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!