.
Croom Lawrence: Okay. How has it changed from last year versus this year?
Tywana Johnson: The ability to use digital tactics and measure engagement. That has been the big change.
Croom Lawrence: Okay. Excellent. Kayte, where is the point of care in oncology?
Kayte Lock: Like Tywana, we’re engaging with patients at a few different points. So we certainly take advantage of the opportunity when the patient is in the waiting room, about to see their physician, making sure that we have surround sound with our messaging, then following that patient to the exam room and reinforcing the message there. We think about how we communicate with patients in both the retail and specialty care pharmacy setting. It’s all part of our broader ecosystem in point of care and how we’re engaging with the patient.
Croom Lawrence: Excellent. Justin, what is your point of view on point of care?
Justin Mattice: The patient journey for us is very important. We view point of care as an important educational opportunity because patients are already close to the prescription pad. So if you’re there for ED, you might also have low testosterone, or you might have a lump or a curve to your erection as well. So we try to educate on that as well. And yes, we’re all fighting for that exam room. Getting in there is the holy grail.
But we do have an advantage—a new channel that’s popped up. Teledoc is point of care and that’s because men aren’t good healthcare advocates for themselves. But they are online in the comfort of their own homes where their interaction is anonymous in nature. They’re looking for information and teledoc-ing away.
Croom Lawrence: Okay. Thank you, Justin. Jenn, can we get your point of view?
Jenn Etheridge: One of the things that I’ve found interesting with idiopathic pulmonary fibrosis: It’s an older demographic. The average age is over 65. We have to think creatively about the right way to reach that audience. We have seen some success with point of care. We communicate right now through waiting room TV screens and some print materials in these offices because this is the population that’s not online as much. They are reading newspapers—the print newspapers, not online newspapers.
Croom Lawrence: Carmine, you have something to say about where the point of care is for you?
Carmine Attanasio: Point of care was not a channel two years ago. Now it is. So that means when it’s a channel, there’s room for connectivity, and if there’s connectivity, it’s got to plug into something, and other things have to plug into it.
Kayte made a comment about surround sound. It is about that, but is point of care leading it or is it following it? The data is supposed to tell the tale.
Croom Lawrence: Joe, where is the point of care for you?
Joseph Ponzo: I believe the point of care is ultimately anywhere or anyone that patients can engage to get their questions answered. A specialty doctor or a primary care physician only plays a small part in the point of care. Many of the products I work on are specialty products, so we work through a hub. We have to think about who’s talking to the patient at any point in the process. Patients want to know that anyone they are speaking with is fully capable in providing them with information and assistance they need following a diagnosis.
Croom Lawrence: Rich, did you want to add to this?
Rich Palizzolo: Sure. Right now I’m at a gene therapy company for very rare diseases. And we are starting to think about point of care as we reach into sickle-cell disease, which will have a much broader scale than other treatments we offer. But previously, I worked in diabetes. Point of care was something we thoroughly evaluated and we made sure we could be as targeted as possible. For instance, we could pull data from patient or caregiver devices and then pull that through from our analytics to try to identify whether or not we are targeting the right people.
Croom Lawrence: Jennifer and Julie, do you have something to add?
Jennifer Liao: I think the point of care is where the patient and HCP are located at the time. Knowing that, we have to think about how we are providing resources to make appropriate decisions. That has evolved in the past 20 years. You simply sat in the waiting room waiting for the doctor back then.
Today, we see a lot of screens in physicians’ offices and in exam rooms. Perhaps folks are looking at the screens, perhaps not. But we have an opportunity. When patients are in the waiting room thinking about what they want to ask, they are in the moment. This moment is critical and we are looking at it more closely—how to tap into that it so that we are with the patient in their journey, providing information they need—and that HCPs need.
Julie Baker: What hasn’t yet been said is the importance of how incredibly well-empowered patients and caregivers are today, and how differently they come in to the point of care setting ahead of time with the research that they’ve done and what they know.
In the space that I’m in, epilepsy, a child could have a very rare and severe form of epilepsy and the child’s parents are incredibly well-educated, activated, and active in social media. They often know more about my product than the physician does, and they often come in knowing more about CBD than the physician does. And these parents know everything about it from the strains to the ratios, and come in very well-informed.
So for us, the question is how do we empower a constructive conversation between the parents and the HCP? We’re very focused on the question of how we can successfully enable a patient to start in that point of care setting.
Croom Lawrence: Who can give any examples of a trend that you think is most critical in shaping what’s happening at the point of care?
Ashley Windus: The increasing shift to digital and the presence of digital in physician offices is an obvious one. Our patient disease education campaign launched in August. In partnering with our media agency looking at point of care buys for the first time in a couple of years, I was pleased to see how much more is being offered, both from what was available as well as what can be tracked and measured. The ability to be extremely targeted, especially through digital and point of care is extremely important to us.
Tywana Johnson: Simple things like geotargeting have given us the opportunity to test and learn messages. What are people trying to understand at this moment? We’ve been able to find out, okay, this is what people are asking for. This is what they’re willing to tune into and engage with when they’re in the point of care. So this gives us more flexibility and more ability to get data and track. We can retarget people, and we can test and learn about what it is that people want to hear from us at that time.
Croom Lawrence: We talked about the point of care, which may or may not be a set place. It can happen virtually or in different kinds of circumstances. Can you unpack this, Carmine?
Carmine Attanasio: I would say that the total ecosystem around the patient is getting larger. It’s also getting, for lack of a better word, noisier, But there’s still the same number of channels and each of those channels is getting louder. The first thing we do is identify whether or not the patient’s been mobilized. Then, we figure out what would be the sequencing order in those channels.
What we’ve found out from our data is it doesn’t start with point of care. Today, it’s social in the first position. We’re also seeing search come into play—there’s a bit of a retargeting aspect to search that we’re delving into because there’s a lot of data there. But we have data roadblocks in some channels, so we can’t get to some places. Yet in those places that we can, we identify, we hone, and we target.
One thing I’ll add: CRM is like the golden child now. So pay attention. I think that we all should start paying attention to CRM, because people think it went dormant. It didn’t. It’s still there. And there’s some major power in that.
Croom Lawrence: Tywana, Carmine spoke about search coming into play. Do you see that as well?
Tywana Johnson: We have not really used search as a point of care tactic and I’m not sure if it is coming into play or not. We do use standard messaging that we’re trying to play because we view point of care as something used mostly to activate conversations—to make sure that our drug is brought up in that conversation. So most messages are reminders about our drug and discussions to have with the doctor. We give patients the questions to ask and tips on how patients can highlight the specifics of what is happening with their conditions.
Croom Lawrence: Julie, do you want to add to this?
Julie Baker: Yes. We use segmentation, both for patients and physicians, and our segmentation is actually driven by beliefs and attitudes around marijuana and CBD rather than more traditional segmentation measures that you use in pharmaceutical marketing. And on the patient side, the very active parents have absolutely no stigma. They have tried products on their own. They have picked up and moved to other states to help their child, to be able to help their severely ill children.
But it’s a smaller number on the HCP side that would say they’re actually well-versed and comfortable having these conversations with their patients. So, we need education on medical marijuana and CBD—and on physician bias, the stigma around these products, that might hold HCPs back from prescribing.
Croom Lawrence: Okay. Thanks. Let’s go to Joseph on trends around point of care.
Joseph Ponzo: The trend that we are now finding at the point of care is that the physician is no longer the sole decision maker of what treatment or therapy patients receive. One approach that we’re taking right now is to empower not just the patient to understand why they’re getting a particular drug or device, but also the doctor. We want physicians to be able to say, “This is why I want it, and this is why I’m prescribing it, and it’s a medical necessity.”
It’s important that you help both the physician and the patient feel empowered in making decisions. This ensures that patients get the medicine they need, and physicians get the medicine they prescribed.
Croom Lawrence: Let’s talk about social media for a moment. How many of your friends would rather go on Facebook and ask, “Does anybody know about this disease? What should I do? How should I treat this? Kayte?
Kayte Lock: I love social because it’s first-party data and it allows us to do more advanced targeting on social. That’s been one of the greatest ROI tactics. And for both unbranded and branded content, we leverage it for insights into unmet needs that we then use to inform patients. It provides a fantastic opportunity to engage directly with the community. We’re also dabbling in the social influencer space. So the trust issues that surround a pharmaceutical company delivering the message versus someone from a patient advocacy group—that’s very different.
Croom Lawrence: I was looking at a fact earlier: We have 94 million caregivers in the U.S. Rich, can you talk about how you think about the caregiver as an influencer or a partner or target in care?
Rich Palizzolo: Bluebird Bio focuses on gene therapy, which is a very complicated process. It can have potentially curative results, so the results are absolutely amazing. But it requires a pretty robust hospital stay, intensive chemo treatments, so the caregiver is very important to us.
And what we’re finding in all market research, which is also starting to drive a lot of our marketing strategy, is a broader focus on the caregiver, because in many of these disease states, patients need the caregiver for a number of reasons. So the caregiver is one of our absolute key segments right now.
Julie Baker: Caregivers in the rare disease space are extremely active. From our market research, 89% say they eventually end up being the one who educates the HCPs about the disease. Ninety-four percent of them are involved in advocacy efforts, and that’s huge in the epilepsy space that we’re in. Eighty-three percent of our neurologists strongly agree that caregivers are partners in deciding treatment, so it’s very collaborative and offers partnership opportunities in this space. We have a panel of caregivers who actually review all of our Facebook posts to make sure that they’re on tone and on message.
Croom Lawrence: For you, Kayte? Agree?
Kayte Lock: Yes. We talk about patients and caregivers on social media. But then we have to think about how are we connecting the HCPs in their world of social? It’s very similar in DTC and TV advertising. You read the HCPs on social, just by default. But are they really engaged, and is that where they want to receive a message? Probably not.
I’ve seen some data that shows HCPs are much more apt to do messaging on social. But we work with organizations like Doximity to meet the HCP on their kind of social sphere. So again, it’s the surround sound I mentioned earlier.
Croom Lawrence: What is it you’re doing to reach the 94 million people who do provide care for the ill people in their lives?
Julie Baker: That’s where printed point of care is still really valuable, and where the sales representatives are still bringing in tremendous amounts of print, both unbranded and branded education. We know that the person who has more time with the patient isn’t always the physician. But there are others in the office who do have more time to help them understand the disease, to help them understand how to navigate the specialty pharmacy or insurance challenges, and how to actually start and maintain therapy.
Then if you think about the value proposition that you extend to the family and the entire unit surrounding the patient who has a serious medical illness, and the burden that places on caregivers and the family, then you start to think differently about how you can help to relieve that burden to make the entire experience with your brand better for the patient and better for their whole family. It’s a slightly different perspective.
Laura Prichard: And when you’re talking about the burden, which can be financial burden, emotional burden, and isolation, especially with rare diseases, how do you view patient advocacy and the value of that relationship with the patient advocacy group? Do you see that effort growing in the future? Small companies probably don’t have a team dedicated to building a relationship with patient advocacy groups. So do you have your own teams and do you see a direct value from that?
Rich Palizzolo: To your question, Laura, we actually have a large team focused on patient advocacy. It has been one of our biggest, most important drivers, especially as our company really focuses becoming as patient first as possible. That is the best connection that we can have right now.
Julie Baker: Another angle to consider: When that family gets a diagnosis, you actually create a community for them through advocacy. The closed Facebook groups are so powerful. Through advocacy groups, parents can find their people and find their support and find the life hacks that make their lives tolerable, that help them see what their future could be, both good and bad in terms of preparing, as well as the potential opportunity for what their family life could be like.
Joseph Ponzo: Yes. So it makes me think—point of care should not be “point of care.” It should be more like a circle of care because it’s not simply one point of care.
Chris O’Toole: Yes. And to the points about caregivers, November is Family Caregiver Month. There can be opportunities to reach caregivers indirectly, but quite effectively.
Croom Lawrence: To Joseph’s point, yes, it’s more of an ecosystem of care. So let’s bridge into this next section on insights, which has a lot to do with listening. Ashley, could you share an insight with us that you thought was really meaningful?
Ashley Windus: It’s really not about being in the room. It’s being in the moment, with the ability to provide that information at the point of care that’s tightly targeted, both with the patient and the caregiver in mind. Frequently, the older population brings others into the room with them, such as a spouse, an adult child, a close friend, or a sibling. Being able to provide content at that point for both audiences has been critical for us as well.
Kayte Lock: And to add to that, Joe brought up the hub earlier. The insights that you get from the hub can be easily overlooked, right? You get the data around bills, and that’s great from a quantifiable perspective, but then you even get the qualitative data. So we have services for both patients and caregivers in which we have the typical access support, but then we also provide social workers. The qualitative insights are revealed in conversations in which patients are just talking about their day and what challenges they face. That’s been a tremendous resource for us.
Croom Lawrence: Fabrizio, it looks like you have something you want to say.
Fabrizio Gambino: Yes. So the question is, how do you bridge the gaps in your communications in point of care when you’re targeting patients along with non-personal promotions with HCPs? And are you seeing any challenges there?
Debra D’Amico: There is probably a gap between communications with the HCP and the patient. But you won’t see the same campaign for the HCP that you’ll see for the consumer. On the HCP side, what they believe patients want, their needs, how they view their prescribing behavior—we’re looking at it versus what we’re hearing from patients. We’re trying to see where they come together, where the disparities are, and asking ourselves as marketers, where can we do a better job of ensuring better alignment?
Joseph Ponzo: It’s also crucial to make sure that the HCPs understand what’s coming from the caregivers and why they do care about it.
Carmine Attanasio: So that’s the point. When I see Martin’s doing a great job of prepping the patients and getting them to ask the right questions, the other side of that conversation is whether the HCPs are prepared to answer those questions in a way that would be hugely beneficial.
Croom Lawrence: We are just about to wrap up, but before we do, I’d like to ask Rodnell, from HMN, if there is anything he’d like to say.
Rodnell Workman: Everyone, thank you for being a part of this. So much learning comes from this roundtable as everyone here has offered so many great insights. Health Monitor Network, as an organization, listens. We make tweaks and adjustments based on your insights, as well as our own. We listen to what’s important to you and what you need to drive your business objectives—and we’re excited to be a part of it.
The opinions expressed in this article are the participants’ own and do not necessarily reflect those of their affiliated companies or organizations.