Calcul ROI Study -IMS Health Consulting

December 2009

Patient Channel ROI Evaluation

IMS Health Consulting

Agenda

• Objective

• Research Methodology

• Methodology Assumptions

• Study Results

• Conclusions

Objective• To assess the impact of the Patient Channel program on Brand X

prescribing behavior of participating physicians

Patient Channel

for

Brand X

Incremental

Brand X NRx,

Physician Penetration

and ROI

Research Methodology

• Impact of the Patient Channel program for

Brand X was assessed using IMS Consulting’s

Promotion EvaluationSM methodology

– Paired comparison analysis to measure changes in Brand X new prescription writing

behavior of a Test group relative to a similar group of Control physicians

– Utilizes physician-level new prescription data* that is “raw,” or not projected, which

removes any potential bias that might be introduced by projection

*Data source: IMS Health’s prescriber prescription database

• Test and Control group physicians are assumed to have similar levels

of exposure to promotional activity for the duration of the study time

period

– Cannot control for disproportionate changes in promotional levels in the post-

program exposure time period

• Managed care influences are also assumed to be similar between the

Test and Control physicians

– Cannot control for disproportionate changes in patient flow or patient health care

plans at any time of the study time period

Methodology Assumptions

Control Group Selection

• 34,345 potential Test physicians were matched to the IMS Health prescriber

universe to identify potential Control physicians based on the following criteria:

– Brand X script writing behavior/volume in the pre-test period;

– MD specialty;

– MD geography; and

– Overall writing decile

• 32,189 Test physicians were successfully matched to a Control physician

Quality Control Procedures

• A key quality control procedure was utilized to ensure that sporadic

reporters do not bias the results

– Active Writers – a physician must generate at least one prescription during the most current three months to be included in the analysis

0

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Pre-6 Per-5 Pre-4 Pre-3 Pre-2 Pre-1 Test Post-1 Post-2 Post-3 Post-4 Post-5 Post-6

Bran

d X

NR

x

Test Control

Brand X NRx ComparisonDuring the six month post period, Test physicians prescribed 1.3% more Brand X NRx compared to

Control physicians. This change in prescribing behavior is statistically significant (cl=95.17%).

Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted

: ANCOVA.

6 Month Analysis

Brand X Physician Penetration Comparison

54.4% 54.4%

56.4%

56.0%

53.0%

53.5%

54.0%

54.5%

55.0%

55.5%

56.0%

56.5%

57.0%

Test Group Control Group

% P

hysic

ian P

enetr

ation .

Pre-Test Post-Test

Physician penetration increased by 2.0 percentage points among the Test group and by 1.6 points

among the Control. The resulting differential in penetration of +0.4 points between the two groups is

not statistically significant (cl=51.47%).

Note: Physician Penetration is defined as the ratio of MDs writing Brand X / MDs in program. Analysis conducted : Z-test

2.0 point increase

1.6 point increase

6 Month Analysis

ROI Analysis – Methodology

Step I

Step II

• Calculate Average Product TRx (average retail price for a prescription) =

TRx sales/ 6 month study period (for Brand X is $154.79 (source: IMS NPA

Plus – TRx retail price)

Step III

• Calculate Revenue Associated with Test Physicians = Projected Product

TRx x Average Product Price

1,151,276 x $154.79 = $178,202,558

Step IV

• Calculate Revenue Associated with Control Physicians = Projected

Product TRx for Control Physicians* x Average Product Retail cost

1,136,501 x $154.79 = $175,915,580

Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.01) from ANCOVA, which means Test

physicians wrote 1.3% more Brand X NRx than Control physicians during a 6 month post-test period. Program costs reflect costs associated

with only the measured hospitals during the 6 mo post-test period.

• Incremental Revenue due to the program = Revenue Associated with Test

Physicians – Revenue Associated with Control Physicians

$178,202,558 - $175,915,580 = $2,286,978

Step V• Return on Investment = Incremental Revenue from program/ Cost of the

program

$2,286,978/$487,749 = 5:1 or $1,799,229

6 Month Analysis

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35000

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45000

Pre-6 Pre-5 Pre-4 Pre-3 Pre-2 Pre-1 Test Post-1 Post-2 Post-3 Post-4 Post-5 Post-6 Post-7 Post-8 Post-9 Post-

10

Post-

11

Post-

12

Bran

d X

NR

x

Test Control

Brand X NRx ComparisonDuring the twelve month post period, Test physicians prescribed 2.1% more Brand X NRx compared

to Control physicians. This change in prescribing behavior is statistically significant (cl=99.94%).

Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted : ANCOVA.

12 Month Analysis


54.4% 54.4%

63.0%

62.2%

50.0%

52.0%

54.0%

56.0%

58.0%

60.0%

62.0%

64.0%


% P

hysic

ian P

enetr

ation .

Pre-Test Post-Test

Physician penetration increased by 8.6 percentage points among the Test group and by 7.8 points

among the Control. The resulting differential in penetration of +0.8 points between the two groups is

directional (cl=88.33%).


8.6 point increase

7.8 point increase

12 Month Analysis

Step I

Step II


TRx sales/ 12 month study period (for Brand X is $158.15 (source: IMS

NPA Plus – TRx retail price)

Step III



2,371,358 x $158.15 = $375,028,845

Step IV



2,322,584 x $158.15 = $367,315,266


physicians wrote 2.1% more Brand X NRx than Control physicians during a 12 month post-test period. Program costs reflect costs associated

with only the measured hospitals during the 12 mo post-test period.



$375,028,845 - $367,315,266 = $7,713,579


program

$7,713,579/$988,905 = 8:1 or $6,724,674

12 Month AnalysisROI Analysis – Methodology

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Bra

nd

XN

Rx

Test Brand X Control Brand X

Brand X NRx ComparisonDuring the eighteen month post period, Test physicians prescribed 3.2% more Brand X NRx compared to Control

physicians. This change in prescribing behavior is statistically significant (cl=100.0%).

Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted : ANCOVA.

18 Month Analysis


54.4% 54.4%

66.9% 65.4%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%


% P

hysic

ian P

enetr

ation .

Pre-Test Post-Test

Physician penetration increased by 12.4 percentage points among the Test group and by 10.9 points among the Control.

The resulting differential in penetration of +1.5 points between the two groups is statistically significant (cl=99.47%).


12.4 point increase 10.9 point increase

18 Month Analysis

ROI Analysis – Methodology –18 Month Post Test

Step I

Step II


TRx sales/ 18 month study period (for Product is $157.64 (source: IMS


Step III



3,442,456 x $157.64 = $542,678,747

Step IV



3,335,713 x $157.64 = $525,851,471


physicians wrote 3.2% more Brand X NRx than Control physicians during an 18 month post-test period. Program costs reflect costs

associated with only the measured hospitals during the 18 mo post-test period.



$542,678,747 - $525,851,471 = 16,872,276


program

$16,872,276/$1,432,035 = 12:1 or $15,440,241

18 Month Analysis

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Bra

nd

XN

Rx

Test Brand X Control Brand X

Brand X NRx ComparisonDuring the 30 month post period, Test physicians prescribed 4.8% more Brand X NRx compared to Control physicians.

This change in prescribing behavior is statistically significant (cl=100.0%).

Note: cl = Confidence level; if cl >= 90% the program impact is significant, cl=80-90% is directional. Analysis conducted :

ANCOVA.

30 Month Analysis


53.4% 53.4%

71.7%68.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%


% P

hysic

ian P

enetr

ation .

Pre-Test Post-Test

Physician penetration increased by 18.3 percentage points among the Test group and by 15.6 points among the Control.

The resulting differential in penetration of +2.7 points between the two groups is statistically significant (cl=100.0%).


18.3 point increase15.6 point increase

30 Month Analysis

ROI Analysis – Methodology –30 month post test

Step I

Step II


TRx sales/ 30 month study period (for Product is $159.48 (source: IMS


Step III



4,887,002 x $159.48 = $779,396,672

Step IV



4,663,170 x $159.48 = $743,699,139

Note: Projected Product TRx for Control physicians calculated using Index of Adjusted Means (1.05) from ANCOVA, which means Test physicians

wrote 4.8% more Product NRx than Control physicians during a 30 month post-test period. Program costs reflect costs associated with only the

measured hospitals during the 30 mo post-test period



$779,396,672 - $743,699,139 = $35,697,533


program

$35,697,533/$1,988,927 = 18:1 or $33,708,606

30 Month Analysis

Conclusions

Metric/

Time Period NRx

Physician

Penetration ROI

6 month +1.3%

Directionally

higher 5:1

12 month +2.1%

Directionally

higher 8:1

18 month +3.2% +1.5 pts. 12:1

30 month +4.8% +2.7 pts. 18:1

This retrospective 5-year look compared prescription writing behavior by doctors affiliated with Patient Channel hospitals

to a control group of physicians in the IMS database that have been matched by the Brand’s script writing in the pre

period, overall script writing volume, geography and physician specialty. The study assessed incremental NRx, physician

penetration (# of docs prescribing) and program ROI at several points over a 5-year period. IMS Consulting’s Promotion

EvaluationSM methodology was employed. Unless otherwise noted, all results are statistically significant.

Documents

Calcul ROI Study -IMS Health Consulting