Upload
vannhi
View
234
Download
1
Embed Size (px)
Citation preview
Pharmaceutical Industry Overview
http://www.medical-tribune.ch
and
The Agenda
http://www.medical-tribune.ch
htttp://www.rxpromoroi.org
•Overview of Healthcare in the United States
•The U.S. Pharmaceutical Industry
•Two Pillars of the U.S. Rx Industry
Research & Development
Promotion
Detailing
Meetings and Events
Sampling
Journals
CME
Compliance and Disease Management
•Promotional Resource Allocation
•Return On Investment - Total Return vs. Average Marginal Return
•ROI Calculator
•Q&A
Data - A single piece of data without context“The return on Wyeth’s investment on promotion in 2002 was $9.21”
Information - Data put into context and linked with like data.“Wyeth ranks second among the major U.S. pharmaceutical manufacturers.”.
Knowledge - Information organized to help assimilate knowledge“Wyeth can improve its performance if it …”
Wisdom – The “Ah-Hah” moment“Oh, I get it…”
The Process Data
Information
Knowledge
Wisdom
$4,8
87
$3,1
60
$3,0
12
$2,8
08
$2,7
92
$2,7
19
$2,6
43
$2,6
26
$2,5
61
$2,5
03
$2,4
90
$2,3
50
$2,2
70
$2,2
12
$2,1
91
$1,9
92
$1,9
84
$1,9
35
$1,8
41
$1,7
10
$1,6
14
$1,6
00
$1,5
11
$1,1
05
$586
$911
$893
$682
$629
0
1000
2000
3000
4000
5000
6000
USA
Switze
rlandNorw
ay
German
y
Canad
a
Luxe
mbourg
Icelan
d
Netherl
ands
Franc
e
Denmark
Belgium
Austra
lia
Swed
en Italy
Austria UK
Japa
n
Irelan
d
Finlan
d
New Ze
aland
Portu
galSp
ain
Greece
Czech
Repub
lic
Hunga
ryKore
a
Slova
k Rep
ublic
Polan
d
Mexico
Per
Cap
ita $
US
ppp
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
% G
DP
Global healthcare expenditures
Source: ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT June 2003
United State Spent $5,440 per person in 2002 (+8.3%)
Life expectancy around the worldThe United States Ranks 12th
Source: World Health Organization; The World Health Report, 2002. 31.830Afghanistan63.815Mexico
3229Zimbabwe65.814Chile
42.928Congo66.613Cuba
43.027South Africa67.412United States50.426Iraq69.211United Kingdom
50.925Pakistan69.410Israel
51.224India69.79Canada
56.323Brazil70.18Germany
56.422Egypt70.47Greece
56.621Russian Federation70.76Spain
57.120Peru70.95Italy
58.419Bahamas71.14France
59.818Saudi Arabia71.43Australia
62.817China72.52Switzerland
62.916Argentina73.51Japan
Life ExpectancyRankCountryLife Expectancy
RankCountry
France
13% 11%76%
Germany
13%12%
75%
Italy
1%
26%73%
UK
0%19%
81%
How healthcare is financed
For year 2000 Source: OECD Health Data 2003
Government-sponsored
Private Insurance
Out of pocket / other
Includes OOP /other sources
Private Insurance33.1%
Out-of-Pocket15.4%
Medicare17.6%
Other Public (1)12.0%
Other Private (2)6.1%
Medicaid & SCHIP15.7%
Total Government
Total Government $0.45 $0.45
Total Private
Total Private $0.40$0.40
United States
US Healthcare Spending Has Grown to Over $1.6T
$73
$247
$700$767
$837$899
$948 $993$1,039
$1,088$1,149
$1,229$1,316
$1,424$1,600
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
1970 1980 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
$000 Billions
Source: CMS, 2003
+9.3%
That’s more than education and defense … combined!
Price Inflation 4-6%
Utilization andTechnology
6-8%%Aging 1-2%
Plan design 1-2%
Underlying Cost Drivers
Source: Towers Perrin
-
500
1,000
1,500
2,000
2,500
2000 2001 2002 2003 2004 2005 2006 2007 2008Hospital Care Professional Services Rx Drugs Gov't Admin / Net cost of Insurance Other
Source: HCFA, 2000
Shifting allocation of costs
Pharmaceuticals +10%
0.0
50.0
100.0
150.0
200.0
250.0
North America EU Europe Rest of Europe Japan Asia (exJapan), Africa,
Australia
Latin America
-15.0%
-10.0%
-5.0%
0.0%
5.0%
10.0%
15.0%2002 Sales ($B) YTY Growth
2002 Global Pharma Sales by Region
Source IMSHealth World Review 2003
411
413
5441,019
1,187
1,3242,053
2,340
3,019
3,115
3,469
3,598
4,198
4,336
4,787
5,9966,079
130,716
Russia
India/Pakistan
Africa
Central/Eastern Europe
Middle East
Australia/NZ
Spain
Asia Pacific
Canada
UK
Italy
Germany
Uncategorzed
France
Latin America
Japan
Other Western Europe
United States
PhRMA company sales by geographic region
Source: PhRMA annual member survey 2003
5,443 7,13611,789
20,743
38,487
57,146
115,882
145,213
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
1970
1975
1980
1985
1990
1995
2000
PhRMA Domestic Sales ($Mill.)
U.S. Pharmaceuticals are One of the Fastest Growing Segments in Healthcare…
• Easily isolated cost
• Highly profitable
• Frequent target of criticism
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
Pfize
r
GlaxoS
mithKline
Johnso
n & Jo
hnson
Merck &
Co.
Astra
Zene
ca
Bristo
l-Mye
rs Sq
uibb
Novart
isWyet
hEli L
illy
Amge
n '
Aven
tisAb
bott
Hoffman
-LaRoch
e
Tap P
harm
a
Sche
ring Pl
ough
Boeh
ringer
Ingleh
eim Fores
tTe
va
Sano
fi-Syn
thelab
o Esaii
-40.0%
-30.0%
-20.0%
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%$ 000 YTY Growth
80:20 rule – Top 20 Deliver 78.5% of Total Sales ‘03
MAT 10/02 – 9/03 Source: IMS National Sales Perspecive 11/2003
0
5,000
10,000
15,000
20,000
25,000
Pfizer
GlaxoS
mithKline
Johnso
n & Jo
hnson
Merck &
Co.
Astra
Zene
ca
Bristo
l-Mye
rs Squ
ibb Novartis
Wyeth
Pharm
acia
Eli Lil
ly
Sche
ring -P
lough Av
entis
Amge
n '
Abbo
tt
Tap P
harm
aRoc
he
Boeh
ringer
Ingleh
eim Fores
tTe
vaEs
aii
-20.0%
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%$ 000 YTY Growth
80:20 rule – Top 20 Deliver 81% of Total Sales ‘02
IMS Health Retail and Provider perspective 2003 Rx Products and Insulin, excludes co-marketing arrangements, JVs to prod owner, includes completed M&A
Retail Market Growth 1992 - YTD June 2002
•Total Rxs Have...
•Increased 65% from 1992 - 2001
•Increased 2% from 6 -2001 – 6 - 2002
•Retail Sales Have…
•Increased 222%222% from 1992 - 2001
•Increased 12% from 6 -2001 – 6 - 2002
Source: Verispan
1.8 1.9 2.02.2
2.3 2.42.5
2.72.9 3.0
1.6
0
0.5
1
1.5
2
2.5
3
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
YTD 6/
2002
Total Rxs (#Billion)
$47 $50 $56 $63 $72$83
$94$111
$132$152
$83
0
20
40
60
80
100
120
140
160
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
YTD 6/
2002
Retail Sales ($Billions)
Increased utilization
8.7%
Price inflation 3.9%
New medicines
2.1%
Source:PhRMAGrowth drivers
Top 10 Therapeutic Classes by U.S. Rx Sales 2002
0
2
4
6
8
10
12
14
Cholest
erol Redu
cers PP
I
SSRI/SN
RI
Antipsyc
hotics
Erythrop
oietins
Siezure
Disorde
rs Cox 2
Antihista
mines
Calcium
Blocker
s
ACE Inhibito
rs
-5.0%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
($000) YTY Growth Source IMS
Pharmaceutical industry v. S&P 500Rx stocks lag despite growth
S&P = S&P 500 Index
DRG = AMEX drug index
Research and Development...Research and Development... Marketing….Marketing….
Understand how chemical compounds work in the
human body
Understand how chemical compounds work in the
human body
Communicate this understanding to
physicians, payers and patients
Communicate this understanding to
physicians, payers and patients
Two pillars of industry investment
Goal - Maximize return on each investment (ROI)
Leading Products: 2002 Total U.S. Sales
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
Lipitor Zocor Prevacid Prilosec Procrit Zyprexa Epogen Celebrex Zoloft Paxil
-25.0%
-20.0%
-15.0%
-10.0%
-5.0%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
Sales ($Bill) % Inc. Sales
Source: IMS Retail and Provider Perspective – wholesale prices, Rx only including insulin
Patent Peak U.S.Expiration Product Maker Rev. ($Mill)
2006 Zocor Merck 6,700 Paxil GSK 2,500 Zoloft Pfizer 2,000 Pravachol BMS 2,000 Zofran GSK 1,400 Zithromax Pfizer 1,200 Imitrex GSK 1,000 Ambien Sanofi 1,000 17,800
2005 Prevacid TAP 3,700 Rocephin Roche 700 Celexa Forest 1,430 Klacid Abbott 600 6,430
2004 Procrit J&J 3,800 Allegra Aventis 1,364 Diflucan Pfizer 600 5,764
2003 Cipro Bayer 1,200 Flixotide GSK 600 Floxin J&J 400 2,200
2002 Prilosec AZ 4,200 Augmentin GSK 1,300 GlucophageBMS 1,800 Claritin Schering 1,700 Prinivil Merck 1,100 Zestril AZ 700 Nolvadex AZ 500 Accutane Roche 500 11,800
Total 43,994
Patent expirations will have a severe
impact on the industry
Many top 10 medicines are on the list
Source: Merrill Lynch 2002 / The Orange book www.fda.gov/cder/ob/default.htm
Source: IMS HEALTH, Pharmaceutical 1984-2000 2001-2004 projection S&P H. Saftlas + regression
19%22% 23%
27%30% 32% 33% 35% 35%
40% 42% 43% 43% 44% 46% 47% 47% 49% 51%
57%
0%
10%
20%
30%
40%
50%
60%
1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2005est
% of Total Rx units
Innovation vs. Imitation - Generic Share is Growing
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
France Italy Mexico Japan U.K. U.S. Canada Germany Chile
% o
f un
it sa
les
0%
10%
20%
30%
40%
50%
60%
70%
% o
f D
olla
r sa
les
% Units % Sales
Source: “Prices and availability of pharmaceuticals: evidence from nine countries,” P Denzon, M Furukawa, Health Affairs 10/2003
Generics use by country
Source: IMS HEALTH, Pharmaceutical 1984-2000 2001-2004 projection S&P H. Saftlas + regression
19%22% 23%
27%30% 32% 33% 35% 35%
40% 42% 43% 43% 44% 46% 47% 47% 49% 51%
57%
0%
10%
20%
30%
40%
50%
60%
1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2005est
% of Total Rx units
Innovation vs. Imitation - Generic Share is Growing
0200400600800
1,0001,2001,4001,6001,800
Brand Generic BrandedGeneric
0%
2%
4%
6%
8%
10%
12%# Rxs (Mil) % Increase
Source: IMS Health, National Prescription Audit Plus, 1/2003
# Prescriptions
70%30%
Traditional Generics"Branded Generics"
$ Dollars
48%52%
Source: WSJ 4/18/03
Value of Intellectual Property (IP) Example:
Value of U.S. Patent 4,572,909 (Amlodipine)
Annual Sales (~ $US 1.6 Billion in U.S. Market)x Effective Lifetime of Patent (~15 years)
= $US 24 Billion in Sales
Each Day of Patent Protection on Amlodipine in the U.S. is worth $US 4.4 Million
783
1992 2002
# Patent ChallengesGeneric manufacturers are becoming more aggressive with legal
challenges
0
5
10
15
20
Sal
es E
xpo
sure
to
p
aten
t ex
pir
atio
n (
$B)
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
U.S. Pharmaceutical Patent Expirations by value: 1990-2006
Source: FDA Orange Book; S&P research as of Jan. 2002
Patent expirations
Period Average
$28.9
$10.9
$12.5
$14.1
$10.6
$10.6
$7.2
$8.9
$6.7
$8.6$11.8
$3.0
$9.4
$4.0
$8.6
$3.9
$6.5$4.3
$5.2$3.1
$4.7$1.6
$4.1$1.9
0
5
10
15
20
25
30
35
40
$39.8 $26.6 $21.2 $16.1 $15.3 $14.8 $13.4 $12.5 $10.8 $8.3 $6.3 $6.0
27.4% 53.0% 50.0% 55.3% 56.2% 20.3% 29.9% 31.2% 39.8% 37.3% 25.4% 31.7%
Pfizer Glaxo Merck AstraZeneca
Bristol J&J Novartis Roche Lilly Schering Abbott Sanofi
Impact of Major Patent Expirations
2001 Sales of Other Products 2001 Sales of Expiring Products
Pharma Sales ($B)
Expiring Products
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Canada Chile France Germany Italy Japan Mexico U.K
OTC Sole source Originator Generic
Global Drug Prices: OTC / On-patent brand / Generics (Manufacturer prices relative to U.S. prices adjusted for U.S. discounts – 1999)
Source: “Prices and availability of pharmaceuticals: evidence from nine countries,” P Denzon, M Furukawa, Health Affairs 10/2003
0.7%1.2%
3.8%3.9%3.9%
4.7%5.3%
7.8%8.4%
10.5%12.8%
15.6%17.0%
0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0%
Paper and Forest Products
Metals & Mining
Aerospace & Defense
Automotive
All Industries Excluding Drugs
Leisure Time Products
Telecommunications
Office Equipment & Services
Electrical and Electronics
Computer Software & Services
Drugs and Medicines
Industrial Sector Comparisons
Global Pharmaceutical R&D
U.S. Pharmaceutical R&D
R&D as a Percent of Sales, Research-Based Pharmaceutical Companies and the U.S Industrial Sector
“Pharmaceutical R&D” tabulated by PhRMA“Drugs and Medicines” tabulated by Standard & Poor’s Compustat (includes research based and non-research based companies)
2421 22
14 12
27 28
14
22
30
20 21 2023 23
3026 25
2228
53
39 3835
27
24
1721
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
R&D productivity has not kept pace
$0
$5,000
$10,000
$15,000
$20,000
$25,000
1970
1975
1980
1985
1990
1995
2000
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%PhRMA R&D Expenses ($Mil) R&D % of Sales
R&D Spending Nearly Tripled in Last Decade
# NMEs approved
“Data, data everywhere and not a drug, I think”
107.8
182.3
664.5
696.6
846.7
1,366.8
2,305.0
2,717.0
3,872.0
3,955.4
4,299.5
Diagnostics
Skin
Biologicals
Respiratory
Digestive or genitourinary
Other Human
Cardiovascular
Infective and Parasitic
Neoplasms, endocrine,metabolic
Central Nervous System
Uncategorized
23.4%
20.0%
13.7%12.6%
9.6%
7.1%
4.1%
3.1%
6.4%
Antiinfective
Cardiovascular
Central Nervous System
Analgesic/Anesthetic
Antineoplastic
Endocrine
Respiratory
Gastrointestinal
Other
NCEs 1963-1999 by therapeutic category
Source: J. DiMasi, PhD Tufts University
R&D – Low Hanging Fruit Has Been Picked
R&D Spending by Category($ Millions)
Source: PhRMA 2001
5,000Compounds
SuccessRate
Assess Safety and
biologicalactivity
ResearchPurpose
Laboratoryand animal
studies
TestPopulation
3.5 YearsYears
Preclinicals
trialsenterOnly
5
Verify efficacymonitor
reactionslonger term
Efficacyand
Side Effects
Safetyand
Dosage
1,000-4,000patient
volunteers
100-300healthy
volunteers
20-80healthy
volunteers
3 years2 years1 year
PhaseIII
Phase II
PhaseI
IND
FILED
NDA
FILED Out of 5,000
1
Review/Process
Approval
2.5 years
FDAReview
LAUNCH
Recall?
Additional post-marketing
testingrequired
byFDA
PhaseIV
U.S. Drug Approval Process
12-16 Years
$900+ Million
NB: Only 3 Of 10 Marketed ProductsPays Back Its R&D Costs
“ It’s the pipeline, stupid!
Development Cycles Are Getting Longer
3.2
5.1
5.9
2.5
4.4
5.5
6.3
2.4
2.1
2.8
1.86.1
0 2 4 6 8 10 12 14 16
1960's
1970"s
1980's
1990's
Preclinical Clinical Approval
YearsSOURCE: DiMasi, J.A. “New Drug Development in the U.S. 1963-1999. Clinical Pharmacology & Therapeutics 2001. May 69
(Time From First Pharmacological Testing To New Drug Approval 1963-1996)
1,5761,321
3,233
4,237
3,567
30 30
36
68
60
0
500
1000
1500
2000
2500
3000
3500
4000
4500
'77-'80 '81-'84 '85-'88 '89-'92 '94-'950
10
20
30
40
50
60
70
80
# Patients # Trials
SOURCE: Boston Consulting Group & Peck, C. “Drug Development:Improving the Process”, Food & Drug Law Journal, Vol. 52, 1997
Number Of Trials And Number Of Patients Per NDA
The industry spends over $1 Billion simply to recruit patients for clinical trials
The Clinical Trial Process Has Become Far More Complicated…and Expensive
“Data, data everywhere and not a drug, I think.’
13.8%
11.5%
10.3% 10.3% 10.2% 10.2% 9.8%
8.2% 8.2% 7.9%
6.8%6.3%
4.3%3.9%
3.9%
-0.7%
3.9%
0.7%
5.1%5.2%
2.4%
4.7%
7.4%
8.9%
2.4%
5.8%
8.8%9.3%
23% 29% 30% 27% 15% 20% 28% 21% 19% 41% 40% 49% 46% 47%
7.3 15.1 13.1 10.6 10.9 17.2 42.6 9.3 17.8 6.9 12.8 28.7 16.6 20.8
Abbott Novartis Roche Lilly Wyeth JNJ Pfizer Schering Aventis Sanofi Bristol Glaxo AZ Merck
2002-2006 Pharma Sales Growth Growth without new products
Product launch dependence by company
Est 2002 Rx Rev ($B)
Patent Exposure
510ADHDLilly2003Strattera
Pain
Infection
Incontinence
Osteoporosis
Thrombosis
Cholesterol
Indication
Pfizer
Bristol
Pfizer
Novartis
AZN
AZN
Company
2003
2003
2003
2003
2003
2003
Year
Dynastat
Garenoxacin
Darifenancin
Prexige
Exanta
Crestor
Product
678
778
835
851
1,070
1,088
2006 Rev ($M)
581
631
822
855
952
2,066
2006 Rev ($M)
AllergySchering2002Asmanex
HepatitisRoche2002Pegasys
EDGSK2002Vardenafil
HypertensionPfizer2002Eplerenone
CholesterolSchering2002Zetia
SchizophreniaBMS2002Abifly
IndicationCompanyYearProduct
Source: FDA Orange Book; S&P research as of Jan. 2002
Squibb Bristol-Myers
Bristol-Myers Squibb1989
Dupont Pharma
Bristol-Myers Squibb2001
Astra Zeneca
AstraZeneca1998
Hoechst Roussel Marion Merrel Dow
Hoechst Marion1995
Rhone Poulenc Rorer
Aventis1998
Agouron1999
Warner-Lambert Pfizer
Pfizer2000
Pharmacia Upjohn
Pharmacia & Upjohn1995
Monsanto
Pharmacia1999
Boehringer Mannheim1997
Syntex1994
Roche Genentech
Hoffman-LaRoche1999
Ciba Geigy Sandoz
Novartis1996
Wyeth-Ayerst American Cyanamid
Wyeth (American Home)1994
Centocor ALZA
Johnson & Johnson2001
Abbott Laboratories
Knoll Boots
Knoll1995
Abbott Laboratories2001
Glaxo Burroghs Wellcome
Glaxo Wellcome1995
SmithKline Beecham
Glaxo/SmithKline2000
Schering Plough Key
Schering1985
To Manage Risk the Pharmaceutical Industry is Consolidating(PhRMA companies – 1990s)
Sanofi-Synthelabo Merck
Source: IMS HEALTH: Retail & Provider Perspective, 2003
Industry is “swinging for the fences”
2 3 46 6
13
18
22
35
41
0
5
10
15
20
25
30
35
40
45
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
# Products with$1 Billion in U.S.
Sales
$920 Million - $1.8 Billion
1%
$180 Million - $460 Million
6%
Less than $180 Million90%
$460 Million - $920 Million
2% $1.8 Billion and Above1%
SOURCE: PriceWaterhouse Coopers & Scrip
Average For All Drugs--$265 Million Per Annum
Only 2% of Drugs Reach $1 Billion in Sales
Research and Development...Research and Development... Marketing….Marketing….
Understand how chemical compounds work in the
human body
Understand how chemical compounds work in the
human body
Communicate this understanding to
physicians, payers and patients
Communicate this understanding to
physicians, payers and patients
Two pillars of industry investment
Goal - Maximize return on that investment (ROI)
Promotional spending by country ($000)January-June 2003 (Source: CAMM Group)
11,3
89,1
52
6,89
5,46
8
1,90
2,36
7
1,54
7,69
9
1,54
4,89
2
1,07
5,39
9
546,
808
536,
343
404,
618
357,
541
351,
739
225,
566
205,
357
153,
149
147,
042
130,
798
72,3
40
55,8
59
46,8
9342
,845
34,0
89
32,8
21
31,0
53
29,1
63
24,8
88
21,0
1317
,801
14,3
23
13,5
38
7,86
4
3,56
6
-
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
USAJa
pan
German
y Italy
France Spa
in
Mexico UK
Brazil
Canad
a
Turke
y
Portug
al
Poland
Austra
liaBelg
ium
Switzerlan
dAus
tria
Argen
tinaGree
ceKo
rea
Morocco
NL
Finlan
d
Roman
iaIre
land
Swed
en
Denmark
Hunga
ry
Norway
New Ze
aland
Luxem
bourg
U.S. = 40% of promotion – 45% of sales
Japan = 24% of promotion – 19% of sales
(1.20)
1.40
( 1 7 . 7 0 )
( 7 . 5 0 )
(51 .40)
9 . 3 0
0 . 3 02 . 4 0
4 . 4 0
8 . 2 0
( 1 9 . 9 0 )
(25.10)
7 . 8 0
( 1 0 . 0 0 )
18.20
11.20
15.60
6 . 6 0
(41 .70)
( 5 . 9 0 )
(12.80)
( 3 3 . 2 0 )
1.002 . 2 0
-60
-50
-40
-30
-20
-10
0
10
20
30
Germ
any
Switz
erlan
d
Austr
ia
Japa
n Fra
nce UK Italy
Spain
Belgi
umNe
derla
ndLu
xembo
urg
Irelan
dSw
eden
Norw
ayFin
land
Denm
arkPo
rtuga
l
Gree
ce USA
Cana
daAr
genti
na
Braz
ilMe
xico
Moroc
co
Promotion : Trend 2003/2002 (% Change)January-June 2003 (Source: CAMM Group)
(*) Growth not available : Poland and Hungary
WorldWide:
- 1,0
Direct Mail1%
Other 0%
Clin Trials2%
Print Advertising
2%
Pharma Detailing
3%
Meetings7%
E-Promotion0%
Web Advertising
0%Samples8%
DTC9%
GP/FP Detailing
31%
SP Detailing37%
Allocation by media
United States 1- 10/2003
Events , 16%
NP/PA 6%
Hosp Detailing,
8%
Office Detailing,
48%
DTC, 21%Journals, 2% e promo, 1%
24 countries 1-6/ 2003
(Source: CAMM Group)
Global
United States
$4.9
$0.8
$3.0
$0.5
$6.0
$1.1
$3.4
$0.5
$6.6
$1.3
$4.1
$0.5
$7.2
$1.8
$4.3
$0.5
$8.0
$2.5
$4.6
$0.5
$10.5
$2.7
$5.5
$0.4
0
2
4
6
8
10
12
14
16
18
20
$ B
illion
s
1996 1997 1998 1999 2000 2001
Samples DTC Detailing Journals
U.S. Allocation of Promotional Spending
Source: IMS Health and CMR
Sampling represents the retail value of sampling activities directed to office based physicians as reported by members of their front office staff. DTC represents TV, magazines and newspapers, radio and outdoors. Office promo includes representative costs for OB physicians. Hospital includes costs for HB physicians and directors of pharmacy.
$19.1$15.6$13.8$12.5$11.0$9.2
Source: Verispan's Pharmaceutical Sales Force Structures & Strategies
40
Specialty Reps as Percentage of Total Reps
0
20,000
40,000
60,000
80,000
100,000
1Q99 1Q00 1Q01 1Q02 1Q03
Specialty Reps All other reps Part-time/contract reps
18% 26%
64%67%
23%
69%
25%
68%
27%
10%10%
10% 6%
72%
5%
Detailing
Ratio of Reps to Physicians is Increasing
SOURCE: Scott-Levin’s Sales Force Structures and Strategies*Includes Contract, part-time and full time from the top 40 companies in the U.S** Office Based Physicians - Synavant
-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
8.79 6.99 6.06 5.54 4.89 4.71
Ratio of Reps to Physicians
340,000
350,000
360,000
370,000
380,000
390,000
400,000
410,000
420,000
Total Reps OB MDs
1996 1997 1998 1999 2000 2001
*Reps **Physicians
Rep:MD Ratio
Ratio in Germany 12:1 ?
93,000 Reps
42,000 Reps
63.6 M Details48.7 M Details
46.5 M Calls33.4 M Calls
1996 1997 1998 1999 2000 2001 2002
Reps Details Calls
Whenever possible, reps make deliver multiple product details in a single call
Increasing sales force size v. productivity
SOURCE: Verispan’s Sales Force Structures and Strategies*Includes Contract, part-time and full time from the top 40 companies in the U.S
More Limited Access to Physicians by Pharmaceutical Representatives
Rep leaves without leaving samples or
seeing Doc15%
Rep leaves samples at front
desk28%
Meets Doc at sample closet
37%
Sit down with Doc20%
Source: Health Strategies Group, Inc. 1999
Schering – Allocation of Product DetailsNetwork:
Week Ending October 3, 2003Time:
October 3, 2003
Source: Impact Rx ImpactRx data is collected daily from our Network of PCP high-prescribers. The sample frame is based on the 30% of PCPs who write 60% of all Rx's. Each Network physician supplies detailed, non-identifying information for the following areas: 1) a census of all representative promotion, 2) a census of all physician-attended meetings/events and 3) 40% of all patients seen each week.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
7/11 7/18 7/25 8/1 8/8 8/15 8/22 8/29 9/5 9/12 9/19 9/26 10/3
Sha
re o
f Atte
ntio
n - P
rodu
ct D
etai
ls
Clarinex Nasonex Zetia Foradil
Primary Care
Foradil 3%
Zetia 22%
Nasonex 30%
Clarinex 43%
All Other 1%
Merck – Allocation of Product DetailsNetwork:
Week Ending October 3, 2003Time:October 3, 2003
Source: Impact Rx ImpactRx data is collected daily from our Network of PCP high-prescribers. The sample frame is based on the 30% of PCPs who write 60% of all Rx's. Each Network physician supplies detailed, non-identifying information for the following areas: 1) a census of all representative promotion, 2) a census of all physician-attended meetings/events and 3) 40% of all patients seen each week.
0%
5%
10%
15%
20%
25%
30%
7/11 7/18 7/25 8/1 8/8 8/15 8/22 8/29 9/5 9/12 9/19 9/26 10/3
Sha
re o
f Atte
ntio
n -
Pro
duct
Det
ails
Zocor Vioxx FosamaxZetia Singulair AR Cozaar
Singulair Asthma Hyzaar MaxaltMaxalt MLT
Primary Care
Hyzaar 3%Singulair
Asthma 3%
Maxalt 2% Maxalt MLT 1%
Cozaar 10% Zocor
24%
Vioxx 17%
Singulair AR 12%
Zetia 12% Fosamax 13%
All Other 2%
AstraZeneca Allocation of DetailsNetwork:
Week Ending October 3, 2003Time:
October 3, 2003
Source Insight Rx ImpactRx data is collected daily from our Network of PCP high-prescribers. The sample frame is based on the 30% of PCPs who write 60% of all Rx's. Each Network physician supplies detailed, non-identifying information for the following areas: 1) a census of all representative promotion, 2) a census of all physician-attended meetings/events and 3) 40% of all patients seen each week.
0%
10%
20%
30%
40%
50%
60%
7/11 7/18 7/25 8/1 8/8 8/15 8/22 8/29 9/5 9/12 9/19 9/26 10/3
Sha
re o
f Atte
ntio
n -
Pro
duct
Det
ails
Crestor Nexium Toprol XLAtacand Rhinocort Aqua ZomigAtacand HCT Zomig ZMT Pulmicort
Primary Care
Zomig 2% Zomig
ZMT 2%
Atacand HCT 2%
Pulmicort 2%
Rhinocort Aqua 5%
Atacand 7%
Toprol XL 13% Crestor
41%
Nexium 24%
All Other 2%
GlaxoSmithKline Allocation of DetailsNetwork: Week Ending October 3, 2003Time:
October 3, 2003
Source: Impact Rx ImpactRx data is collected daily from our Network of PCP high-prescribers. The sample frame is based on the 30% of PCPs who write 60% of all Rx's. Each Network physician supplies detailed, non-identifying information for the following areas: 1) a census of all representative promotion, 2) a census of all physician-attended meetings/events and 3) 40% of all patients seen each week.
0%
5%
10%
15%
20%
25%
7/11 7/18 7/25 8/1 8/8 8/15 8/22 8/29 9/5 9/12 9/19 9/26 10/3
Sha
re o
f Atte
ntio
n -
Pro
duct
Det
ails
Levitra Advair Diskus Wellbutrin XL
Coreg Augmentin XR Paxil CR
Avandia Flonase AvandametImitrex Valtrex Avodart
Augmentin ES-600
Primary Care
Augmentin XR 9%
Advair Diskus 12%
Wellbutrin XL 10%
Coreg 10%
Paxil CR 9%
Augmentin ES-600 1%
Avodart 1%
Valtrex 3%
Levitra 13%
Imitrex 4%
Avandamet 6%
Flonase 7%
Avandia 9%
All Other 4%
Pfizer Allocation of DetailsNetwork:
Week Ending October 3, 2003Time:
October 3, 2003
Source Impact Rx ImpactRx data is collected daily from our Network of PCP high-prescribers. The sample frame is based on the 30% of PCPs who write 60% of all Rx's. Each Network physician supplies detailed, non-identifying information for the following areas: 1) a census of all representative promotion, 2) a census of all physician-attended meetings/events and 3) 40% of all patients seen each week.
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
7/11 7/18 7/25 8/1 8/8 8/15 8/22 8/29 9/5 9/12 9/19 9/26 10/3
Sha
re o
f Atte
ntio
n -
Pro
duct
Det
ails
Lipitor Viagra Bextra CelebrexZoloft Relpax Norvasc Zithromax
Aricept Zyrtec Detrol LA Neurontin
Primary Care
Neurontin 2%
Detrol LA 4%
Zyrtec 5%
Aricept 5%
Zithromax 6%
Norvasc 6%
Relpax 7%
Zoloft 8%
Lipitor 16%
Celebrex 10%
Bextra 11%
Viagra 15%
All Other 5%
Growing Physician Dissatisfaction
? Top decile physicians receive three to five times as many details as they did in 1990
? Two-thirds of primary care physicians have restrictive policies on rep visits
?Only 20% of US Reps visiting the office actually get to speak with the physician and 87% of those calls last less than 2 minutes
? Physicians recall only 4% of all sales details attempted
Access
0
50
100
150
200
250
300
350
1995 1996 1997 1998 1999 2000
events details 65
60
55
50
45
40
# of
Eve
nts
(000
)Detail Visits and Events Growth are Linked
Source: Scott-Levin and WR Hambrecht + Co EstimatesNote: Events include physician meetings
As access to physicians declined, companies increased events
# of
Det
ails
(Mill
.)
123.115151.434
166.699
225.46
281.93
314.022
370.348
402.9 420.057
0
50
100
150
200
250
300
350
400
450
1995 1996 1997 1998 1999 2000 2001 2002 1-10 03
All PMEA specialties
Almost 1,400 Meetings per day
Source: Verispan 2003 Physicians Meeting and Event Audit
Promotional Trends: Meeting & Event GrowthThru
Oct. 2003
Other12%3rd Party
13%
Lg. Group5%
Teleconf.20%
Sm. Group50%
Lg. Group4%
Other9%
3rd Party8%
Teleconf.9%
Sm. Group70%
1996 EventsBase = 151,434
165% increase
SOURCE: Physician Meeting & Event Audit from Verispan
2001 EventsBase = 370,000
Meeting Type Price Meeting Type PriceVideoconference 2,500$ Symposium >51 or 4 hrs + 50,000$ Teleconference 2,500$ Large Group 21-50, 2hr + 50,000$ Focus/Personal Interview 2,500$ Small Rep <20 5,000$ Third Party 2,500$ Small Group (restaurant) 5,000$
More “Creative” Event Locations
Res. Facility
8%
"Other"16%
Home10%
Unspec.2%
Hotel11%
Office19%
Convention1%
Restaurant33%
Office17%
"Other"19%
Res. Facility
4%
Unspec.2%
Home6%
Hotel6%
Convention.4%
Restaurant46%
1996 EventsBase = 151,434
YTD 9/01 EventsBase = 275,704
“Other” Event Locations Include…Baseball game WinerySpa Golf Course
SOURCE: Physician Meeting & Event Audit, Scott-Levin, 1996, YTD 9/01
$820,000 Surgery - Plastic
$936,000Surgery - Neurological
$911,000Radiology
$238,000Psychiatry
$271,000Pediatrics
$1,352,000ORS - Spine Surgery
$417,000Obstetrics/Gynecology
$245,000IM (Hospitalist)
$238,000Internal Medicine
$271,000Infectious Disease
$685,000Hematology/Oncology
$590,000Gastroenterology
$363,000FP - Sports Medicine
$241,000FP (with OB)
$811,000Interventional Cardiology
$647,000Cardiology: Invasive
Top CompensationPhysician Specialty
Even by U.S. standards
physicians are well compensated
SOURCE: Verispan's PMEA 55
0% 10% 20% 30% 40% 50% 60% 70% 80%
% of Invitations Accepted
Other
Textbooks
Gift Cert.
Medical Inst.
Cash
Charity Contrib.*
Meals
Honoraria Influence on Attendance
0% 10% 20% 30% 40% 50% 60% 70% 80%
% of Invitations Accepted
Other
Textbooks
Gift Cert.
Medical Inst.
Cash
Charity Contrib.*
Meals
• Although offered infrequently, acceptance rates for events that offered charitable contributions as honoraria increased throughout 2003, to 80% acceptance rates by the quarter ending Oct. 2003.
Note: Percentages may add up to more than 100% due to multiple responses.* Less than 30 raw events
QTR Oct 2003 - Base: 12,948 Event InvitationsQTR Apr 2003 - Base: 15,056 Event Invitations
•Meals with physicians feature education
•Meals only at “appropriate” locations
•Meals at “appropriate $$ levels”
•No meals with spouses or guests
•No entertaining (golf, baseball, etc.)
•Gifts (<$100) must be practice related (no golf balls, etc)
•Consultants must be bona fide (Payments are acceptable)•Advisory board meetings must be bona fide (no spouses or guests)
New Guidelines
•Integrity of data used by states and fed to establish payments (AWP)
•Kickbacks and illegal remunerations
•Compliance with laws regarding samples.
•COMPLIANCE STEPS
•Written standards addressing specific areas of potential fraud and abuse
•Appoint a compliance officer reporting to the Chairman and the Board to monitor programs
•Establish effective an ongoing education for all employees involved
•Establish a free line of communication for “whistleblowers”
•Establish audits to monitor compliance
Meetings and Events still used extensivelyNetwork:
Rolling 4 Weeks Ending October 3, 2003
Promotion Research Organization
Time:
October 3, 2003 n= 178
Share of MD Reported Meetings and Events
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
7/11n=115
7/18117
7/2581
8/184
8/872
8/1567
8/2281
8/2991
9/5101
9/12121
9/19140
9/26157
10/3178
Sha
re o
f MD
-Rep
orte
d M
eetin
gs a
nd E
vent
s
Crestor Lipitor Zetia Zocor
Pravachol Lescol Pravigard Pac
Primary Care
Pravachol 6%Zocor 7%
Zetia 15%
Lipitor 26%
Crestor 43%
Lescol 3%
Source: ImpactRx
Consumer Influence
Deg
ree
of In
fluen
ce Physician
Consumer
Managed Care
1970s 1980s 1990s 2000s
Source: IMS HEALTH Market Survey, 2001
. . . DTC emerges
Direct To Consumer Advertising
$0.0
$0.5
$1.0
$1.5
$2.0
$2.5
$3.0
1995 1996 1997 1998 1999 2000 2001 2002
SOURCE: Scott-Levin’s Direct-to-Consumer Advertising Audit, CMR
93% 46% 28% 40% 33% 10% -5.4%
$ D
TC
Spe
ndin
g in
Bill
ions
0.00
50.00
100.00
150.00
200.00
250.00
300.00
350.00
400.00
450.00
Pfizer GSK Merck J&J AstraZeneca
DT
C s
pen
d in
$ m
illio
ns
-15.0%
-10.0%
-5.0%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
YT
Y %
Gro
wth
$ Mil YTY Growth
DTC - First eight months 2002-2003
Source: TNSS Media Intelligence/CMR tracking 14 media platforms
DTC Is Used On Limited Categories and Brands But With Very Large Budgets
47.848.551.254.1
6162.3
73.5
74.876
78.38686.5
90.495.4
98.5104.5
119.9
134.3142.3
211
0 50 100 150 200 250
Zoloft
Diflucan
Valtrex
Plavix
Vioxx
Ambien
Imitrex
Flonase
Fosamax
Procrit
Paxil
Lipitor
Celebrex
Prevacid
Zocor
Viagra
Advair
Allegra
Clarinex
Nexium
Allergy20%
GI Disorder10%
Cholesterol8%
Depression8%
Arthritis6%
Asthma6%
Other42%
Leading DTC categories YTD 6/02Top 6 = 55%
Source: Market Measures/Cozint’s 2002 DTC Monitor
Source: Nielson Monitor-Plus TV, Print & Radio
Leading products by DTC spend 2002 $ Millions
0
500
1,000
1,500
2,000
2,500
Vicodin Viox
x
Celebre
xViag
raProz
acXana
x
Claritin
Ortho T
ri-Cycl
en Paxil
Percoce
t
Occ
urre
nces
(000
)Top Drugs Requested by Patients
Seven of the top 10 drugs requested by patients were DTC advertised in YTD 7/01.
SOURCE: Scott-Levin’s Physician Drug and Diagnosis Audit YTD 9/01; DTC Audit, CMR, YTD 7/01 - AARP
Source: Food and Drug Administration Surveys of patients in 1999 and 2002
Increasing the odds…
“More than 70% of physicians said that they were more likely to prescribe a brand name medication based on a patient’s request when a sample is readily available and can be provided during an office visit” IMS survey 2001
Physician Response to a Patient’s RequestsPatient Attitudes
14%14%
15%13%
29%41%
32%34%
50%49%
0 10 20 30 40 50 60
Recommend OTC
Recommend no drug
Behavior/lifestyle chg
Recommend diff. Drug
Gave Rx asked about
1999 2002
14.4%
48.8%
14.4%6.4% 9.6% 6.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
% o
f MDs
repo
rting
None 1-10% 25% 50% 75% Over90%
% of Reps doctors would see
No Sample, no detail
The vast majority of doctors say they would see fewer reps if they did not provide samples
Accel Healthcare 2003
504,990
315,559
99,149
505,995
283,992
88,563
481,914
285,488
95,621
472,285
296,953
94,590
1997 1998 1999 2000
By Delivery Type
MailIn-PersonService Visit
Sample Volume(Volume in 000’s )
- 20,000 40,000 60,000 80,000 100,000
GlaxoSmithKline
Shering Plough
Pfizer
Merck
J&J
Aventis
Wyeth
Pharmacia
BMS
AstraZeneca By Manufacturer (2000)
- 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000
Claritin
Allegra
Vioxx
Celebrex
Zyrtec
Augmentin
Allegra D
Claritin D 12
Claritin D 24
PrilosecBy Product (2000)
$10 Billion Spent on Sampling64% of Professional Promotion
Source: IMS 2001
In a service visit, the physician is not seen
Drive-by sampling
120,
760
83,0
8772
,963
56,6
28
38,6
4230
,449
19,9
3819
,096
15,5
22
11,7
80
10,9
34
8,68
67,
694
7,47
1
7,08
36,
801
5,15
7
4,85
64,
835
4,11
0
2,25
72,
028
1,47
3
770
749
697
645
366
337
207
27
U.S.A
Franc
e
German
y U.K.
Spain
Canad
aIta
lyJa
pan
Austra
lia
Belgium
Switze
rland Kore
a NL
Portug
al
Austria
Irelan
dFin
land
Swed
enPola
nd
Denmark
Mexico
Norway
New Ze
aland
Greece
Turke
yBraz
il
Hunga
ry
Luxe
mbourg
Roman
ia
Morocc
o
Argentin
a
Print advertising by country ($000)January-June 2003 (Source: CAMM Group)
1.7
1.7
2.2
2.4
2.9
3.6
3.6
4.1
4.2
4.3
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Video conferences
Direct mail
Pharmaceutical representatives
CD / Computer Instruction
Internet / Web sites
References
Medical Meetings
Colleagues
CME Courses
Medical Journals
Not very important Very important
Value of Clinical Information Sources
Source: Who are these Academy Doctors? AAFP 2003
Phone Pads
Phone Detail
Faxes
Calendars
e-Detail
Co-op DM
e-Conferences
Patient Records
Video
On-line
Rx Pads
Direct Mail
Study Club
Poster
Internet
Audio Cassettes
Govt Bulletin
Reference
Dinner Meetings
Detail Reps
Colleagues
Medical Journals
Conferences
CME Courses 76.1
50.2
50.4
58.4
67.3
70.1
31.6
11.0
10.3
8.9
7.6
6.6
6.4
6.0
4.6
3.8
22.5
17.9
19.1
12.6
14.5
11.9
16.8
16.3
17.3
% Response
Source: PERQ/HCI, FP/GP/IM/DO/CD, February 2001
The leading sources of information for physicians
Where do primary care physicians get medical information?
0
10
20
30
40
50
60
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 20020
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
FDA Approvals All Journal Pages
Journal Ad Pages Are Linked to Product Approvals
PAGESNMEs
$6.5
$10.7
$11.8
$8.4
5.6
$12.7
$10.6
$11.7
$7.5
9.3
$11.6
$10.8
$9.7
$6.3
$5.9
$13.0
$11.4
$8.1
$7.3
11.3
1999 2000 2001 2002
Lexapro Lipitor Norvasc Avandia CelexaNexium Prevacid Protonix Effexor
Top 5 products in journals
$43 MM$52 MM
$44 MM
Top Advertisers in Journals
NDCHealth and Quintiles Informatics
$51 MM
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
91 92 93 94 95 96 97 98 99 00 01 02
Multispecialty Internal Medicine OB/ GynPediatrics Oncology PsychiatryInfectious Disease Neurology Diabetes
Professional Ad Pages Vary By Specialty
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
91 92 93 94 95 96 97 98 99 00 01 02
Mul
tispe
cial
ty
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
Spe
cial
ty
Multispecialty Internal Medicine OB/ Gyn Pediatrics Oncology
Psychiatry Infectious Disease Neurology Diabetes
OB/GYNOncology PediatricsPsychiatry
NeurologyInfectious Disease
Diabetes
Professional Ad Pages Vary By Specialty
0%
10%
20%
30%
40%
50%
60%
70%
80%
Anti-s
eizure
Antipsy
chotic
s
Antibioti
cs
Antide
pressa
nts
Quinolo
nes PP
I
SSRI/S
NRI
Antihi
stamine
sCox
2
Beta b
locke
rs
Oral co
ntrac
eptive
s
ACE I
nhibit
ors
Calcium
Chann
el Bloc
kers
Choles
terol d
rugs
Diabete
s Med
s
% O
ff-la
bel R
x
0
2
4
6
8
10
12
14
16
18
20
# O
ff-la
bel
Rx
(Mil)
% off-label Rx Number of Rxs
Discussion of off-label use of medications is generally restricted to accredited CME programs
Source: Knight Ridder analysis of Rx data from Verispan’s Physician Drug and Dispensing Audit –St. Paul Pioneer Press 11/2/03 www.twincities.com/mld/twincities/news/special-packages/riskyrx
Analysis of top 3 drugs in each class – 8/02-7/03
$188.79
$461.19
$288.22
$437.25
$301.95
$586.59
$387.62
$722.86
$466.96
$804.22
$568.77
$825.16
$746.02
$850.18
0
200
400
600
800
1000
1200
1400
1600
1996 1997 1998 1999 2000 2001 2002
Commercial Support User Revenue and Other
Continuing Medical Education (CME) $1.6 Billion and Growing
Revenue in $ Millions by Source (ACCME Annual Reports)
$649.99 $725.47 $888.54 $1,110.48 $1,271.18 $1,393.93 $1,596.20
+14%
+31%
+3%
Physician use of Enduring Materials is GrowingFaster Than Live CME Events
43,848
9,548
42,445
4,684
43,217
6,233
43,218
7,831
46,319
9,648
1998 1999 2000 2001 2002
Activities
Live Enduring
544,683
75,865
549,105
36,343
506,666
45,074
539,327
44,142
572,785
76,141
1998 1999 2000 2001 2002
Hours
Live Enduring
2,958,679
945,402
3,468,707
967,491
4,018,948
1,074,587
3,946,932
1,231,924
4,018,693
1,397,252
1998 1999 2000 2001 2002
MD Participants
Live Enduring
1,339,791
399,161
1,580,567
179,938
1,726,889
156,922
1,876,764
282,552
2,127,035
565,936
1998 1999 2000 2001 2002
Non-MD Participants
Live Enduring
+6% +1% +5% 0%
+36% +48%+59% +42%
Source:ACCME
All that data – so well organized Terrific Information Jim !
Now…• What am I supposed to do with all this?• How can I use it to do my job better?
0.6%0.9%
1.8%1.4%
0.6%0.2%
-1.2%-1.2%-1.6%
-2.4%-2.5%-2.8%
2Q00
3Q00
4Q00
1Q01
2Q01
3Q01
4Q01
1Q02
2Q02
3Q02
4Q02
1Q03
Rx Gross Margin Rate of Change
Source: Company data
The U.S. Pharmaceutical Industry is facing new pressures
17% 16% 18% 16% 8%0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
YT
Y G
row
th R
ate
1998 1999 2000 2001 2002
Industry earnings growth(Source: Thomson’s First Call)
Margin pressure
Profit pressure
Cost Containment measures are everywhere
Range of Containment MeasuresRange of Containment Measures
Outright Price
Controls
Fixed Reference
Price
Mandatory Molecule
Substitution (Generic/PI)
Enforcementof
Prescribing Guidelines
Therapeutic Substitution
(under discussion)
Growth & Spending
Caps/ Penalties
GermanyItaly Poland
GermanySpainAustria
CanadaDenmarkFinlandGermanyPortugalSpainSwedenUK
AustriaBelgiumGermanySwedenFrance (emerging)
DenmarkGermany
FranceSpainItalyPortugal
IntellectualProperty
Czech RepublicPolandHungarySlovakiaCEERGermany
Manufacturer’s rebates to Medicaid 1991-2002
$550
$900
$1,500 $1,600$1,800 $1,900
$2,200 $2,300
$2,900
$3,700
$4,700
$5,400
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Source: Muse & Associates, May 2002 based on CMS State Medicaid Data
Rebates in Millions of Dollars
Other, 2%
Medicare HMO 15%
Medicaid, 10%
Employer sponsor, 28%
No Coverage,
38%
Medigap, 7%
Rx Drug Coverage under Medicare
In 2002, government = 32%
Government could soon control 70% or more
If U.S. seniors were concerned about how much drugs used to cost,
Just wait till they see how much they cost when they are free!
Demands for greater “efficiency” in marketing and sales.
•Eli Lilly
•Aventis
•Bristol Myers Squibb
•Johnson & Johnson
•TAP
• And so on ….
Source: IMS Health Integrated Promotional Services and CMR 2/2003 12 Months ending 9/02
0
5,000
10,000
15,000
20,000
25,000
Pfizer
GlaxoS
mithKline
Merck &
Co.
AstraZ
enec
a J&J
Novart
is
Pharm
acia
Sche
ring-P
lough Wye
th
Aventi
s
To
tal U
.S. S
ales
$M
il
0
500
1,000
1,500
2,000
2,500
3,000
3,500
Pro
mo
tio
n $
Mil
Sales $000 Promotion $000
Total Sales and Promotional Spending 2002
So, who are the most efficient U.S. companies?MEDICAL TRIBUNE GROUP
Higher spending doesn’t guarantee higher return
Source: IMS Health Integrated Promotional Services and CMR 2/2003 12 Months ending 9/02
$6.76
$7.50
$9.09
$6.07
$6.87
$9.27 $9.21
$8.48
$7.64$8.14
Pfize
r
GlaxoS
mithKline
John
son &
John
son
Merck &
Co.
AstraZ
enec
a
Novart
isW
yeth
Pharm
acia
Sche
ring -P
lough
Aven
tis
Source: Verispan
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
Pfize
r +14
%
GSK +0
%
Merck -
2%
J&J +
11%
A-Z +1
6%
Pharm
acia -
8%
Aventi
s +11
%
Novart
is +22
%
Wyeth
+6%
Sche
ring -
3%
Lilly
-16%
BMS -35
%
Abbott
+2%
Detail Sample $$ Journals DTC Events
Promotional Spending by tactic 2002
How do you improve return on investment?
Allocation of Promotional Spending 2002Allocation of promotional resources varies significantly
Source: Verispan
43%
10%3%
30%
15%
40%
7%1%
38%
13%
44%
11%1%
31%
13%
45%
7%3%
32%
13%
45%
7%2%
28%
18%
47%
9%1%
30%
12%
47%
3%4%
31%
14%
60%
7%3%9%
21%
49%
10%
5%
16%
20%
53%
4%1%
32%
9%
57%
14%
1%2%
26%
51%
6%1%
28%
15%
78%
8%3%0%
11%
Pfizer
GSK
Merck J&
J A-Z
Pharm
acia
Aventi
s
Novart
is
Wye
th
Sche
ring Lil
ly BMS
Abbott
Detail Sample $$ Journals DTC Events
SSRI/SNRI Market Retail Total Rx Volume/ Growth
24,550
27,634
25,34427,305
15,609
20,361
6,968
19,502
12,524
15,050
17,945
5,368
1,333 1,212
Paxil Family Zoloft Celexa &Lexapro
GenericProzac
EffexorFamily
ProzacFamily
Others
2001 2002
SSRI/SNRI 2001 2002
Retail TRx 92,247 104,273
% Increase +13%
Total Sales 10,375,313 10,239,404
% Increase -1%
Source: Verispan
The ROI on SSRI – (Paxil and Paxil CR)
YTY YTY 2000 2001 % Growth 2002 % Growth
Total Sales 22,995 24,550 7% 27,634 13% Total Sales 2,227,568$ $2,384,810 7% $2,757,980 16%
% of % of % Change % of % Change$ Spend Spend $ Spend Spend YTY $ Spend Spend YTY
Detail 65,093 33% 75,557 40% 16% 88,444 32% 17%Sample 20,747 10% 24,426 13% 18% 26,802 10% 10%Journals 2,370 1% 2,284 1% -4% 2,831 1% 24%DTC 91,572 46% 65,207 34% -29% 137,602 50% 111%Meet/Events 18,178 9% 22,160 12% 22% 17,456 6% -21%
Total Promo 197,960 189,634 -4% 273,135 44%
ROI 0.12$ 0.13$ 11% 0.10$ -22%
Source: Verispan
The ROI on SSRI – Effexor
YTY YTY 2000 2001 % Growth 2002 % Growth
Retail Trx 10,251 12,524 22% 15,050 20% Total Sales $1,040,433 $1,478,584 42% $1,878,307 27%
% of % of % Change % of % Change$ Spend Spend $ Spend Spend YTY $ Spend Spend YTY
Detail 44,651 60% 49,207 51% 10% 60,427 48% 23%Sample 11,437 15% 20,610 21% 80% 24,194 19% 17%Journals 4,881 7% 5,292 5% 8% 9,257 7% 75%DTC 230 0% 28 0% -88% - 0% -100%Meet/Events 13,762 18% 21,538 22% 57% 31,828 25% 48%
Total Promo 74,961 96,675 29% 125,706 30%
ROI 0.14$ 0.13$ -5% 0.12$ -8%
Source: Verispan
PPI Market Retail Total Rx Volume/ Growth
23,530 23,209
27,294
20,608
3,848
12,792
5,694
9,967
5,7846,889
Prevacid Prilosec Nexium Protonix Aciphex
2001 2002
PPI 2001 2002
Retail TRx 56,269 66,151
% Increase +18%
Total Sales 12,345,688 13,659,237
% Increase +11%
Source: Verispan
The ROI on PPI – (Prevacid)
YTY YTY 2000 2001 % Growth 2002 % Growth
Total Sales 3,940,603$ 4,157,308$ 5% 4,073,553$ -2%
Retail Trx 22,485 23,530 5% 23,209 -1%
% of % of % Change % of % Change$ Spend Spend $ Spend Spend YTY $ Spend Spend YTY
Detail 69,942 45% 76,578 46% 9% 81,436 45% 6%Sample 34,968 23% 38,685 23% 11% 35,786 20% -7%Journals 7,510 5% 5,856 4% -22% 5,893 3% 1%DTC 34,384 22% 36,859 22% 7% 48,983 27% 33%Meet/Events 7,883 5% 7,262 4% -8% 10,900 6% 50%
Total Promo 154,687 165,240 7% 182,998 11%
ROI 25.47$ 25.16$ -1% 22.26$ -12%
Source: Verispan
The ROI on PPI – (Prilosec +Nexium)
YTY YTY 2000 2001 % Growth 2002 % Growth
Total Sales 4,642,811$ 5,202,655$ 12% 5,409,568$ 4%
Retail Trx 29,603 31,142 5% 33,400 7%
% of % of % Change % of % Change$ Spend Spend $ Spend Spend YTY $ Spend Spend YTY
Detail 60,915 28% 112,908 36% 85% 116,565 29% 3%Sample 23,987 11% 32,465 10% 35% 35,800 9% 10%Journals 9,318 4% 10,828 3% 16% 5,943 1% -45%DTC 106,087 49% 128,215 41% 21% 204,882 52% 60%Meet/Events 15,006 7% 28,909 9% 93% 34,042 9% 18%
Total Promo 215,313 313,325 46% 397,232 27%
ROI 21.56$ 16.60$ -23% 13.62$ -18%
Source: Verispan
How can you use this information to adjust the allocation of promotional
resources and improve the Return On Investment on your brand?
The Ebbinghaus memory curve
0%
10%
20%
30%
40%
50%
60%
70%
5 Minutes 1 Hour 8 Hours 24 Hours 2 Days 5 Days 31 Days
Herman Ebbinghaus (1850-1909) conducted the first research to isolate the factors that influence memory
% o
f inf
orm
atio
n re
tain
ed
Time interval
The Ebbinghaus CurveCreating awareness is not an instantaneous occurrence. Multiple appeals are needed before a message will be noticed and remembered. The communication task involves continuous reminders about a product using various media promotional tactics.
1st 2nd 4th 6th 8th 9th 10th 11th 12th3rd 5th 7th
50%
% o
f Mes
sag
e R
ecal
l
Months
100%
0%
Overcome Objections
Total
Follow-Up and Service
Generate the prescription
Make Specific Recommendations
Demonstrate Competitive Advantages
Build Basic Awareness
6 Steps required to win a prescription
Marketing Logic Step #1Based in part on the age of the product
15%Overcome Objections
100%Total
10 %Follow-Up and Service
15 %Generate the prescription
10 %Make Specific Recommendations
30 %Demonstrate Competitive Advantages
20 %Build Basic Awareness
% of Marketing Responsibility NON-PERSONAL
% of Marketing ResponsibilityPERSONAL
% of Marketing Effort
6 Steps required to win a prescription
Marketing Logic Step #1Based in part on the age of the product
20 %Overcome Objections(Price, efficacy, safety)
100 %Total
5 %Follow-Up and Service
5 %Generate the prescription
10 %Make Specific Recommendations
25 %Demonstrate Competitive Advantages
40 %Build Basic Awareness(Professional/DTC)
% Of Marketing Effort
6 Steps required to win a prescription
Steps needed to win shareAllocation varies based in part on the age of the product
20 %
100 %
15 %
15 %
10 %
25 %
15 %
% Of Marketing Effort
25 %
100 %
15 %
10 %
10 %
15 %
10 %
% Of Marketing Effort
Don’t use a tactic simply because your competitor doesYour objectives are different!
40%60%15%Overcome Objections
100%Total
75%25%10 %Follow-Up and Service
25%75%15 %Generate the prescription
70%30%10 %Make Specific Recommendations
30%70%30 %Demonstrate Competitive Advantages
80%20%20 %Build Basic Awareness
% of Marketing Responsibility NON-PERSONAL
% of Marketing ResponsibilityPERSONAL
% of Marketing Effort
6 Steps required to win a prescription
Marketing Logic Step #1Based in part on the age of the product
20%40%100%Overcome Objections
5 %15 %80 % 100%Customer Follow-Up and Service
20 %5 %20 %50 %5 %100%Make Specific Recommendations
20%15 %5 %10 %25 % 25 %100%Demonstrate Competitive Advantages
10%10 %20 % 10% 50 %100%Build Basic Awareness
OtherSales Aids
Trade Shows
P.R. CME AdSpace
Total Effort
Non-Personal CommunicationObjectives
Marketing Logic Step #2
Allocation Matters!
Everyone company wants to be able to measure the Return On Investment (ROI) of their
promotion
This is a measure of Total ROI
If your salespeople are trying to grow market share, how many salescalls would it take before their efforts ceased to increase return?
1x Year 2x Year 4x Year 12x Year 26x Year 52x Year
5%
Market Share
Number of sales visits per year.
15%
10%
20% 20%20%
At what point would their efforts be better used elsewhere?
Hypothetical Example
The Concept of Average Marginal Return On Investment
1,080,000
1,070,000
1,060,000
1,050,000
1,040,000
1,030,000
1,020,000
1,010,000
1,000,000
990,000
980,0001-2 1-1 1-0 1+1 1+2 1+3 1+4 1+5 1+6 1+7 1+8 1+9 1+10 1+11 1+12 1+13 1+14 1+15 1+16 1+17 1+18 1+19 1+20 1+21 1+22 1+23 1+24
CD
A
B
E
Total / Average ROI v. Marginal ROI
A. Base CampaignB. Base Campaign + $0.5MMC. Base Campaign + $1 MMD. Base Campaign + $1.5 MME. Base Campaign + $2 MM
Total Avg ROI$ 8.82$ 12.10$ 10.79$ 9.22$ 7.64
Marginal ROI$ 8.82$ 8.65$ 6.86$ 2.93$ -0.21
Source: R.Anderson, Mattson Jack ROI Inc. 2003
Monthly Sales
Time in Months
Marginal Return on Investment v. Total Return on Investment
Wouldn’t you love to determine the Average Marginal ROIThe ROI on the Last Dollar Spent
for each promotional tactic?
The point where the next dollar spent will only generate that ROI or less
Dollars Spent
ROI
Hypothetical Example
>
LAST
$$
SPENT
You need to do a regression analysis
Regression analysis examines multiple variables and analyzes howchanges in those variables correlate with the results over time.
Average Marginal ROI
ROI Analysis of Pharmaceutical Promotion (RAPP): Dr. Scott Neslin
Albert Wesley Fry Professor of Marketing Amos Tuck School of Business, Dartmouth College
May, 2001
Two Comprehensive Reviews of AMROI
Analysis of ROI for Pharmaceutical Promotion (ARPP)Dick R. Wittink, Ph.D.
General George Rogers Clark Professor of Management and MarketingYale School Of Management
September, 2002
Dean SlackDirector, Strategic AnalysisBayer Corporation
Treasurer, PMRG
Paul RabideauDirector, Marketing ScienceNovartis Pharmaceuticals
Past-President, Pharmaceutical Management Science Association
Bill FriedrichAssoc. Dir., Global Mkt. ResearchWyeth-Ayerst Global Pharmaceuticals
President, Pharmaceutical Marketing Research Group (PMRG)
ARPP Steering Committee
RAPP and ARPP
Objectives: Estimate the Average Marginal Return On Investment AMROI of marketing investments
DetailingDTC AdvertisingJournal AdvertisingMeetings and Events (ARPP only)
Data: All brands with $25,000,000 or more in revenue
Almost 400 branded drugsOver 100 generic drugsData from 1993 – 2000Over 20,000 monthly observations
For more detail visit www.RxPromoROI.org
ARPP and RAPP did determine Average Marginal ROIfor detailing, meetings & events, DTC and journals
You can use ARPP and RAPPfindings to determine:
Overspending/overutilizationof a tacticUnderspending/underutilizationof a tactic
AARP/RAPP Does Not
Indicate that one tactic is better than anotherIndicate that a tactic works or doesn’t workMeasure any particular brandIncorporate non-ROI strategies
Dollars Spent
ROI
Hypothetical Example
>
LAST
$$
SPENT
RAPP Brands - Revenue/Launch Year CellsMedian Brand Profile by Cell
Launch Year
Annual Revenue ?1993 1994-1996 1997-1999
$25-$50MMNumber of Brands (n=104) 66 18 20PCP Fraction 39.3% 49.7% 22.3%Median Price/script $46 $55 $66Scripts / month 68,000 38,000 22,000Revenues/year $38MM $25MM $17MM
$50MM-$200MMNumber of Brands (n=181) 108 32 41PCP Fraction 39.6% 37.3% 41.9%Price/script $45 $53 $78Scripts / month 156,000 94,000 59,000Revenues/year $84MM $60MM $55MM
$200MM+Number of Brands (n=106) 60 27 19PCP Fraction 61.8% 54.6% 54.3%Median Price/script $57 $62 $76Scripts /month 674,000 332,000 229,000Revenues/year $461MM $247MM $209MM
ARPP - Revenue/Launch Year CellsLaunch Year
Annual Revenue <1994 1994-1997 1998-2000
$25-$100MMNumber of Brands (n=137) 86 37 14PCP Fraction 43% 37% 38%Scripts 1,000/mo 154 79 62Revenues/Year $43MM $34MM $46MM
$100-$500MMNumber of Brands (n=192) 112 59 21PCP Fraction 50% 43% 53%Scripts 1,000/mo 475 179 159Revenues/Year $144MM $134MM $143MM
$500MM+Number of Brands (n=63) 36 18 9PCP Fraction 52% 53% 58%Scripts 1,000/mo 1,126 718 609Revenues/Year $692MM $585MM $627MM
Range of Monthly Expenditures ($000)
Brand $ Detailing $ DTC $ Journals $ Meetings
Actos $ 658- 7,593 $0- 2,741 $0-1,244 $609- 3,065
Avandia 5,118-10,099 0-10,053 167-1,047 646- 2,912
Celebrex 10,965-28,750 0-12,424 6-1,345 2092-12,545
Celexa 3,840-11,300 0- 0 82-1,916 742- 4,642
Enbrel 88- 1,079 0- 3,204 0- 212 0- 334
Plavix 176- 6,692 0- 0 0- 876 133- 1,939
Singulair 1,926- 7,636 0-11,959 0-1,738 523- 3,619
Viagra 514-16,646 0-10,825 0-2,267 476- 4,325
Vioxx 4,293-19,226 0-28,455 0-1,754 689- 7,038
ARPP – Brands in $500MM+, Launch Year 1998-2000 Cell
Key Variables
• DET detailing dollars includes 1-to-1 physician visits, but excludes samples (Scott-Levin) may include some small sales driven meetings and events
• DTC direct-to-consumer dollars: includes television, print, radio, and outdoor (Scott-Levin)
• JAD medical journal advertising dollars (PERQ/HCI)
• PME physician meetings & events dollars (Scott-Levin)*
• Scripts number of scripts filled at retail (Scott-Levin)
• Price retail pharmacy price per script (Scott-Levin)
•Meetings and Events ROI has a large margin of error (Plus or Minus $1.92). It is highly correlated with other marketing variables (especially Detailing), making it particularly difficult to determine Meetings and Events ROI by size/launch date
Methodology - Computing ROI
• ROI (Return On Investment) = Increase in revenues per additionaldollar spent
• ROI is calculated by estimating how unit sales (prescriptions) depends on expenditures for each promotional tactic, and multiplying this unit sales change for an investment of $1 by the script price. The multiple regression result shows how unit sales depends on the individual expenditures, holding other things constant.
• So, ROI is the estimated increase in revenues for a $1 increase in each variable, DET, DTC, JAD, PME, one at a time.
• ROI = change in unit sales (for a $1 increase in a promotion tactic) x average unit price per script
Regression Analysis
• Regression analysis examines every brand in every month.
• Regression analyzes how changes in spending correlate with changes in Rx levels.
• Regression concludes that a marketing variable has a high ROI if that variable can consistently explain changes in Rx levels
• Regression analysis controls for causes of sales not attributed to a brand’s marketing (eg, generics, external trends affecting brand growth, competitive spending, price)
Average Marginal ROI by Revenue/Launch Date
ARPP ROI Results 2002
<1994 1994-1997 1998-2000
Detailing$25-$100MM $0.90 $1.00 $ 1.00$100-$500MM $1.20 $1.60 $ 2.10$500MM+ $3.10 $5.90 $11.60
Direct to Consumer$25-$100MM $0.00 $0.00 $ 0.00$100-$500MM $0.10 $0.20 $ 0.20$500MM+ $0.40 $0.70 $ 1.30
Journal Advertising$25-$100MM $6.20 $6.70 $ 7.20$100-$500MM $2.30 $3.10 $ 4.20$500MM+ $3.10 $6.20 $12.20
Meetings and Events$25-$100MM $0.10 $0.10 $ 0.10$100-$500MM $2.00 $2.70 $ 3.60$500MM+ $3.10 $6.00 $11.70
Average Marginal ROI by Revenue/Launch Date
ARPP ROI Results 2002
<1994 1994-1997 1998-2000
Detailing$25-$100MM $0.90 $1.00 $ 1.00$100-$500MM $1.20 $1.60 $ 2.10$500MM+ $3.10 $5.90 $11.60
Direct to Consumer$25-$100MM $0.00 $0.00 $ 0.00$100-$500MM $0.10 $0.20 $ 0.20$500MM+ $0.40 $0.70 $ 1.30
Journal Advertising$25-$100MM $6.20 $6.70 $ 7.20$100-$500MM $2.30 $3.10 $ 4.20$500MM+ $3.10 $6.20 $12.20
Meetings and Events$25-$100MM $0.10 $0.10 $ 0.10$100-$500MM $2.00 $2.70 $ 3.60$500MM+ $3.10 $6.00 $11.70
These Findings Can Be Used to PredictRevenue Changes
Based on Changes in Allocation
Add a $300,000 budget increase to a $250 Millionbrand launched in 1994-1997:
TacticDTCJournalsMeetings
AverageMarginal
ROI$0.20$3.10$2.70
Budget Change+$100,000+$100,000+$100,000
PredictedRevenue
+$ 20,000+$310,000+$270,000=$600,000
The resulting revenue increase would be $600,000.
For example:
X =
• Estimate the Average Marginal ROI for various allocations of a 15% increase ($.788MM)
Annual Annual Total Annual ROI on BudgetDetail*($2.68) DTC*($0.43) Budget* Revenues* Increase$5,256 $ 0 $5,256 $59,784 -$6,044 $ 0 $6,044 $61,922 $2.71$5,650 $394 $6,044 $60,998 $1.54$5,256 $788 $6,044 $60,090 $0.39
• Allocating additional funds to DTC, in this case is less productive
*Numbers are in $000
+15%
RAPP – Allocating New Marketing Funds Detailing vs Direct to Consumer (DTC)
Median Brand Profile: $50-200MM, Launched 1994-1996
• Estimated Average Marginal ROI for various allocations of a 15% increase ($2.513MM)
Annual Annual Total Annual ROI on BudgetDetailing($2.34) Journals($6.79)Budget* Revenues* Increase
$16,128 $ 624 $16,752 $461,139 -$18,641 $ 624 $19,265 $467,253 $2.43$17,384 $1,880 $19,265 $472,443 $4.50$16,128 $3,137 $19,265 $478,870 $7.06
• Allocating additional funds to Journal Advertising enhances the Average Marginal ROI
RAPP – Allocating New Marketing Funds Detailing vs Journal Advertising
+15%Median Brand Profile: $200MM+, Launched ?1993
• Estimated Average Marginal ROI when you reallocate the current $16.752MM Detailing and Journal budget?
Annual Annual Total Annual ROI onDET* ($2.34) JAD*($6.79) Budget* Revenues* Budget Change
$16,128 $ 624 $16,752 $461,139 $2.66$15,504 $1,248 (2X) $16,752 $464,101 $2.84$14,136 $2,496 (2X) $16,752 $470,728 $3.26$11,640 $4,992 (2X) $16,752 $488,372 $4.32
• Reallocating more toward JAD, which in this case is more productive than DET, enhances ROI
*Numbers are in $000
IncreaseRAPP – Reallocating Budget
Detailing vs Journal Advertising
Median Brand Profile: $200MM+, Launched ?1993
Thank you
The ROI calculator can be accessed at:http://www.rxpromoroi.org
For a powerpoint version of this presentation,
please contact Brigitte Niederberger
A pdf file of the slides can be obtained at
http://www.medical-tribune.ch
Source: Verispan ePromotion Annual Study.
128
Physician’s Use of the Internet
• Eighty percent of physicians surveyed reported using the Internet daily for general purposes, but 16% use it daily for health research or product information.
Internet Use for any Purpose
80%
12%
6% 2%0%
Daily 4-6 times/wk.1-3 times/wk. < once /wk.Never
n=1,004
Internet Use for Health Research/Information
3%
28%
36%
17%
16%
Daily 4-6 times/wk.1-3 times/wk. < once /wk.Never
n=1,004
Source: Verispan ePromotion Annual Study.
129
Invitations/Participation in ePromotion
1 to 359%
None19%
10 or more3%
7 to 95%
4 to 614%
• Over half of physicians surveyed reported receiving one to three invitations per month to participate in ePromotion activities.
• Over one-quarter responded that they accept 20% or fewer of the invitations.
n=1,004
12%
28%
12%10% 9%
10%
0%
5%
10%
15%
20%
25%
30%
% o
f res
pond
ents
None 1-20% 21-40% 41-60% 61-80% 81-100%
n=815
Source: Verispan ePromotion Annual Study.
130
Time Spent Participating in ePromotion Activities
21 - 30 min.34%
11 - 20 min.43%
1 - 10 min.12%
More than 60 min.
0%31 - 60 min.11%
• Two-fifths of respondents indicated they spend between 11 and 20 minutes on average for each ePromotion activity in which they participate. This is significantly longer than reported for detailing activity.
n=704
Source: Verispan's ePromotion Audit 131
Industry Trends: ePromotion
4Q02 1Q03 2Q03 3Q03
TherapeuticClasses 162 190 193 181
Corporations 93 98 99 107
Products 406 442 448 392
Activities 494,315 590,047 624,477 497,721
Expenditures $46million
$55million
$61million
$48million