Health Seeking Behaviors

Who are the Solution Seekers?

May 23, 2012

AMA Presentation

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“Perception is reality.”

Lowell Sever, Ph.D.

Medical Anthropologist

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SIGNIFICANCE OF HEALTH SEEKING BEHAVIORS

Healthcare in Transition

Consumers Control Healthcare Spend

Choice of whether or not to seek care

Choice of where to seek care

Consumer Empowerment

More Informed

More involved in treatment decision-making

Digital Revolution

Personal Health Records

Patient Portals

On-line health care

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Consumer Health Beliefs and Attitudes

Adult health seekers are more likely to rate themselves as

having poor health status than teen health seekers

Adolescent health seekers are more likely to demonstrate

clinical impairment or depressive symptoms than adult health

seekers

Middle-aged adults (45 to 65 years) are more like to search on-

line for health information compared to their older and younger

counterparts

Limited evidence to suggest that the internet has motivated

individuals to seek health care*

No evidence to suggest that that internet impacts utilization of

healthcare services* * Ybarra ML and Suman M. 2006 Help seeking behavior and the internet:

A national survey. Intn’l J Med Informatics 75, 29-41

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HEALTH BELIEF MODEL

Why People Seek or Do Not Seek Care

SEEK

HELP

Perceived

Susceptibility

Perceived

Barriers

Perceived

Severity

Perceived

Benefits

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An individual will seek care when the perceived benefits outweigh perceived

risk, perceived consequences of no action and perceived barriers.

Example: People Who Will Not Seek Care for Insomnia

Does not

Seek Help

Perceived Susceptibility

• “I’ll catch up on my

sleep over the weekend.”

• “When the doctor lowers

the dose on my stomach

meds, I’ll sleep again.”

Perceived Barriers

• “I know I need help, but I can’t

afford to buy any more

medications.”

• “I can’t drive two hours each

way for a therapist appointment.”

Perceived Severity

• “It takes awhile to fall

asleep, but when I do, I’m

out for the count.”

• “It only takes 15 to 20

minutes to get back to

sleep.”

Perceived Benefits

• “Nothing will help; sleeping

less is part of getting older.”

• “There’re better things to do

with my time and money.”

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Case Study: Insomnia

Consumer-driven market

Consumers in a unique position → Ability to “diagnose the problem”

and quickly assess treatment effectiveness

Critical Market Drivers → Perceived Need and Perceived Efficacy

What is the market opportunity?

Is insomnia included in sleep medicine

hospital services?

Is insomnia an outpatient outreach

activity?

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What We Know About Insomnia

Inability to Fall Asleep Easily, to Stay Asleep or to Have Quality Sleep

Set of subjective sleep complaints that 20 percent to 35 percent of the

general population will report as experiencing at any one point in time

Estimated prevalence in the United States: 40 to 70 million adults, about

20% of the population

• 6 percent to13 percent of eligible patients seek health care, usually

from a primary care provider.

• 45 percent experiencing transient or chronic insomnia prefer to either

ignore the problem or self-treat from an arsenal of over-the-counter

sleep aids and products available on-line and through retail outlets.

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Attempts to Motivate Individuals to Seek Help for Insomnia

No One Treatment has been Shown to Relieve Insomnia Symptoms

Since 2000, pharmaceutical companies have spent an average of

$520 million/year in direct-to-consumer (DTC) advertising to

motivate adults with insomnia to seek drug-related relief.

Advertising analysts estimate that every dollar spent in insomnia

DTC advertising results in $3.45 in prescriptive drug sales.

In 2006 Americans made about 707,000 physician office visits for

primary and secondary insomnia: 47.8 million prescriptions were

filled that generated $3 billion in sales.

Whether DTC advertising has a “wash-over effect” or not on non-

drug therapies and OTC products is not known. In 2006, sales of

OTC sleeping pills and sleeping aids were $1.8 billion.

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Insomnia Solution Seeking Choices

• Cognitive Behavioral Therapy

• CES, TMS, Biofeedback

• Acupuncture

• Spinal Manipulation

RX Drugs

• BENZODIAZEPINES

• NONBENZODIAZEPINES

• MELATONIN AGONISTS

• ANTIDEPRESSANTS

Seek M.D. Care

(Pill Takers)

Seek Non-M.D. Care

(Non-Pill Takers)

CONSUMERS

Self-Directed Care

SOLUTION SEEKER SOLUTION AVOIDER

Pill Taker

• OTC Drugs

• Herbal/Nutritional Supplements

Non-Pill Taker

• Light therapy, Sound Therapy

•Relaxation Therapy (yoga, massage)

• Sleep Device Pillows, TMS mattress pads

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Available Sleep Devices

CES Ultra (Neuro-Fitness, LLC)

Cost: $249.95 - $359.00.

Alpha Stim 100 Cost:

$495-$895

EarthPulse. Cost: $499.00

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Available Sleep Devices

• SleepSonic Sleepmate™ Cost:

$34.95; with sound system $229.00

•Cost: $29.95

• Dreammate Sleep Aid Effects.”

• Cost: $125.00

• Sound Screen Sleep Mate® Cost:

$49,96 to $75.50

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What Would You Choose to Do? Why?

VALUE CONSIDERATIONS

Take a branded sleep drug at $3.00/night

versus

Drink a Decaf Starbuck’s mocha latte at $3.25/night

versus

Use a OTC sleep aid at $0.75/night

versus

Drink a warm glass of milk at $0.35/night.

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Health Seeking Options are the Pulse of Healthcare Spend

KEY TAKE-AWAYS

Consumers will only seek a health solution if the benefits (getting

better) outweigh the barriers to care and risk of doing nothing

Knowing health seeking behaviors is critical to assessing a product

or service opportunity, formulating a market strategy, and

conducting successful marketing campaigns

Knowing health seeking behavior drills down on unmet need.

There is a need for effective insomnia relief, but few people seek

relief

You can lead a horse to water, but you can’t make him drink!