Educating the Market: Creating Value Through Support of Continuing Medical Education

BEST PRACTICES,®

LLCCopyright© 2006

Educating The Market: Creating Value Through Support of Continuing

Medical Education

Best Practices, LLC Benchmarking Report

BEST PRACTICES,®

LLCCopyright© 2006

Table of ContentsResearch Background Summary of Key Findings, Insights & TrendsCurrent CME Structural TrendsLeveraging Budgetary ResourcesAccelerated Evolution: Aligning Resources, Targets & Applicable Lessons LearnedCME Functional ManagementBuilding Talent Depth, Breadth & Competence: CMEOptimizing CME Delivery ChannelsCultivating E-LearningCME Content ManagementCME Lessons LearnedAppendixAbout Best Practices, LLC

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LLCCopyright© 2006

Using Field Benchmarks to Assess Current Trends & Future Directions

of CME in North America and Europe & Map the Path to Future CME Success in Both Regions

Research Background:

Copyright© Best Practices®, LLC BEST PRACTICES,®

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Key Study Objectives

What is the current landscape of continuing medical education in North America and Europe?

What structural forms are used to deploy CME, optimize budgets & best deliver content?

How rapidly is E-CME advancing?

What CME delivery channels are preferred?

What are the current trends and future directions of CME?

Best Practices, LLC conducted this research to identify the most important current trends and future directions of Continuous Medical Education (CME) in the North American and European marketplace. Research partners participated in a quantitative benchmark study and also contributed their qtheir qualitative thoughts, observations and narratives detailing the evolving CME landscape.

Research Objective and Methodology

Study Objective & Methodology

Benchmark research examined the existing North American and evolving European CME landscape and probed how companies structure their CME functions to best deliver educational content to medical professionals.

Study data, findings and insights were developed using in-depth “lessons learned” interviews with CME corporate leaders and CME providers – as well as through a detailed on-line CME benchmark survey.


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Universe of Learning: North American ParticipantsThirty CME leaders and practitioners from twenty-six pharmaceutical and biotechnology companies shared their strategies and perspectives on CME in the North American marketplace.


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Universe of Learning: European Participation

Executives from eighteen pharmaceutical and biotechnology companies make-up the sets of data and insights specific to European Continuing Education.


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Universe of Learning: CME Vendors

Seven CME vendors also participated in the research – contributing insights, data and observations from the perspective of third-party Medical Education providers.


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Medical Education leaders and managers primarily from North American and European countries contributed insights, observations, data and commentary for this research. Data from North America and Europe were segmented to provide comparative results.

Partner LocationsPartner Job Levels & Titles

C-Level: CEO, President, Principal

Vice Presidents: Global Commercial Development, Global Marketing, Marketing, Marketing Services, Medical Affairs, Professional Education

Directors: Commercial Development, Health Education, Global Conference, Global Medical Education, Independent Medical Education, Medical Affairs, Medical Communications, Medical Education, Professional Education, World-Wide Marketing

Managers: Continuing Education, Global Professional Relations, Group Product Manager, Independent Medical Education, International Products, Marketing, Medical Affairs

Australia Greece Sweden

Canada India Switzerland

Denmark Italy United Kingdom

France Mexico United States

Germany South Africa

Insights Span the Global Bio-Pharma Market


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Participants Oversee Diverse CME FunctionsBenchmark partners serve across multiple CME functions, Brand groups and Regional Marketing Organizations. Benchmark levels range from Vice President to Manager. All participants had direct or indirect responsibility for CME activities in their countries, regions, brands or therapeutic areas.

Benchmark Class RepresentativesBenchmark Class RepresentativesCEO

Director, Commercial Development

Director, Health Education

Director, Global Conference Department

Director, Global Medical Education

Director, Independent Medical Education

Director, Medical Affairs

Director, Medical Communications

Director, Medical Education

Director, Medical Education & Scientific Media

Director, Professional Education

Director, World-Wide Marketing

Group Product Manager

International Product Manager

Manager, Continuing Education

CEO

Director, Commercial Development

Director, Health Education

Director, Global Conference Department

Director, Global Medical Education

Director, Independent Medical Education

Director, Medical Affairs

Director, Medical Communications

Director, Medical Education

Director, Medical Education & Scientific Media

Director, Professional Education

Director, World-Wide Marketing

Group Product Manager

International Product Manager

Manager, Continuing Education

Manager, Global Professional Relations

Manager, Independent Medical Education

Manager, Medical Affairs

Marketing Manager

President

Principal

Senior Director, Oncology

Senior Marketing Manager

Senior Director

VP, Global Commercial Development

VP, Global Marketing

VP, Marketing

VP, Marketing Services

VP, Medical Affairs

VP, Professional Education

Manager, Global Professional Relations

Manager, Independent Medical Education

Manager, Medical Affairs

Marketing Manager

President

Principal

Senior Director, Oncology

Senior Marketing Manager

Senior Director

VP, Global Commercial Development

VP, Global Marketing

VP, Marketing

VP, Marketing Services

VP, Medical Affairs

VP, Professional Education

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Summary of Key Findings, Insights & Trends


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Insight #1: Decentralized CME Structures PrevailDecentralized Management Structures proliferate across the CME landscape where language differences, learning style differences, and local market variation create hurdles for centralized management structures.

Key Findings1. Decentralized Structures Reflect Balkanized CME Landscape:• Rapid Evolution of Structures: Especially in Europe, the CME landscape is a tapestry of nations at

different stages of evolution; as if by “natural selection” in their given markets, different decentralized structures spring up.

• Three Epicenters of Emergent CME Forms: Countries requiring their physicians to maintain ongoing educational levels cluster in three epicenters: North America, Big 5 European Countries and South Africa. However, their collective impact is not yet so broad-reaching as to set global or regional standards.

• Cross-border Variation: Significant variation exists regarding CME requirements and policy across regions, countries and local states. A greater number of countries have no CME requirements firmly in place. In response, various structures, approaches and strategies have evolved to meet local needs.

• Decentralized Structures Favor Local Market Response: The majority of benchmark companies do not utilize a globally centralized function for CME management or oversight. Companies employing such centralized structures report significant impact through increased leverage of budgets and headcount. However, decentralized structures are more typical – reflecting the rapidly evolving CME marketplace and need to reflect local market requirements.

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Current CME Structural Trends


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Decentralized CME Structures Proliferate

36.0%

32.0%

0.0%

4.0%

18.0%

11.0%

CentralizedOversight, Local

Management

CentralizedOversight,Regional

Management

IndependentOversight per

Region

Local Oversightper Country

Oversight withSeparateOperatingCompany

OutsourcedEntirely

% o

f Com

pani

es

Within your company, choose the one approach that best describesWithin your company, choose the one approach that best describes how the management and how the management and infrastructure support of CME activities are organized globally infrastructure support of CME activities are organized globally across your key country units.across your key country units.

(n=28)(n=28)

The majority of benchmark companies do not utilize a globally centralized function for CME management or oversight. Companies employing such centralized structures report significant impact through increased leverage of budgets and headcount. However, decentralized structures are more typical – reflecting the rapidly evolving CME marketplace.

Decentralized Decentralized Structures Structures ––

68%68%

Centralized Centralized Structures Structures ––

29%29%

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Leveraging Budgetary Resources:

Learning to Align Resources With Key Priorities and Target Physician Groups


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Engage CME Practice Communities to Accelerate Learning

“The ‘Hub and Spokes’ model facilitates learning exchange. The affiliate countries come together three times a year to discuss gaps and how they are building on that. It occurs across all therapeutic area support. We present: ‘Here is what we’re going to do from the hub. Here’s how we’re adjusting. All the spokes come back with their initiatives and needs. . . We also do weekly learning reviews at the hub in my office. This happens a lot in which we take learning from the affiliates (local market countries) and then discuss among ourselves and share with different affiliates.”

–– Director of Global Medical Director of Global Medical EducationEducation

Accelerate learning across countries, therapeutic areas and brands through the use of councils and communities of practice. The “balkanized” state of CME local markets can be an obstacle to cross-border learning. The use of councils and best practice sharing can be a catalyst for rapid learning and sharing that does not occur on its own.

Quarterly Quarterly CrossCross--Country Country

MeetingsMeetings

Weekly Reviews Weekly Reviews at Regional at Regional

HeadquartersHeadquarters

Best Practice Best Practice Identification & Identification &

SharingSharing

Global Global Meetings Meetings

(1(1--2 Times Per Year)2 Times Per Year)

Informal Informal ExchangeExchange

(Phone, E(Phone, E--mail, IM)mail, IM) Accelerating CME Accelerating CME Learning & Best Learning & Best

PracticesPractices

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CME Evolution Models:

Forward-looking CME Leaders Try To Align Resources, Targets & Applicable

Lessons Learned


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Performance measurement is a key driver of CME program effectiveness and evolution. Most benchmark partners acknowledge CME performance measurement is early-stage in Europe. However, CME outcomes measurement pilots are under way – and the Internet offers promise – even though it is still a relatively young, lesser used delivery program in Europe.

CME Performance Measurement EvolutionCME Performance Measurement Evolution

CME Program + Physician Interaction + Case Vignettes applicable to Physician Practice = Better CME Retention

CME Program Attendance

Satisfaction With CME Program

Post-Program Knowledge Retention

CME Program Learning Objectives

Learning Helps Physicians Take Action in Patient Care

& Improve Outcomes“I don’t want to imply that the Internet is the answer to all things. But the Internet is the way to go. You tell me to go read it on the Internet, I won’t do it; I’ll print it out. That’s me. Others will play on the Internet. Different learners havedifferent styles and preferences. With the Internet you can have all these case vignettes, interactivity. . . You find out where they are in their learning styles. . . and they can self-select where they are and how they want to learn.”

-- Global Director of Medical Education

Improving CME Performance Impact

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CME Functional Management:

Learning to Manage CME Activities With and Apart from Promotional

Education


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Medical Affairs & Communications Commonly Have CME Oversight

Separate Operating Company,

13% Scientific Communicati

ons, 4%

Medical Affairs, 44%

Medical Communicati

ons, 9%

Marketing & Sales, 22%

Commercial Operations,

9%

To what functional area of the company does the group managing support of CME

activities for European markets report?

(n=23)(n=23)

For both Europe and North America, the CME function is managed primarily within the Medical Affairs/Communications areas. The greatest difference between markets is the significant segment managing the function through Marketing or a separate operating company in Europe.

To what functional area of the company does the group managing support of CME

activities for North American markets report?

Medical Affairs, 54%

Separate Operating Company,

4% Other, 4%

Scientific Communicat

ions, 4%

Marketing & Sales, 7%

Medical Communicat

ions, 11%

Corporate, 4%

Commercial Operations,

14%

(n=28)(n=28)

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Optimizing CME Delivery Channels:

Evolving the Best Channel Delivery Mix To Reflect Your Local Market, Budget &

Target Physician Groups


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Face-to-Face & E-CME Dominate in North America

(n=26)(n=26)

Half of North American research partners deliver CME most often through face-to-face modes – but nearly one-quarter is delivered via the Internet. Enduring materials also make up one-fifth of delivery forms.

Estimate the mix of CME delivery forms utilized by your company Estimate the mix of CME delivery forms utilized by your company for the North American for the North American marketplace. (Percentages should sum to 100%)marketplace. (Percentages should sum to 100%)

Internet Teleconference Face-to-Face Enduring Materials

Minimum 0% 0% 20% 0%

Maximum 75% 25% 90% 50%

Mean 23.9% 6.4% 50.4% 19.3%

Median 20% 5% 50% 20%

1st Quartile 10% 0% 32.5% 10%

3rd Quartile 40% 10% 60% 25%

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Using Past Victories & Failures To Navigate To Success Going Forward

CME Lessons Learned:


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CME Delivery Modes: E-CME

Research participants shared the following observations regarding E-CME:

E-CME Positives:- Easier for customers- Quite cheap and fast- Available 24/7 global participation in 92 countries provides education convenience to customers that

cannot travel, have declining budgets and would like to optimize time- Twenty-four hour access- Cost effective way to reach a worldwide audience.- Reaches large audience, chosen by the participant, long lasting, reaches audience 24/7.- Internet-reach is greater- Internet provides breadth and can be interactive/participatory if adult learning principles are applied- Wide reach of audience- Broader reach than face-to-face programs- Internet is the most cost-effective, has the greatest reach, and can better manage data regarding

participants and their learning and progression in behavior change- Internet is growing method of delivery.

E-CME Negatives:- E-CME not really implemented - Not everybody likes this model- Individual relationships are not developed with company- Participants have to find it, and be fairly computer-oriented- Internet-info overload, too many portals- Little content flexibility once developed- Impersonal and can have lack of awareness of the CME supporter- Expanding e-formats with lack of success meeting program goals- Interpersonal exchange can be lost

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LLCCopyright© 2006

Appendix


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Best Practices, LLC6350 Quadrangle Drive, Suite 200,

Chapel Hill, NC 27517(919) 403-0251

[email protected]

About Best Practices, LLCWe are a research and consulting firm that conducts work based on the simple, yet profound principle that organizations can chart a course to superior economic performance by studying the best business practices, operating tactics and winning strategies of world-class companies.

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Health & Medicine

Educating the Market: Creating Value Through Support of Continuing Medical Education