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HIV MONITORS

A Line of Three Dedicated Studies to Monitor Marketing Strategies & Outcomes

January 2007

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OBJECTIVES OF THE STETHOS MONITORS

1) Understand today’s prescribing dynamics and gains/losses

2) Quantify market segments and shares

3) Measure promotion activity and impact

OBJECTIVES

3

DYNAMIC Prescriptions

Specialized tool focused only on new prescriptions

DYNAMIC Prescriptions

Specialized tool focused only on new prescriptions

Segmenting - Sizing - Positioning - ForecastingSegmenting - Sizing - Positioning - ForecastingSegmenting - Sizing - Positioning - ForecastingSegmenting - Sizing - Positioning - Forecasting

3 OBJECTIVES = 3 SPECIFICALLY-DESIGNED STETHOS MONITORS

PROMO Tracking

Promotional pressure and images

PROMO Tracking

Promotional pressure and images

View of the market and product shares

in each segment

View of the market and product shares

in each segment

What physicians prescribe today when

choosing a new treatment

What physicians prescribe today when

choosing a new treatment

Contacts, Resulting perception

of company, com. andproducts

Contacts, Resulting perception

of company, com. andproducts

TOTAL Market

Realistic snapshot of the whole Market

TOTAL Market

Realistic snapshot of the whole Market

METHODOLOGY

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DYNAMIC

PRESCRIPTIONS

DYNAMIC

PRESCRIPTIONS

PRINCIPLES

PROMO

TRACKING

PROMO

TRACKINGTOTAL

MARKET

TOTAL

MARKET

Does your message affect prescribing ?

Do your share match your strategy ?

How does the market evolve ?

How does your product performance compare to How does your product performance compare to your and your competitors’your and your competitors’ positioning ?positioning ?

How does your product performance compare to How does your product performance compare to your and your competitors’your and your competitors’ positioning ?positioning ?

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PROMO TRACKING MONITOR

Promotional pressureDoctors’ perceptions

January 2007

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TWO CHAPTERSTWO CHAPTERS

Study side to sideStudy side to side : : « Promotional Pressure » + « Perceptions »« Promotional Pressure » + « Perceptions »

vs. Dynamic Prescriptions Monitorvs. Dynamic Prescriptions Monitor

Study side to sideStudy side to side : : « Promotional Pressure » + « Perceptions »« Promotional Pressure » + « Perceptions »

vs. Dynamic Prescriptions Monitorvs. Dynamic Prescriptions Monitor

Image of product

Image of product

Quality of communication

Quality of communication

Image of pharma co.

Image of pharma co.

OBJECTIVESOBJECTIVES

NUMBER OF CONTACTS

1/ Reps

2/ PR Promotional Pressure

NUMBER OF CONTACTS

1/ Reps

2/ PR Promotional Pressure

PERCEPTION FROM PHYSICIANSPERCEPTION FROM PHYSICIANS

PROMO TRACKING

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PROMO TRACKING MONITOR

Promotional pressurefor ARV Market

January 2007

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1. Number of argued visits :

-share of voice pharma company

-share of voice product or class of product

- share of voice associations

- presentation ranking

2. Number of transmitted documents

3. Number of meetings/symposia per product or company :

- share of voice

- topics

1. Number of argued visits :

-share of voice pharma company

-share of voice product or class of product

- share of voice associations

- presentation ranking

2. Number of transmitted documents

3. Number of meetings/symposia per product or company :

- share of voice

- topics

Measure of the promotional pressureMeasure of the promotional pressure

(no argument records – neither a recall test, nor visit reconstitution study)(no argument records – neither a recall test, nor visit reconstitution study)

Measure of the promotional pressureMeasure of the promotional pressure

(no argument records – neither a recall test, nor visit reconstitution study)(no argument records – neither a recall test, nor visit reconstitution study)

1- THREE MEASURED PARAMETERS1- THREE MEASURED PARAMETERS

PROMO TRACKING

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Requirements :

1) EXHAUSTIVITY of contacts per product/pharma co.2) REPRESENTATIVITY of the schedule of visits3) RELIABILITY of collected data

Prospective or retrospective methodology ?

RETROSPECTIVE : relies on the memory of the physician. However, the aim is not to measure recalled but actual visits.

PROSPECTIVE: the physician, informed priorly, indicates all met contacts Must ensure that any questionnaire is completed regularly, daily (answering at the end of the collection period relies on memory, thus is retrospective).

Electronic or paper questionnaires ?

THE E-QUESTIONNAIRE : flexible, comfortable, with routing options … But not all physicians can acess a computer every day or easily after each visit.

THE PAPER QUESTIONNAIRE : Handy and easily accessible Can be completed anytime, including right after a visit.

Requirements :

1) EXHAUSTIVITY of contacts per product/pharma co.2) REPRESENTATIVITY of the schedule of visits3) RELIABILITY of collected data

Prospective or retrospective methodology ?

RETROSPECTIVE : relies on the memory of the physician. However, the aim is not to measure recalled but actual visits.

PROSPECTIVE: the physician, informed priorly, indicates all met contacts Must ensure that any questionnaire is completed regularly, daily (answering at the end of the collection period relies on memory, thus is retrospective).

Electronic or paper questionnaires ?

THE E-QUESTIONNAIRE : flexible, comfortable, with routing options … But not all physicians can acess a computer every day or easily after each visit.

THE PAPER QUESTIONNAIRE : Handy and easily accessible Can be completed anytime, including right after a visit.

2- COLLECTION PRINCIPLES2- COLLECTION PRINCIPLES

PROMO TRACKING

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In conclusion, we recommend to measure the promotional pressureIn conclusion, we recommend to measure the promotional pressure : :

1.1. A PROSPECTIVE COLLECTION :A PROSPECTIVE COLLECTION :Physicians agree for the year and are reminded prior to each fieldwork

2.2. RECORD FORMS TO BE COMPLETED DAILYRECORD FORMS TO BE COMPLETED DAILY

3.3. PAPER-MADE QUESTIONNAIRESPAPER-MADE QUESTIONNAIRESPocket size carry-one notebook, one card per visit with pre-coded questions and one card for the symposia/meetings of the last month

In conclusion, we recommend to measure the promotional pressureIn conclusion, we recommend to measure the promotional pressure : :

1.1. A PROSPECTIVE COLLECTION :A PROSPECTIVE COLLECTION :Physicians agree for the year and are reminded prior to each fieldwork

2.2. RECORD FORMS TO BE COMPLETED DAILYRECORD FORMS TO BE COMPLETED DAILY

3.3. PAPER-MADE QUESTIONNAIRESPAPER-MADE QUESTIONNAIRESPocket size carry-one notebook, one card per visit with pre-coded questions and one card for the symposia/meetings of the last month

PROMO TRACKING

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SAMPLEMARKET

Specialty 1* Specialty 2* …

Product X Pathology 1Pathology 2…

Product Y Pathology 1Pathology 2…

…

1ere Stage : Define the market

Targetted products & pathologies* 2e Stage : Build representative samples*

•In collaboration with subscribers

3e Stage : Analysis from true or weighetd panels: - Horizontally by market or pathology - Vertically by specialty

QUESTIONNAIRES

PROMO TRACKING

3- IN APPLICATION (according to the study)3- IN APPLICATION (according to the study)

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EXAMPLE OF HIV VISIT CARDEXAMPLE OF HIV VISIT CARD

Monday Tuesday Wednesday Thursday Friday

Presented Product*

Rank of present

Suggested assoc. codes)

Allocated time (min)

Quality

present./10

Induce

Rx

Doc.

left

1- Combivir 2- Kivexa 3- Truvada 4- Kaletra 5- Reyataz 6- Telzir 7- Invirase 8- Aptivus 9- TMC 114 10- Sustiva 11- Viramune 12- Fuzeon 13- Maraviroc 14- Atripla

/__/ /__/ /__/ /__//__/ /__/ /__/ /__//__/ /__/ /__/ /__//__/ /__/

/__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ / /__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ //__ __ __ /

/_/_/ /_/_//_/_//_/_//_/_/ /_/_//_/_//_/_//_/_/ /_/_//_/_//_/_//_/_/ /_/_/

/__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ //__ __ /

• Pocket-size weekly

book of cards.

• 20 cards per week.

• Products validated

with subscribers*

4- PROMOTIONAL PRESSURE REPORT CARDS4- PROMOTIONAL PRESSURE REPORT CARDS

PROMO TRACKING

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EXAMPLE OF MONTHLY STANDARD PR CARDEXAMPLE OF MONTHLY STANDARD PR CARD

Staff meeting Symposium National Congress International Congress

Inviting

Pharma Co.

Participated If product related,

Which one(s)

Other Topic(s)

Abbott

BMS

Boehr. Ingelheim

Gilead

GSK

Janssen-Cilag

MSD

Pfizer

Roche

/__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________//__________/

/____________________________/ /____________________________//____________________________/ /____________________________//____________________________/ /____________________________//____________________________/ /____________________________/ /____________________________/ /____________________________//____________________________/ /____________________________/ /____________________________/ /____________________________//____________________________/ /____________________________/ /____________________________/ /____________________________/

PROMO TRACKING

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Principles :

Visitors are on the field 10-12 months per year

Common visit periods selected with subscribers in consideration of the

local annual schedules Representativity of the typical physicians’ weeks of activity Rotating collection weeks

Weeks representative of the monthly activity of the physicians

Principles :

Visitors are on the field 10-12 months per year

Common visit periods selected with subscribers in consideration of the

local annual schedules Representativity of the typical physicians’ weeks of activity Rotating collection weeks

Weeks representative of the monthly activity of the physicians

3 fieldworks par year3 fieldworks par year

2 one-week collections per fieldwork; thus 6 weeks of reported visit 2 one-week collections per fieldwork; thus 6 weeks of reported visit

activity per year per physician .activity per year per physician .

3 fieldworks par year3 fieldworks par year

2 one-week collections per fieldwork; thus 6 weeks of reported visit 2 one-week collections per fieldwork; thus 6 weeks of reported visit

activity per year per physician .activity per year per physician .

5- DURATION AND FREQUENCY OF FIELDWORKS5- DURATION AND FREQUENCY OF FIELDWORKS

PROMO TRACKING

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6- SAMPLES6- SAMPLES

Country Targetted Specialists* Representativity

criteria

Reported wks

of visits

(6 per year)

Number of

reportsPopulation Panel size Ratio

FRANCE 1 200 80 7% Geography

Status/position

Primary setting

480 3/year

UK 500 50 10% 300 3/year

GERMANY 500 50 10% 300 3/year

SPAIN 800 60 6% 360 3/year

ITALY 800 60 6% 360 3/year

TOTAL EU (G5) 3 800 300 8% 1 800 3/year

* Specialists selected from common subscribers’ lists of pre-qualified physicians

PROMO TRACKING

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PROMO TRACKING MONITOR

Perception of Physicians

January 2007

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Image productImage productImage Quality of the communication

Image Quality of the communication

Image companyImage company

PERCEPTION FROM PHYSICIANS ORGANIZED

IN 3 IMAGE SECTIONS

PERCEPTION FROM PHYSICIANS ORGANIZED

IN 3 IMAGE SECTIONS

PROMO TRACKING

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1- Identify strengths and weaknesses of :

- COMMUNICATION: the analysis of the perception that a physician has of the overall communication can lead to immediate corrective adjustments

- PRODUCTS- PHARMACEUTICAL COMPANIES

2- Distinguish true competitive advantages.

1- Identify strengths and weaknesses of :

- COMMUNICATION: the analysis of the perception that a physician has of the overall communication can lead to immediate corrective adjustments

- PRODUCTS- PHARMACEUTICAL COMPANIES

2- Distinguish true competitive advantages.

- Selection by each physician of key criteria from a list pre-determined with the subscribers- Rank each selected criteria according to given grade of significance- Grade each pharma company or product for each selected criteria- General grade

1- OBJECTIVES1- OBJECTIVES

2- PRINCIPLES OF THE QUESTIONNAIRES (same for com., company., products)

2- PRINCIPLES OF THE QUESTIONNAIRES (same for com., company., products)

PROMO TRACKING

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1. Determine the list of criteria to choose from with the subscribers

2. Questionnaire administered via Internet

1. Determine the list of criteria to choose from with the subscribers

2. Questionnaire administered via Internet

1. Common reports Promotional pressure + Perception each quarter :• Promotional pressure 3/year• Quality of the communication 3/year• Images products 3/year• Image pharma company 1/year

2. Measures scheduled to match the the « New Prescriptions » fieldworks.

1. Common reports Promotional pressure + Perception each quarter :• Promotional pressure 3/year• Quality of the communication 3/year• Images products 3/year• Image pharma company 1/year

2. Measures scheduled to match the the « New Prescriptions » fieldworks.

3- METHODOLOGY3- METHODOLOGY

4- FREQUENCY4- FREQUENCY

PROMO TRACKING

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Reputation

Q1 - Which is the first name of company which come sponstaneously to your mind?

Importance of company characteristics in the relationship between the company and the physician

Q2 –Rank from the list below the key criteria which are essential for you to establish good Q2 –Rank from the list below the key criteria which are essential for you to establish good

relationships with the pharma company ?relationships with the pharma company ?

Medical and scientific competencies of representativesMedical and scientific competencies of representativesCompetencies of the medical dept of the companyCompetencies of the medical dept of the companyQuality of the communication and training toolsQuality of the communication and training toolsEthics of the relationship physician-pharma companyEthics of the relationship physician-pharma companyQuality of the assistance/services provided to the physician/deptQuality of the assistance/services provided to the physician/deptRegular visits from RepresentativesRegular visits from RepresentativesRepresentative or company doctor easy to reachRepresentative or company doctor easy to reachInvitations to top congressesInvitations to top congressesConditions of travel and stay during congress or eventsConditions of travel and stay during congress or events

5- EXAMPLE OF “COMPANY IMAGE” QUESTIONNAIRES5- EXAMPLE OF “COMPANY IMAGE” QUESTIONNAIRES

PROMO TRACKING

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1- Medical and scientific

competencies of representatives

2- Competencies of the medical

dept of the pharma company

3- Quality of communication

and training tools

4- Ethics of the relationship

physician-company

5- Quality of the assistance/

services provided to physicians/dept

Non importantNon important Very importantVery important

Q3 –To which degree the selected company-related key criteria are important to build good Q3 –To which degree the selected company-related key criteria are important to build good

relations between the company and you (characteristics selected in Q2)relations between the company and you (characteristics selected in Q2)

PROMO TRACKING

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Characteristics which make a good pharma company

Q4 – Rank from the list below the key criteria which to your opinion are important to make a « good » manufacturer for a « ARV » product ?

Offer reference products Propose a wide array of treatment options Major R&D Experience Ethics Innovation Support to patient associations

Q5- To which extent the characteristics selected above are crucial to make a « good" manufacturer for a product ? (charactéristics selected in

Q2)

1- Offer reference products

2- Propose a wide array of treatment options

3- Major R&D

4- Experience

Not so importantNot so important Extremely importantExtremely important

PROMO TRACKING

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Q6 – Grade the following pharmaceutical companies of the following scales for each criteria :

Ex : Medical competencies of representatives

Abbott

BMS

Borhringer

…

Very badVery bad Very goodVery good

In general, which grade would you give to the Co. X ? /__ / /10

Q7 –Global gradeQ7 –Global grade

PROMO TRACKING

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6- EXAMPLE OF “COMMUNICATION IMAGE” QUESTIONNAIRES6- EXAMPLE OF “COMMUNICATION IMAGE” QUESTIONNAIRES

TOP OF MIND

Q1 - Cite the 3 names of products which spontaneously come to your mind ?

1- /_________________ /

2- /_________________ /

3- /_________________ /

PROMO TRACKING

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THE COMMUNICATIONTHE COMMUNICATION

Thinking back about the information transmitted over the past month in relation with each Thinking back about the information transmitted over the past month in relation with each product through visits, PR activities, congresses, meetings, grade the following criteria : product through visits, PR activities, congresses, meetings, grade the following criteria :

Product : e.g. Combivir

•Scientific content

•Interest for the practice

•Level of the Reps scientific knowledge

•Quality of congress/meeting content

•Frequency of contacts on the product

•Relationship with the Rep

•Services provided by the related company

Very badVery bad Very goodVery good

Overall, which general grade on 10 do you associate with the communication of Combivir ? /__ / /10

(Same questions for all other products pre-selected wth the subscribers)

PROMO TRACKING

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7- EXAMPLE OF “PRODUCT IMAGE” QUESTIONNAIRES7- EXAMPLE OF “PRODUCT IMAGE” QUESTIONNAIRES

PROMO TRACKING

Importance of product characteristics when choosing a product of class « NRTI »

Q1 – Rank from the list below the key criteria which are essential for you to choose a NRTI Q1 – Rank from the list below the key criteria which are essential for you to choose a NRTI

product ?product ?

Tolerability short termTolerability short termTolerability long termTolerability long termResistance profileResistance profileIntrinsic power of the moleculeIntrinsic power of the moleculeComplianceComplianceRegular visits from RepresentativesRegular visits from RepresentativesIntake comfort for patientIntake comfort for patientCostCostEfficacyEfficacy

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Importance of key criteria

Q2 - What is the importance of the following selected key criteria ?

When you initiate a first treatment

Tolerability

Intrinsic power of the molecule

Long term efficacy au long cours

Resistance profile

Compliance

Intake comfort for the patientNot ImportantNot Important Very importantVery important

PROMO TRACKING

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When you change treatment for e.g. Lack of efficacy

Tolerability

Intrinsic power of the molecule

Long term efficacy au long cours

Resistance profile

Compliance

Intake comfort for the patient

Not ImportantNot Important Very importantVery important

PROMO TRACKING

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IMAGE

Grade the following products for each criteria

e. g. : Long term Efficacy

NSP

Combivir

Truvada

Kivexa

…

Very badVery bad ExcellentExcellent

PROMO TRACKING

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Characteristicswhich « pull up" the

image

Characteristicswhich« pull down" the

image

= STRENGTHS = WEAKNESSES

IDENTIFICATION OF STRENGTHS & WEAKNESSESIDENTIFICATION OF STRENGTHS & WEAKNESSESIDENTIFICATION OF STRENGTHS & WEAKNESSESIDENTIFICATION OF STRENGTHS & WEAKNESSES

A regressive analysis allow the identification of the product/pharma A regressive analysis allow the identification of the product/pharma characteristics which can be associated with good or low general grades..characteristics which can be associated with good or low general grades..

8- RESULTS8- RESULTS

PROMO TRACKING

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PROMO TRACKING

IDENTIFICATION OF COMPETITIVE ADVANTAGESIDENTIFICATION OF COMPETITIVE ADVANTAGESIDENTIFICATION OF COMPETITIVE ADVANTAGESIDENTIFICATION OF COMPETITIVE ADVANTAGES

5th criteria

4th criteria

3rd criteria

2nd criteria

1st criteria

« very important"

« Notimportant"

« very bad"

Better image on the 1Better image on the 1stst selected criteriaselected criteria

=> Strong competitive => Strong competitive advantage advantage P1 vs. P2P1 vs. P2

Weaker imageWeaker imageon the last selected criteria => Not a on the last selected criteria => Not a

true weakness of P1 vs.P2true weakness of P1 vs.P2

Product 1

Product 2

Selected Criteria Image

"excellent"

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PROMO TRACKING

CROSS ANALYSIS PROMOTIONAL PRESSURE x PERCEPTIONCROSS ANALYSIS PROMOTIONAL PRESSURE x PERCEPTIONCROSS ANALYSIS PROMOTIONAL PRESSURE x PERCEPTIONCROSS ANALYSIS PROMOTIONAL PRESSURE x PERCEPTION

0

5

10

15

20

25

30

35

40

45

50

-5 -3 -1 1 3 5

Quality of Communication %(ou Image Product, Co…)

Share of Visits. %

Prod 1 Prod 2 Prod 3 Prod 4 Prod 5

Many visits but low Many visits but low quality of com.quality of com.

Good Quality of Good Quality of Com. with few Com. with few

visits.visits.

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PARALLEL WITH THE COLLECTED NEW PRESCRIPTIONS

Contacts : Reps, PR Perception Prescriptions

①① Follow the chronology to matchFollow the chronology to match

Promotion – Images – Prescriptions.Promotion – Images – Prescriptions.

Include de prescribers from the Dynamic Prescriptions Monitor Include de prescribers from the Dynamic Prescriptions Monitor in the Promo Tracking panel.in the Promo Tracking panel.

PROMO TRACKING

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0

5

10

15

20

25

30

35

40

45

50

0 10 20 30 40 50

Share of DP %

Sh

are

of

Vo

ice P

rom

oT

r. %

Prod 1 Prod 2 Prod 3 Prod 4 Prod 5

Many visits but low share Many visits but low share of initiationsof initiations

Good share of Good share of initiations but few initiations but few

visitsvisits..

PROMO TRACKING

CROSS ANALYSIS PROMO TRACKING x NEW PRESCRIPTIONCROSS ANALYSIS PROMO TRACKING x NEW PRESCRIPTION

= IMPACT OF THE DELIVERED MESSAGE= IMPACT OF THE DELIVERED MESSAGE

CROSS ANALYSIS PROMO TRACKING x NEW PRESCRIPTIONCROSS ANALYSIS PROMO TRACKING x NEW PRESCRIPTION

= IMPACT OF THE DELIVERED MESSAGE= IMPACT OF THE DELIVERED MESSAGE