The Physician Value Index: A Framework for Optimizing Marketing Performance and Spend in the Digital Age

June 12th, 2013

The Physician Value Index™ A Framework for Optimizing Marketing Performance and Spend in the Digital Age

By Venkat Gullapalli, MD, Mark Goldstone, and Nita Nehru Intended Audience: Pharmaceutical Marketing Professionals

A Medikly White Paper

Intended Audience: Pharmaceutical Marketing Professionals A Medikly White Paper

© 2013, Medikly, Inc. Reproduction Prohibited June 12th, 2013

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Executive Summary

The “Age of the Empowered Physician” represents a contradiction of sorts for pharmaceutical companies—there have never been more ways to reach healthcare providers (HCPs)—yet it’s never been so challenging to effectively engage them. Driven by the decline in face-to-face interactions and the increasing availability of on-demand access to digital channels, HCPs now choose when, where, how, and if they interact with pharmaceutical companies.

With more than $60 billion being spent annually on marketing and communications to HCPs, pharmaceutical marketers need to reinvent how they allocate, optimize, and justify spend through real-time, data-based insights and intelligence.

We propose a new model, the Physician Value Index™ or PV Index™, which integrates four key aspects of how a physician interacts with a pharmaceutical brand—presence, participation, influence and sentiment. Using the PV Index™, pharmaceutical marketers can now incorporate a new capability model of measuring marketing performance, and its contribution to driving business value.

Target Audience

This white paper is intended for pharmaceutical marketers to discuss and agree on an appropriate set of metrics that will demonstrate marketing performance while driving business value within their individual organizations.



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Does Pharma Need to Change How It Values Physicians?

The traditional view of the HCP has been—for the last two decades—based primarily on face-to-face interactions by sales reps, by mail, and in call centers. Fast-forward to today, when 95 percent of HCPs get necessary and relevant information online through various digital touch points on their desktops or laptops, and 87 percent use a smartphone or tablet.1 These two systems (old and new) often exist in parallel silos without exchanging information, giving marketers an incomplete view of the HCP. In the past five years this view has fragmented even further due to multiple new mobile, social, and other communications platforms and channels. Connecting these disparate channels is crucial for not only understanding, but also predicting HCP behavior.

This digital evolution has changed the fundamental skills and technologies required for pharmaceutical marketing. Excelling at one marketing capability or channel is no longer acceptable. As Accenture points out in its recent survey of over 200 pharmaceutical sales and marketing executives, “…[A] customer engagement revolution in the ‘new normal’ demands entirely new capabilities from pharmaceutical companies’ sales and marketing organizations.”2

Figure 1: Trends and Challenges

Source: Medikly, Inc

New Trends and Challenges

The Pharmaceutical Sales Force is Evolving. One of the biggest changes facing pharmaceutical marketers is the evolving role of the sales force in the marketing mix. Powered by the decline in face-to-face interactions, pharmaceutical organizations are now looking for other ways to determine who their target HCPs are, where they active, what conversations they’re having and with whom.

Traditional Marketing Tactics are Producing Less and Less ROI. A decade ago, sales reps, print mailers, brand reminders, and banner ads were the norm. And they were incredibly successful. But we’re in a fundamentally different environment today: Restrictions on rep activity are increasingly stringent, and due to their declining numbers, it is increasingly difficult to generate as much frequency as is optimal. As a result, the sales force is becoming increasingly expensive for a much smaller ROI.

Explosion of Digital Channels. In the “Age of the Empowered Physician,” over 95 percent of physicians are digitally savvy and connected with each other through numerous new channels and touch points. With this hyper-connectivity come new behaviors and expectations on how they access and consume content from pharma. This evolution is challenging marketers to integrate these channels into their marketing mix while providing personalized and coordinated brand experiences to physicians and other HCPs.

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BIG DATA INSIGHTS Need faster way to sort, analyze, target and segment the HCP digital footprint

SPECIALTY MARKETS Sophisticated Rx criteria and niche segments create need for personalized and targeted content

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30+ CHANNELS Brands must better

understand how to manage and integrate new channels

NO HCP ACCESS Decline in sales rep access

force brands to rethink how they approach marketing

MARKETER!



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“Big Data” Brings New Opportunities. With the explosion of new channels and touch points, there is a tremendous increase in the volume, velocity, and variety of data being generated. This data, generated in real-time, needs to be captured, sorted, and analyzed to enable marketers to make informed, real-time decisions on optimizing their audience, channels, and content. This data provides insights into the needs, interests, behaviors, and preferences of HCPs, helping marketers better understand the specific triggers that influence prescribing decisions.

The Era of the Blockbuster Drug is Over. With the business model that drove the pharma’s “blockbuster era” no longer viable, marketers must now market drugs geared toward specialized patient populations, where the HCPs that prescribe these drugs have very specific information needs. And when combining fewer addressable markets with dwindling budgets, generic competition, reduced R&D budgets, lower revenues, and reduced profitability, marketers are ultimately put in a position to do more with a lot less.

Physician Value: A Whole New Dimension

While the above trends and challenges may seem insurmountable at first, they give pharmaceutical marketers the opportunity to think and act in entirely new ways. In fact, the evolution of digital now allows them to better understand the behaviors and preferences of their physician audiences and take appropriate action.

All Physicians Are Not Created Equal. Given that technology and social media are playing such an integral role in how HCPs interact, it is important to note that from a marketing perspective, each individual HCP does not hold the same weight. In the old world, a disgruntled physician or nurse practitioner simply did not prescribe the offending product. In today’s digital world however, a disgruntled HCP has the ability to tell 2,000 of their friends via social media how unhappy they are, which can be very detrimental to a brand and its sales. Alternately, even a low prescriber can be tremendously valuable to a brand, as they may positively encourage their networks to consider prescribing as well. In this model, positive influencers are valuable and should be seen as brand assets, whereas detractors must be managed and neutralized.

Managing a Pharma Brand Now Means Managing an Audience. Social media has opened the door to a brand new marketing channel—the HCP audience. Traditionally, a brand manager’s role was to ensure that all messaging, advertising and media was uniform, consistent, and “on brand.” In the new digital world, branding is frequently outside of the brand’s control and must be shared with multiple audiences. In fact, a report by McKinsey & Company states that “…marketing management…has become more complex through the emergence of online tools—especially social media—that are shifting the balance of power to [customers].”3

Once branded messaging or content is on the web, users can comment, add their opinions, and republish. Goodbye months of careful brand planning! Thus the pharmaceutical marketer’s role now must include understanding and managing their audience as another brand media channel.

Current Systems and Databases Exist in Silos. Pharmaceutical organizations today utilize different platforms, systems, and databases, each with their own set of analytics and metrics, to gain insights into HCP behaviors and preferences. These systems are rarely integrated nor automated, and to gather any real insights, pharmaceutical marketers must manually aggregate and analyze the data generated—a prohibitively costly and time-consuming task—in a market that requires real-time decision making.

“…even a low prescriber can be tremendously valuable to a brand, as they may positively encourage their networks to consider prescribing as well.”



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Existing metrics and models do not capture these new realities. While technologies have advanced tremendously, metrics and application of insights have remained largely unchanged. “The metrics of yesterday just don’t do a good job of capturing the insights necessary in our new digital world. The more digital channels there are and the more transactions physicians perform in them, the higher our expectations should be of what we can measure,” says Eric Pilkington, Executive Vice President at McCann Health.

If traditional marketing methods and systems are losing their utility and the audience has become another media channel to be managed, what must pharmaceutical marketers now do to handle this shift? We propose a new metric for pharmaceutical marketers to measure marketing performance by—the Physician Value Index™.

The Physician Value Index: Pharma’s New Marketing Metric

The PV Index™ is a weighted aggregate measure of the presence, participation, influence, and sentiment a physician or other HCP generates as they interact with content, a brand, or messaging over time.

The PV Index™ does more than just gauge reach and frequency; it gives marketers real-time insight into the impact an individual HCP can have on their brand. This value in turn, enables marketers to understand who is worth talking to and who is not, who must be neutralized and who can be a brand asset.

Once understood, physician value can then be used to define the ROI metrics relevant to one’s own brand and organizational goals. Ultimately, the objective is to help pharmaceutical marketers better allocate their time, money, and effort in the most efficient and effective ways possible, and to generate ROI.

What is Physician Value?

The PV Index™ covers four broad aspects of how an HCP interacts with a brand, with each of these aspects broken down into various aggregate measures combining online and offline data, eg, information gathered from sales calls, live meetings, and sample requests.

By combining these measures, pharmaceutical marketers can now identify the various elements of physician value that drive marketing performance and ultimately demonstrate business value. The four aspects of the PV Index™ are below.

• Presence – Presence is a measure of one-way activity that an HCP has with a brand at various touch points. Metrics to track include unique visits, average number of page views, average duration of visit, downloads, logins, time spent per page or per web property, the number of different assets touched, frequency—the number of times each HCP sees branded content—and other similar quantitative metrics. While only providing a partial indication of content, message or brand reach, these metrics are crucial to track and understand, as they provide insight into the initial interaction and growing awareness the audience has with a brand at a specific touch point.

“The PV Index™ is a weighted aggregate measure of the presence, participation, influence, and sentiment a physician or other HCP generates as they interact with content, brand, or messaging over time.”

“The metrics of yesterday just don’t do a good job of capturing the insights necessary in our new digital world. The more digital channels there are and the more transactions physicians perform in them, the higher our expectations should be of what we can measure.”

Eric Pilkington, EVP of Digital Strategy, McCann Health



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• Participation – As the word implies, Participation is the intensity of interaction an audience has with the content, brand, or message at specific touch points. Participation is a two-way street and includes metrics such as the frequency and quantity of reading and writing of content on a branded digital property. Metrics to track include scroll depth and speed for text-based content, and quality and quantity of user-generated content (UGC). This is a much stronger measure of how engaged an audience is with a brand than the transactional metrics of Presence. We can equate Presence with the breadth of interaction an audience has with the brand at multiple touch points, whereas Participation is akin to the depth of each interaction.

• Influence – The metric of Influence is binary, tracking both the influence of the brand’s content on the degree of change in an HCP’s knowledge, skills or behaviors pre- and post-content, and the degree of influence a particular HCP has on the brand through sharing, suggesting, or recommending that content to their network. To understand Influence, key metrics include shares, likes, recommendations, suggestions of brand content or messaging to other physicians, and how those metrics are attributed back to the original HCP. When measuring influence, marketers need to also capture the type of influence an HCP has on a brand. For example, influence can be either positive or negative, allowing an influencer to be either an advocate or a detractor.

• Sentiment – Sentiment is the final yet crucial component in building the PV Index™, as it enables us to discern affinity, assigning separate values to HCPs who hold positive or negative perceptions about the brand. Sentiment can be tracked by analyzing words and context in user-generated content. Tracking sentiment in real-time can be critical in acknowledging and addressing any potential problems, or better yet, opportunities facing the brand. Measuring sentiment can also be an ideal way to assess brand equity or affinity among HCP audiences.

Dr. Jim Golden, Managing Director, Accenture Analytics, adds that “By leveraging a PV Index™, pharmaceutical organizations can segment and manage their audience and make strategic decisions regarding where to spend their time, money, and marketing resources.”

“By leveraging a PV Index™, pharmaceutical organizations can segment and manage their audience and make strategic decisions regarding where to spend their time, money, and marketing resources.”

Dr. Jim Golden, Managing Director, Accenture Analytics



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Understanding Physician Value Index™

Utilizing the PV Index™ as a Key Performance Indicator (KPI) can demonstrate tremendous value to pharmaceutical companies looking to assess the effectiveness of their marketing campaigns. Understanding and leveraging physician value enables a marketer to make distinct and specific real-time marketing decisions around optimizing content, channels, and audiences.

Now, pharmaceutical marketers can spend their marketing dollars on the HCPs who provide the most long-term value for the organization’s goals. Furthermore, the PV Index™ allows for more granular and real-time audience segmentation and the effective targeting of HCPs based on specific brand goals, whether to raise awareness, drive prescriptions, or promote brand advocacy.

Let’s take a look at a few ways a marketer can apply the PV Index™:

Sarah Chin, MD (HIGH VALUE): Dr. Chin, a much-respected physician with a PV Index™ of 86 is an advocate of your brand and frequently prescribes your product, as many of her patients have the appropriate disease state. Moreover, many of her patients take the product and have seen great results, so she is a big fan and is fiercely loyal. Since she is very actively followed on Twitter, her love of the brand spreads via word of mouth to her 4,500 followers, many of whom are HCPs in her hospital and are members of the same associations.

Maria Gonzales, MD (MODERATE VALUE): Dr. Gonzales, with a PV Index™ of 48, is neutral regarding your brand. She sometimes prescribes your product but also prescribes your competitor’s with similar frequency. She rarely discusses brand opinions online, though does frequently comment in open forums on the effects of obesity on Type II diabetes, a relevant topic to your brand. With appropriate and relevant promotional messages, Dr. Gonzales could be converted into a brand advocate.

82%

PRESENCE! PARTICIPATION! INFLUENCE! SENTIMENT!

94% 78% 88%

PV INDEXTM!

86

Intensity Intensity Intensity Intensity

51%


56% 53% 32%

PV INDEXTM!


48



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DAVID CLAIRE, MD, MPH (LOW VALUE): Dr. Claire is highly engaged with your brand but has a PV Index™ of 37. He visits your e-detailing portal frequently, has downloaded prescribing information, and follows your latest updates. Despite this level of engagement, Dr. Claire is not an advocate. In fact, many of his patients have complained about adverse events and therefore he does not particularly like your brand. Moreover, he shares this sentiment via social media to his 1,200 followers and, given his moderate level of influence, is negatively swaying others.

PV Index: What It Can Mean For Pharmaceutical Marketing

The real benefit of creating a PV Index™ is in its application. As previously mentioned, healthcare organizations can leverage the Index to make strategic marketing decisions, appropriately target their audience(s), and optimize spend for a brand’s objective or stage in its lifecycle.

The PV Index™ provides a way to match an HCP’s interactions with the business goals and objectives of a brand. For example:

Increasing Awareness. To achieve this goal, the initial objective for pharma marketers will be to understand the best methods to build awareness of their brand among their target audience. To accomplish this, they must focus on a particular set of KPIs across all of their channels and touch points. Sample KPIs that provide an assessment into brand health include, but are not limited to, digital share of voice, brand recall, amplification, and brand equity.

A great example is assessing the effectiveness of a pre-launch, multichannel campaign in a therapeutic category where there are multiple “me-too” drugs. The effectiveness of these efforts can be gauged by monitoring the pre- and post-campaign reach, velocity, volume, and amplification of digital share of voice over time, and also the overall sentiment of those conversations.

Increasing Brand Preference. A marketer tasked with building and measuring brand preference must track how HCPs are engaging with their brand, content, or message across multiple channels and touch points. This requires utilizing attitudinal-based KPIs that capture metrics such as the percentage of HCPs willing to consider or prescribe their brand, and utilizing surveys to capture preference or the number of likes, shares, and recommendations combined with sentiment of comments and posts on social media.

For example, assume that after the launch of a novel product within a new therapeutic area, it was found that the efficacy message was not believable or not resonating with the target audience. A way to address this is to create multiple mechanism of action videos that tie to the brand’s efficacy message, and then track the real-time change in consumption among their HCP audiences.

37%


54% 42% 16%

PV INDEXTM!

37




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Driving Prescriptions. Marketers can leverage the PV Index™ to understand the impact of various channels on prescribing behavior, as well as how different types of content influence an HCP’s intent to prescribe. With today’s technology, marketers can now attribute specific channels to particular actions, such as tracking the impact of social media on prescribing.

As an example, marketers interested in understanding the effects of social media channels on script lift can measure the number of prescriptions generated from a specific user in select social channels, as well as the growth of sales over time and the increase in repeat number of prescriptions from that HCP in that particular channel.

Creating Brand Advocacy. Creating brand advocacy as a business goal requires the support and dedication of HCPs that can act as brand ambassadors without having any official affiliation with the brand. Brand advocacy allows pharmaceutical brands to extend their reach beyond their immediate spheres of influence by taking advantage of the virility of social networks. Among the many KPIs that indicate the overall health of brand advocates are active advocates, advocate influence, and advocacy impact.

For example, a mature product that’s facing patent expiration and has no new clinical data or announcements will need to be seen as a trusted and quality source with significant brand equity. By monitoring conversations and segmenting influencers into advocates and detractors, a brand can identify what specific key messages set it apart from competition, while simultaneously building a stable of genuine interest amongst HCPs by tapping into their respective areas of interest. This will allow the brand to create future marketing programs incorporating these new messages, in turn creating more loyal users and brand advocates.

Conclusion

Today’s successful marketers realize that we live in the Age of the Empowered Physician, where there is no “one-size-fits-all” marketing approach. They understand the value of their HCP audience as a media channel—whether positive, negative, or neutral. They know that creating meaningful relationships with their HCP audiences is the new imperative because those deep connections drive engagement, loyalty, and ultimately prescription decisions.

Marketers and brands that utilize the PV Index™ as a key corporate asset will be able to leverage it to drive media planning and budget optimization decisions. They will develop deeper audience relationships with their audiences by offering relevant, personalized, and timely content in the channels preferred by individual HCPs. They will have the unique ability to understand exactly where, when, and how to allocate resources to achieve business objectives and improve ROI on marketing campaigns. Until the use of the PV Index™ becomes widespread, those that apply it first will most certainly have an unfair advantage over their competitors.

“Until the use of the PV Index™ becomes widespread, those that apply first it will most certainly have an unfair advantage over their competitors.”



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References

1. Google/Manhattan Research. Screen to Script: The Doctor's Digital Path to Treatment.

http://www.thinkwithgoogle.com/insights/uploads/940659.pdf. Published June 2012. Accessed June 9, 2013.

2. Accenture. Survey Results: Life in the New Normal: The Customer Engagement Revolution. http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Life-Sciences-Life-in-the-New-Normal-the-Customer-Engagement-Revolution.pdf. Published 2013. Accessed June 9, 2013.

3. Haas S, McGurk M, Mihas L. A new world for brand managers. http://www.mckinsey.com/insights/organization/a_new_world_ for_brand_managers. Published April 2010. Accessed June 13, 2013.



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About Medikly, Inc

Medikly helps pharmaceutical organizations better reach, engage, and understand HCPs by gaining insights into the HCP journey through various digital touch points and highlighting how these touch points impact the behaviors and preferences of HCPs and their intent to prescribe.

Contact Information

35 East 21st Street, 5th floor New York, NY 10010 USA Phone: 212-951-1525 Email: [email protected]



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Technology

The Physician Value Index: A Framework for Optimizing Marketing Performance and Spend in the Digital Age