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May 28, 2015

More than 500 DTC marketing industry executives convened at the 15th annual DTC National Conference this past April to learn more about what patients want – and how they, as marketers, can best serve those wants and needs.

The overarching theme of the 2015 event was clear: working with the new patient. Kicking things off was health economist and advisor, Jane Sarasohn-Kahn, whose presentation on the new health ecosystem provided a well-rounded layout for the rest of the agenda. Noting that more engaged patients cost the healthcare system less in the long-run, she explained that doctor-patient conversations about costs are shifting from “what a medication costs” to “what health it provides”; consumers are willing to pay more for something they deem to be worth it.

This added value can come in many forms – including a personalized experience. Sarasohn-Kahn cited data from a Makovsky/Kelton survey which found that 88% of patients are willing to share personal information about their health to improve their care and treatment options while 66% are also willing to use mobile apps to manage their health. While consumers want to hear from “someone like them” when researching health information or seeking support, they do also want pharma companies to be actively involved as well. But patients aren’t just looking for incentives – they want help in managing their health. One way pharma can get involved while simultaneously gaining trust among consumers is to partner with another company. For example, she suggested looking at the recent joint venture between Cox Communications, a broadband communications and entertainment company, and the Cleveland Clinic for inspiration. Forming Vivre Health, the alliance created by the two companies will bring telehealth to the home. In the value-focused ecosystem, marketers need to think beyond the medicine explicitly and turn focus to where they can provide complementary inputs to health and the healthcare journey, she concluded.

Authentic involvement
Another way pharma can get involved authentically, noted Howard Courtemanche, is to help fill information and support gaps created by the insufficient amount of time patients have with their doctors. [Pharmacists also help fill such voids. For more details about the Health Renaissance in the Pharmacy presentation by Cathy Paulson of Walgreens and Jim O’Dea of Rx EDGE Pharmacy Networks, turn to page X to read the article they co-authored based on their speech.] Courtemanche, the Global CEO of J. Walter Thompson Health / J. Walter Thompson New York, explained during an agency expert panel that there is a real opportunity for brands to step in and provide necessary information as well as support to help patients better comprehend materials and adhere to treatment regimens. “We need to think of content differently – as a continuum,” Alex Jutkowitz, GroupSJR’s Mananging Partner, advised during the panel session. He explained that patients fuel insights which creates content that informs / educates / supports patients. By thinking of this as a cycle, a brand’s messaging will evolve and continually provide the patient or consumer with what they want or need, he elaborated.

During the discussion with four top-level agency executives, Eric Weisberg, Creative Director at JWT, also encouraged marketers to break out from their conservative mindset to explore new ways of connecting brands and patients. Jim Radosevic, NY President with Y&R, dovetailed on that idea by pointing out the emerging innovations and technologies, in the point-of-care space as well as other channels, which are creating new ways to deliver messages. By understanding how target consumers interact with the different media, Radosevic detailed, marketers can talk with consumers “in a really relevant way that resonates.”

Humanizing the connection
One tactic that appeals greatly is providing a human connection. Drawing from Remedy Health Media research, the company’s Chief Strategy Officer, Jim Curtis, along with agency partner, Andrea Palmer, SVP of Publicis Health Media, noted that emotional storytelling can affect one’s state of mind, which is “the most powerful tool for engagement and positive health actions.” According to study data, 72% of respondents became hopeful when they were presented with an inspirational stimulus and realized they could do better; 84% took action as a result of that inspirational stimulus. Having a clear understanding of the patient’s state of mind, developing a disruptive catalyst to evoke emotion or motivate, and knowing the right moment to share the inspiration elicits hope and creates a connection that will drive consumers to make more, healthy actions, Curtis explained.

Also echoing the value of humanizing the message through patient stories were panelists from The Future of Technology and DTC discussion, moderated by Ashik Desai, Executive Vice President of Business Growth & Analytics for ContextMedia. Panelist and CEO of Health Perspectives Group, Cheryl Lubbert, remarked that patient stories are “a great way to remember complex information.” Acknowledging how multifaceted healthcare is, Lubbert recommended co-creating content with consumers; this will ensure that the information is put together in ways that truly matter to them.

And while consumers also want something that will aid in their healthcare management, “the use of ‘utility’ [opens] a new marketing channel for brands,” predicted Eugen Lee, Executive Vice President, Managing Director at Communications Media, Inc. Marketers shouldn’t fear things like apps or other emerging telehealth capabilities. Ben Putman, the SVP of Innovation for JUICE Pharma Worldwide, noted that tactics available now, such as pretotyping, to explore concepts. Putman explained that pretotyping is like prototyping, but for testing ideas. (His team was able to test four apps in two days by utilizing this approach.) Desai wrapped up the session by encouraging marketers to change how they think when posed with significant challenges. As Courtemanche stated during his panel, “we have the opportunity to become brands of the future.”

TV Optimization
With television still commanding the lion’s share of DTC spend, it is still the best way to reach a large audience quickly. With advancements in metrics, marketers’ investments can be further optimized in this media channel. As explained by Jeremy Mittler and John Stermer, planning is moving beyond demographics and geotargeting to utilize predictive Rx and OTC treatment data. Mittler, VP Analytics Services with Crossix Solutions, and Stermer, Executive Vice President of Business Development for Nielsen Catalina Solutions (NCS), shared NCS data from Q4 2014 that found “nearly $63 million [was] spent on low-preforming inventory.” Using a blinded case study from Q2 2014, Mittler and Stermer revealed that a previously under-performing campaign implemented predictive treatment data to identify networks, programs, and day parts that would index most favorably for reaching their targeted audience. By improving the campaign’s qualified audience index, it allowed for increased efficiency and reduction of media waste. This led to the rising of the brand’s qualified index for both its broadcast (+18.5%) and cable (+22.5%) inventory. In general, the co-presenters explained, “by leveraging this audience data to buy media more efficiently, healthcare brands are observing 5%-15% in TV-driven incremental sales improvement.”

Jennifer Kovack

May 28, 2015

After a patient initiates treatment, the real selling-process begins. More than ever, patients are approaching Rx-trialing with a heavy dose of skepticism. It’s understandable. Oftentimes, long-term treatment is thrust upon patients without time to get comfortable. And sometimes, those patients have healthy fears over side effects. On the other side of the coin, many patients expect treatment to fix everything fast or they diminish the value of Rx treatment altogether (before giving it a real chance).

This net skepticism has fueled – no, skyrocketed – a behavior patients hold dear when trialing treatment. And that is finding the authentic truth – conducting their own in-depth exploratory research into Rx treatment expectations, outside of brand communications. Outside of the brand context is where patients perceive to find this authentic truth and the optimal basis for their own opinions and behaviors toward Rx treatment.

Here, I’ll explore this rising phenomenon a bit more and then present an opportunity for brand adherence communications. Essentially, I’ll show you how to guide patients toward external content, in order to help them find their own, preferred version of the truth. In the end, they want to put the “authentic” puzzle pieces together. If we can help them do that, we can help them feel more comfortable with treatment early on and more receptive to the rewarding possibilities of long-term treatment.

Origins of the truth
A year or so ago, I spent time reflecting on the success of online services such as Angie’s List, Yelp, and others, with large investments into customer review networks. I came to one conclusion: in the digital age, the truth comes from strangers.

My hope is that this speaks to you, as both logically flawed and intuitively accurate. Let me explain. Logically speaking, we put our trust in people/entities we know, or in some cases, those we think we know. In this case, the ol’ saying “never trust a stranger” holds true. But today, we live in a hyper-consumerized world where we have many “long-term relationships” with an array of organizations and companies we really “know” little about (e.g., mobile phone, streaming, cable, grocery delivery, etc.). We expect those companies to meet our expectations or, in other words, be trustworthy.

In many cases, the results have been less than stellar. However, there are exceptions. Brands like Zappos and Wayfair have elevated the benchmark of customer service to a religion – but again, these are exceptions. And, the fault cannot be placed entirely on either side – it’s a combination of consumers and companies. Consumers can exaggerate or even create the problems, yet companies (or brands) aren’t exactly model citizens, when the almighty dollar rules the day.

Regardless of who’s right and who’s wrong, the net result has been a heightened mistrust among consumers. You could even say it’s already hit the boiling point with persistent steam ahead. Who can we trust these days?

The person/entity we often trust is the person/entity with no vested interest in us: the stranger. They don’t want our money, our commitment, or a relationship. They do have opinions, though – invaluable ones about the subjects that matter most to us. And they like to voice these opinions. It’s these anonymous voices we seek in order to find the authentic truth and, as a result, make better decisions.

The patient “truth-seeking” journey

This is the kind of approach patients take when trialing Rx treatment. They get the doctor’s version of the story, they get the brand version (e.g., brochure, site), and then they go looking for the outsider context: the anonymous opinion, the unknown academic perspective, the clinical trial data, the virtuous community site, and even sponsored content, but on a trusted site.

Now, let’s bring these learnings back to the question at hand: how can Rx brands become an integral part of the content system patients tap into when finding their authentic truth?

First, I have to acknowledge that this is not a one-stop shopping experience for patients. They will leverage this behavior at multiple points during treatment. In my experience, the best way to manage this is to glean the most important barriers to short-term, intermediate, and long-term adherence. Typically, short-term issues surround potential side effects, whereas intermediate and long-term issues usually surround side effect experiences, efficacy, and cost.

On the subject of cost, we often think of cost-saving programs benefitting patients just starting treatment. What I’ve learned is that most patients wrestle with treatment value relative to cost, once they’ve come to the conclusion that they’ve experienced said treatment’s full potential. For the commercially insured, if their treatment co-pay is negligible (through a branded support program), they will likely accept average efficacy, for example, and stay on treatment longer.

So, how do we use branded content to encourage adherence, while embracing a patient’s journey to find the authentic truth? Below are five recommendations to help you, and your patients, succeed:

1.     Use a trustworthy environment to evolve your brand marketing into brand truth. In the case of a patient’s search for more information, the environment may be more important than the content itself. In pharma, where there’s a lot of scrutiny, the context in which consumers find your brand message can have a major impact on the credibility and trustworthiness of the content itself. This is because a trustworthy environment is perceived to only house trustworthy content. As an analogy, when are you expected to be on your best behavior? Answer: When you’re in someone else’s home. Then, when you go home you can be as sloppy and loud as you want to be. The point is that the environment your brand message lives in influences the perceived value of your message.

To accomplish this, leverage portable brand content on sites or with organizations that deal in truth. For example, health blog sites with strong followings are generally successful because the site is valued for one thing above all else: the truth. Brand content within this context will be viewed as trustworthy, and can also be longer. In order to amplify the “authenticity” of your brand content, think less about banner ads and more about portable content capsules. These are essentially miniaturized microsites that provide a comprehensive experience within an external site environment.

In addition, consider partnering with a news organization that will develop and conduct influencer conferences about a particular topic that’s relative to your brand. While I’m not here to promote specific news organizations, I can say with experience that these capabilities exist among them. Not only can you sponsor these conferences, but once the event is done, you have access to the content (post-production). This not only shows leadership, but it proves to your patients that the brand is entrenched into the broader health context and can be taken seriously.

2.     Market clinical studies without feeling like your marketing clinical studies. The more patient research I’m involved with, the more I hear, “I’m the kind of person who looks for any clinical studies done on the drug.” Well, it seems like “that kind of person” has become almost every person. Patients are savvier than ever with information and see clinical studies as a way to break through to the “real” facts. Increasingly, patients are looking for clinical research to find the authentic truth.

Therefore, I recommend leaving a consumer-friendly trail of clinical research breadcrumbs. Instead of just feeding the MOA through branded communications, think about consumerizing clinical data (think infographics, even), and seeding the content to academic sites and health foundation organizations. If there is heavy demand for clinical studies among your patients, consider a microsite or a content capsule mentioned in recommendation #1. Also, consider inviting a health information organization to write about the scientific category of drugs to which your brand is connected. From there, you can promote the article in branded CRM communications or even look to find ways to ensure the content is conducive for search and easily found by patients.

3.     Gain their trust by setting them free. If your brand can demonstrate to the patient that it encourages them to peruse and discover product information elsewhere, the brand can be perceived as acting with greater transparency, and with information accurately corroborated in both branded and external environments.

One way to tackle this is through a traditional CRM. Leverage CRM to promote outside sources of information about your brand – not in a heavy promotional sense, but in a way that provides the patient with an alternative channel to find essential brand information. Think about linking out to a channel like WebMD or even Wikipedia. If the opportunity exists, partner with the outside channel on shaping the story with additional accurate information.

4.     Let patients – even help them – find the good and bad about your brand. Consumers are skeptics. Instead of proactively looking for the good, they are attuned to looking for what’s wrong with a product. Deep down, most consumers believe there must be something they can find that will sound an alarm. It’s a defense mechanism that allows them to feel a greater sense of control. The more they know, the more they are in a position to validate a decision to continue treatment or discontinue.

With your communication partners, I recommend developing content ideas that present both the pros and cons of treating with your brand. Patients are skeptical of brand information cast only in a positive light. By balancing the content out in a “Pros and Cons” format, the information will be seen as more credible, and if guided correctly, the pros will stand out as the guiding principal for long-term usage.

In many cases, you can turn this into an exercise in targeting – using product cons to identify who the product is not right for, while using pros of the product to help your target agree with the positive benefits of staying on treatment. The more control of information they have, the more control they will feel with your brand. Drop-off often happens when patients don’t have the full story. Using this format helps patients have both sides of the story – including the truth they seek.

5.     Lastly, recognize how search can unearth issues patients were never searching for. Most think of search as a method of matching interest to information (with precision). But given all the negative content on the Rx category/brands, I see search these day as a tool that can open Pandora’s Box. Even general search queries can pull information about your brand that patients never intended to find. Cryptic stories, Rx lawsuits, you name it – we’ve all seen it.

To overcome this issue, maintain constant vigilance over negative stories surrounding your brand so that your team can put a search/content plan in place to proactively combat this issue. In a perfect world, search should be focused on matching interest to information, but search can be a battlefield that brand teams must actively manage. When brand teams are proactive, there’s a lesser chance of negative sentiment taking over. With more and more people unwilling to complete Rx trial, let alone stick with treatment long-term, this is paramount.

Patients hold all the power these days. Let’s help them realize that dream… and get rewarded for it.

EDITOR’S NOTE: This is the full-length version of John’s article. An abbreviated version ran in the April issue of DTC in Focus. For more information on the DTC in Focus newsletter, please visit

John Nelson

May 28, 2015

Patient non-adherence is a serious public health concern. But three factors – motivation, recall, and comprehension – have been shown to yield the best results for combatting this issue. To leverage the power of these key influencers, brands should consider utilizing narrative communication methods. Specifically: Strategic, regulatory-compliant, patient-driven storytelling.

Sometimes it’s striking how healthcare topics that have been around for centuries remain current and highly relevant. Think of the Hippocratic Oath and how it encouraged patient centricity millennia ahead of our time. Or think of Molière’s classic 17th century comedy Le malade imaginaire and how it highlights the responsibility of care partners and the balancing act between a patient’s and an HCP’s authority. Of course, there are revolutions in the medical field that do not simply recycle old ideas but are genuinely new: Science and evidence-based medicine was one of those revolutions; the institution of regulatory bodies to oversee the pharmaceutical industry was another one; and public health policies as well as private health insurances have also all played their part in shaping healthcare into what it is today. Yet a lot of things that preoccupy our industry have in some form or other been around for a long time.

One current trend that made me think of that is the shift in who’s sitting in the driver seat on treatment decision-making. Shifts in policies around the globe, due to fiscal restraints and an aging population, force patients to carry a larger share of the cost burden, so naturally patients demand a bigger say about their care. Another factor that gives patients more weight is, of course, the way information is now accessible. The web and social media make it possible for patients to form their own opinions before they meet with an HCP. The negative side of that coin is the difficulty for experts and regulatory bodies to enforce quality standards of that information. So with patients covering more of their own healthcare costs and making up their own minds online, patients and HCPs again enter into a delicate balancing act of competing authority, reminiscent of the one described by Molière, even though, of course, there is no comparison between the expertise and ethics of real-world 21st century doctors and the ones caricatured in the 17th century play.

Double-edged sword of emotions
The fact that patients assert themselves in the doctor’s office has major consequences on how treatment decisions are made: An expert HCP may still be weighing statistical significance, relative risk, absolute benefit, effect size, sample size, and whatever else is available for rational treatment decision-making. But this process is now compounded with a patient or care partner who responds much more strongly to personal experiences and emotionally charged anecdotes. The bad news is: Emotions can undermine medical best practice. Just consider parents who actively choose to expose their children to the risk of serious infections rather than to provide them with the protection of a vaccine.

The good news is: Emotions can just as well be a powerful driver of medically sound decisions. Many HCPs in their everyday practice point to specific anecdotes to illustrate how their proposed prescription has, in concrete cases, helped others with the same condition. People respond to stories, and they like to hear them. We are all storytellers, and we instinctively prefer to receive information in this approachable way over having to analyze intellectually challenging piles of data. Several pieces of research indicate how narrative communication can be a tool for health behavior change.[1],[2] Clearly, here’s a call for the life science industry to support adherence and other positive behaviors through storytelling, to blunt emotionally charged disinformation with emotionally charged information.

The cost of non-adherence
No matter how captivating these stories are though, they are easily dismissed and can even backfire if they lack authenticity. You cannot just tell stories and expect them to have the desired effect. Your stories have to be true, believable, relatable, and vetted for the right messaging. In other words: They should come from people living with the condition concerned who, at some point in their journey, made good decisions for themselves. Even people who had made poor health choices in the past can demonstrate to others just like them that anybody can eventually find a more positive approach to life.

Improving medical treatment adherence is of course of major interest to our industry: $188 billion of lost revenue is attributed to patients not taking their medication as prescribed. That’s just the industry side, but what about all those avoidable hospital readmissions? What about the public and private resources for treatment and prevention going to waste? The man-hours lost from people who can’t work, because their disease has gotten the upper hand? The material loss to the whole of society through non-adherence is estimated to be $300 billion in the United States, and that doesn’t even count the human suffering from preventable pain and death.

Motivation, recall, comprehension
It is often presumed that non-adherent patients willingly reject their prescriptions; that’s why sometimes we still hear the expression “non-compliant” in this context, even though in the UK the terminology has shifted to “non-concordant,” and internationally to “non-adherent,” in order to stop implying disobedience on the patient’s part[3]. The perception of willful non-adherence focuses on patient motivation alone and generously overlooks all of the other factors that play a part in the puzzle. Patients may also simply forget to follow their treatment (patient recall). Or they may have misunderstood their physician’s instructions (patient comprehension). Or it could be external factors, such as medication access, that cause patients to go without the right treatment. To address external factors, some companies have co-pay assistance programs, or they join advocacy groups in their lobbying for improved access.

For patient factors such as motivation, recall, and comprehension, narrative communication has been shown to be the strategy that yields the best results. Specifically: Strategic, regulatory-compliant, patient-driven storytelling. As fMRI studies at the University of Princeton have shown, storytelling can lead to neural coupling, where the brains of listeners essentially mirror activities happening in the brain of the storyteller.[4] This means that if the storyteller shares an authentic, subjective perspective on why he or she adheres to treatment, the audience will likely feel the same way about it. Through neural coupling, a storyteller who shares a personal account of events will get the audience to almost experience the same thing and go through the same emotions and the same rational thoughts. The increased levels of attention and alertness that come with following a story improve intellectual processing of the content. In other words: The audience understands better and will also remember better.

The peer factor
People diagnosed with a life-changing condition and those caring for someone newly diagnosed long for nothing more than to speak to someone just like them. Of course, they want to exchange ideas on how to best cope with their own situation; but more than that, they really want to get hope and inspiration from strong peers who can act as role models, and they want to know they’re not alone with this disease. No doubt: When you’re diagnosed with a life changing, scary disease, you tap into any resource you’ve got. You’ll go online, consult medical books and journals, and seek advice from HCPs, friends, and family. You’re not going to let the dry language of textbooks bore you out of reading them. But being personally affected, you’ll also soon realize how overwhelming all this information is, and how difficult you find it to see the right path for yourself. So stories come in as an additional resource for you, acting as a compass in the vast ocean of information you’ve got. Therefore, an audience of people affected by the disease as patients and care partners will resonate most strongly with stories, just like they’re also most likely to dive into the details and data and seek as much information as they can get.

The most credible messenger for any target group is a peer. Testimonials and personal recommendations by people in our inner circle have always had the strongest influence on our most important life decisions. We trust people who are just like ourselves more than total and utter strangers. That’s why the storyteller should share the background of the target demographic. Especially when it comes to cultural backgrounds, we often find that the patient journey can look markedly different from one population to the other. Hispanic epilepsy patients, for instance, sometimes find it hard to relate to the epilepsy story of a Caucasian, simply because their own experience with friends and family doesn’t match what their Caucasian counterpart is sharing, as certain superstitions surrounding epilepsy are more common in Hispanic communities than in other parts of the population. So it makes sense to choose spokespeople who don’t just speak the language but who can also say to their audience: “Yes, I’ve been through that as well.” When you work on a disease that affects African Americans more than the rest of the population, of course you’re going to make sure you recruit a suitable proportion of African American Patient Ambassadors®. In a specific case my colleagues at Snow Companies worked on, the pharma company involved created targeted info packages, including culturally appropriate multimedia stories. The creation and distribution of this award-winning material didn’t just get the word out to the community but created lasting ties with African American doctors and advocacy groups. So it’s well worth it to give a voice and a platform to vetted patients of the right demographic to talk to their peers.

Engaging the disengaged
This doesn’t mean that the value of a personal story is lost on audiences not directly affected. On the contrary, compared to other outreach efforts, stories are the most likely way to get through to previously unengaged audiences. In other words: If we need to reach, say, at risk populations who should get tested for a disease, it is all but imperative to give a voice to those who have a personal perspective to share that illustrates the need to be proactive. Policymakers, HCPs, and various other stakeholders can also benefit greatly from patient stories in order to make decisions informed from all angles.

Stories are a constant in human communication. They’ve been our way of teaching and learning since the beginning of humankind. And they’re not foreign to healthcare either. Patients and care partners who share their stories have been as universal as Hippocratic patient centricity, or patient-doctor sparring about choosing the right treatment option. What’s new though is that we are now aware of the power of stories. This helps us influence the narrative to improve health outcomes to the benefit of all. It’s worth tapping into this great potential.


[1] T.K. Houston, J.J. Allison, M. Sussman, W. Horn, C.L. Holt, J. Trobaugh, M. Salas, M. Pisu, Y.L. Cuffee, D. Larkin, S.D. Person, B. Barton, C.I. Kiefe, S. Hullett (2011) Culturally Appropriate Storytelling to Improve Blood Pressure: A Randomized Trial. Annals of Internal Medicine, 154, 77-84.
[2] L.J. Hinyard, M.W. Kreuter (2007) Using Narrative Communication as a Tool for Health Behavior Change: A Conceptual, Theoretical, and Empirical Overview. Health Education & Behavior, 34, 777-792.
[3] E. Vermeire, H. Hearnshaw, P. Van Royen, J. Denekens (2001) Patient adherence to treatment: three decades of research. A comprehensive review. Journal of Clinical Pharmacy and Therapeutics (2001) 26, 331-342.
[4] G.J. Stephens, L.J. Silbert, U. Hasson (2010) Speaker-listener neural coupling underlies successful communication. Proceedings of the National Academy of Sciences of the United States of America, 107 (32), 14425-14430.

Oliver Portmann

May 28, 2015

Like Abraham Maslow’s famous quip about every problem looking like a nail if your only tool were a hammer, healthcare marketers have traditionally had an understandably narrow focus on the specifics of a disease state and how consumers engaged in related care. While this focus has repeatedly proven to be effective, one wonders if an approach that is grounded in a fuller appreciation of how consumers now make health-related decisions would lead to better interaction and engagement.

The consumer decision-making process is evolving and is inextricably linked to changes in our healthcare system, either as a cause or an effect. The “new” American healthcare consumer is more in control, takes a more holistic view, is redefining aging to be ageless, and is shifting perspective from health to wellness and beyond. This empowerment of the consumer has the potential to result in significant gains in health outcomes and satisfaction. Paradoxically, today’s consumer is better equipped than ever before – but simultaneously often disadvantaged in making optimal choices affecting the wellbeing of themselves and their families. Comprehending this paradox through a common understanding of what the pursuit of wellness entails is crucial to building consumer-driven healthcare brands.

Several underlying trends that have taken hold in healthcare consumer marketing together create significant opportunities for brands to connect with consumers in more meaningful, beneficial, and sustainable ways:

1. From health to wellness to wellbeing:  The new American healthcare consumer has increasingly recognized that a healthy lifestyle encompass far more than the traditional definition of health. Health is now often viewed within the broader context of wellness, which is an overall balance of the physical, social, spiritual, emotional, intellectual, environmental, and occupational aspects of a person’s life. While many marketers have fully embraced this shift, most have fallen short in successfully engaging consumers in that they have treated wellness as a destination or state of being. This does not ring true to consumers who are challenged daily with working toward a greater degree of wellness and recognize it as a worthwhile but elusive goal. We at Ogilvy believe that this distinction is critical and that the pursuit of wellness is in fact the central need that today’s consumer most requires help with. We refer to this pursuit as wellbeing, which we define as the active process through which people become aware of, and make choices toward, a more successful existence. This view of wellbeing as a progression rather than an end unto itself makes it far easier to recognize achievable benefits to the individual – regardless of current health status.

2. Increased self-reliance (ready or not): Unfortunately, consumers’ desire to pursue greater wellbeing is being confounded by the evolving dynamics of the American healthcare system. Accountability, now shared by both the consumer and healthcare providers and systems, has significantly increased and all stakeholders are incented to focus on wellness and prevention. Consumers have willingly or unwillingly taken on this increased accountability, but are often unprepared for their new role and the self-reliance it requires. The unresolved challenge for consumers in successfully managing their own wellbeing lies primarily in making informed decisions.

3. Better informed, but challenged by decision making: As consumers have become more responsible for driving their own wellbeing there has been a coincidental explosion in the amount of relevant information available to them. While consumers are becoming increasingly sophisticated in how they acquire and utilize information, the wellbeing decisions they are faced with are becoming more complex and, as a result, health-related decision making does not appear to have improved (as evidenced by ever-increasing rates of diseases with behavioral components, such as type 2 diabetes). This may be due in part to their traditional sources of authority, such as their healthcare provider or informed third parties, becoming less available. Rather than being externally directed as in the past, consumers are now increasingly looking personally for validation through data, experience, and social interaction – creating both a tension among consumers and an opportunity for brands to credibly partner with them.

There is a great opportunity for brands to increase their relevance and value to consumers by recognizing their evolving needs and offering solutions that align with the pursuit of wellbeing. Forming a closer and more advisory relationship with consumers around wellbeing requires deeper insight into the motivators and challenges they are continually exposed to. Importantly, responsible marketing that recognizes wellbeing allows brands to play a positive role in helping guide health and wellness choices and behaviors. When seen as part of a progressive journey, these choices and behaviors become easier to identify and positively influence – and can form the basis of a stronger and more durable relationship between consumers and brands.

Communications planning is critical in partnering with consumers in this area. Rather than force messaging, create experiences and relationships that will lead to behavioral change in the pursuit of wellbeing. Several key considerations in creating these experiences and relationships include:

  • Make wellbeing a series of small, realistic steps, as behavior change rarely happens in leaps and bounds
  • Design for positive engagement and influence in every interaction
  • Employ storytelling to increase interest and the recall of important information needed to make better behavioral choices
  • Provide choice autonomy, allowing consumers to control their path
  • Create a connected community

Today’s consumer is more engaged and in control than ever before – but they often feel this to be both a blessing and a curse. Recognizing that wellbeing happens one choice at a time and designing communications to support this creates common ground for both consumers and brands to embrace with a shared objective.

Paul ONeill

May 20, 2015

In her 1996 book It Takes a Village, current presidential candidate and former United States Senator, First Lady, and Secretary of State Hillary Rodham Clinton detailed her view that multiple determinants, such as community involvement, cultural/environmental influences and social interactions, contribute to how a child is raised. Similarly, inciting a consumer call to action with disease prevention outreach programs takes an amalgamation of different social and behavioral theories which rely on the same factors as the village concept. Studies assert that outreach programs based on more than one theoretical foundation, including Million Hearts which was established by combining the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), are more likely to produce a desired positive outcome than those that lack theory or are based on only one theory.

The Health Belief Model

The first social behavioral theoretical foundation, Health Belief Model (HBM), emphasizes that the willingness to take action and prevent risk depends upon the beliefs about the susceptibility and severity of disease; the perceptions about the benefits and barriers; cues to action and self-efficacy.

In a hypertension prevention study, Hispanic respondents not only misperceived that certain behaviors are barriers that would increase their risk factors, but also expressed a lack of confidence in their ability to perform such behaviors as having their BP checked regularly, limiting their salt intake, eating five or more servings of fruit and vegetables daily, exercising at least 30 minutes four or more days of the week, and controlling their weight. The general perception that hypertension was not a severe disease and the susceptibility misunderstanding resulted in 68.6% of the respondents being at increased risk for developing hypertension.

The Theory of Planned Behavior

The second social behavioral theoretical foundation, Theory of Planned Behavior (TPB), assumes that attitude, subjective norms, and perceived behavioral control predict actual behavior. Attitude refers to beliefs merged with the value placed on the behavioral performance outcome. Subjective norm signifies the perception of the social expectations to adopt a specific behavior. Perceived behavioral control reflects the beliefs about the level of ease or difficulty of performance behavior.

A circle of culture surfaced in a hypertension prevention study concerning poor eating patterns passed from generation to generation; physician distrust and questioning reasons doctors would want to lower BP because of the belief that physicians would not have a job if they addressed this health issue; and an unwelcome move that changes consumers from insiders to outsiders when they act differently by engaging in healthy behaviors. Severing cultural traditions and adopting preventive behaviors suggested by health care professionals resulted in social pressures.

Combining HBM & TPB: The Million Hearts™ Program

The Million Hearts™ national outreach program engages Community Health Workers (CHWs) to help achieve the goal of preventing one million heart attacks and strokes in the United States by 2017. The CHWs educate consumers about the importance of fit lifestyles and specifically promote these tenets for maintaining a healthy BP:

1)     Having routine screenings for high BP;

2)     Understanding BP numbers and the significance of lowering BP while searching for economical ways to increase lower sodium and whole grain foods and still keep their weight within BMI;

3)     Comprehending the ramifications of uncontrolled BP that include damage to eyes, kidneys, heart blood vessels, and brain; high risk of heart attack and stroke; and chronic kidney failure requiring dialysis.

CHWs encourage consumers to interact with other members of the community including their physicians about clearly defined health goals and keep a daily record of BP readings to track progress. CHWs also introduce consumers to social workers and others who can teach them how to apply for programs and insurance that help pay for health care. Many Hispanic consumers prefer to learn information with plain language fotonovelas, similar to comic books, which are common in the culture. Personal interaction is carried out by “promotoras” from the same ethnic background who honor the tradition of reading a fotonovela with consumers.

In summary, creating a consumer call to action with disease prevention outreach programs such as a Million Hearts™ takes a village of community involvement, cultural/environmental influences and social interactions supported by different theories including HBM and TPB. The underlying premise is that a combination of theories informs the message. Theories determine why, what, and how a health issue should be addressed and assist in developing successful program strategies that reach targeted priority populations to affect a positive impact.


Del Pilar Rocha-Goldberg, María et al. “Hypertension Improvement Project (HIP) Latino: Results of a Pilot Study of Lifestyle Intervention for Lowering Blood Pressure in Latino Adults.” Ethnicity & Health 15.3 (2010): 269–282. PMC. Web. 19 May 2015.

Glanz, Karen, Rimer, Barbara K., andViswanath, K. Health Behavior and Health Education: Theory, Research, and Practice (4th ed). San Francisco: Jossey-Bass. 2008.

Noar, Seth M., Chabot, Melissa, and Zimmerman, Richard S. “Applying Health Behavior Theory to Multiple Behavior Change: Considerations and Approaches.” Prevention Medicine. Volume 46. March 2008.

Peters, Rosalind M., and Thomas N. Templin. “Theory of Planned Behavior, Self-Care Motivation, and Blood Pressure Self-Care.” Research and Theory for Nursing Practice 24.3 (2010): 172–186.

Peters, Rosalind M., Karen J. Aroian, and John M. Flack. “African American Culture and Hypertension Prevention.” Western Journal of Nursing Research 28.7 (2006): 831–863. PMC. Web. 19 May 2015.


May 20, 2015

Most pharmaceutical marketers understand the importance of including search marketing in their media plans. Often the champion of the final click, a good paid search campaign contributes to the overall success of any advertising effort and connects your brand to active seekers within the marketplace. Unfortunately, advertisers often focus the majority of their attention on the site and, at times, overlook the importance role disease awareness (DA) sites play within search strategy through enabling the option of executing a multiple listing strategy.

Let’s take a step back and look at how a good DA site provides marketers with the opportunity to better capitalize search results.

But… what if I’m not first-to-market?

I know what you’re thinking – unless you’re at the helm of a first-to-market treatment, you’re probably thinking that a DA site just doesn’t fit your strategy. Certainly first-to-market competitors have a great opportunity to educate and grow interest in a category for patients and HCPs with an awareness site. However, the opportunity to influence this audience on a condition or disease state exists for more than just the first-to-market competitor. Unbranded education content generally resonates strongly with audiences wary of an overtly branded message and provides marketers with a forum to set the stage for a branded message to follow at a later point in time.

What’s more, a proper DA site need not be overly complex or represent the pinnacle in site design to be effective. Instead, focus investment on good, quality content that stands out from the crowd and strikes a new position on the condition. Savvy digital marketers can take this opportunity to set the table and influence what patients and HCPs should expect or demand from the category. Following on-brand messages can then reinforce differentiation to maximize this added perception. Examples of differentiation can include cost, safety, or even dosage and delivery (e.g., why take an injection when treatment is available via pill).

Finally, DA sites generally resonate better than sites for unbranded search campaigns. Diagnostic indicators of post-click success – including bounce rate, page views per visit, and even time on site – generally return stronger numbers when an unbranded searcher consumes DA content. With the right site design and layout, the engaged audience can be converted to the site and ultimately shaped to take the action the advertiser desires.

Once advertisers commit to adding a DA site to the portfolio, a multiple listings approach can be pursued within search. Below, I’ve broken out what makes this tactic so powerful for search advertisers.

Competitive blocking

This additional listing provides added flexibility to advertisers looking to provide active seekers with as many opportunities as possible to connect with their brand and their message. You may already be following this strategy without knowing it – having a separate website for HCPs and patients enables a second listing to populate the search results with a message unique to each audience. The DA site furthers this approach and provides the opportunity to reach both audiences who may be higher up the funnel.

Some advertisers truly embrace the multiple listing approach and create separate DA sites for patients and HCPs, creating yet another additional search listing. The possibilities are endless!

Added coverage and efficiency

Employing a multiple listing strategy provides a great way to even the playing field against competitors with deep pockets determined to remain in the top position. Added listings provide added impression share and SOV opportunities at greater efficiency than an all-or-nothing approach to search positioning (which is why I always advocate employing a separate domain for your patient and HCP brand sites).

If each of your site properties achieves even a 15% impression share, you can quickly begin accruing over half of the available search opportunity without spending the same cost per visitor that you would with fewer listings forced to remain at the top to ensure traffic volume forecasts are achieved.

Flexible messaging opportunities

Multiple listings provide advertisers with greater opportunities to determine the optimal investment levels within search. What’s more, using a test-and-learn approach often reveals which unbranded categories make sense to drive directly to and which respond better to the unbranded table setting of your DA site – and of course, which terms should have the opportunity to drive to both!

Know thy funnel

Many brand managers regard the branded site as the best chance to engage patients and HCPs. Unfortunately, speaking to a brand naïve audience searching on general condition terms via a branded site usually leads to poor engagement and a questionable user experience. Since we know that qualified patients and HCPs tend to search using basic, single-phrase keywords, it remains difficult to assume what level of brand awareness a searcher has based on the keyword they input.

Disease awareness websites play a critical role in successfully engaging patients and HCPs who may remain higher up in the conversion funnel. Multiple listings provide the opportunity to not only engage in message testing but also audience A/B testing. Which site property makes the most sense for these keywords and ad groups?

Creating a DA site provides brand managers with added flexibility in how they create and execute their paid search campaigns. Having the advantage of added listings in the search results allows advertisers the opportunity to customize their messaging and audience alignment approach at a much more granular level, all while returning greater efficiency and engagement.

Oliver J. Nelson

May 20, 2015

It’s pretty much impossible to count how many people in the world are afflicted with disease; there are simply too many diseases and too many people to count. And if you count the loved ones of those with diseases, then it’s safe to say that virtually everyone is affected by disease.

Our global population of roughly 7 billion people is afflicted with all kinds of diseases, from infectious to non-communicable. Yet education and action are sorely lacking in developing countries and even powerhouse nations like the United States.

It isn’t till one is burdened with illness that one can actually be aware of the severity and implications of it. Unfortunately, by then we must act in a reactive mode, rather than a proactive, preventative, and healthier one.

Activating: a year of disease awareness

Disease awareness months have been around since at least 1985, when the American Cancer Society and the pharmaceutical division of Imperial Chemical Industries (now part of AstraZeneca) formed National Breast Cancer Awareness Month. Since then, every month has been claimed as an awareness month for many diseases. For example, May is Mental Health Month, Stroke Month, Lyme Disease Awareness Month, Celiac Awareness Month, Healthy Vision Month, and Arthritis Awareness Month, to name a few. The monthly “real estate” is totally crowded and the months have less impact when they are sharing with other groups who are also trying to build awareness.

The goal of awareness months is to educate and drive screening. They promote action by driving checkups, and get the larger communities involved in many different initiatives, from walks and runs to health fairs.

The abundance of disease awareness days, weeks, and months provides an opportunity to take a holistic educational view on disease states at large. Even if you’re living with and being treated for only one particular disease, it’s necessary to understand that there’s a whole universe of diseases out there. Get screened and try to prevent illness. The more you’re aware and understand what you need to do, the better chance you have of avoiding disease. And helping others avoid it, too.

Social platforms: spread disease awareness

HealthWellNext, a thought leadership publication, has created a social platform called HealthAwareNext to spotlight and educate around disease months throughout the year. They refer to it as “A Year of Disease Awareness.”

The goal of HealthAwareNext is to educate and drive awareness about disease states. Each month will feature impactful call-to-action content showcasing unique graphics that not only grab attention but educate as well, with real-world information on screening and testing for that month’s condition. The content will be spread via as well as through the social media platforms Facebook, Pinterest, Twitter, Tumblr, and Instagram. The hashtags #HealthAwareNext and #YearofDiseaseAwareness, as well as disease-specific hashtags, will drive to relevant content.

HealthAwareNext started in January by focusing on cervical health, followed by heart health in February. March was dedicated to vision health and colon cancer awareness. April put a spotlight on sexually transmitted infections (STIs), and May highlights mental health and stroke. When 2015 ends, it will be with a collection of disease month assets that are as informative as they are visually arresting, and that provide always welcome attention for these diseases. The ultimate goal is to get people to take charge of their health – and make prevention a year-round activity.

Elizabeth Elfenbein

May 20, 2015

Diabetes. Heart Disease. Obesity. These are three preventable conditions that millions of Americans are living with today. Is misinformation or lack of information the cause? Are they educated but lack motivation to take necessary precautions? Each day people make numerous decisions that have a tremendous impact on their overall health. As health industry marketers, our job is to give them the right information, support, and inspiration to help them make judicious decisions to live healthy lives and prevent chronic conditions, when possible.

According to the CDC, diabetes, heart disease, and obesity are among the top diseases that are the most preventable. “Diabetes is the leading cause of kidney failure, lower limb amputations (other than those caused by injury), and new cases of blindness among adults.” One would think these consequences could provide enough motivation to make healthy choices, yet millions of Americans continue to be diagnosed because they fail to take action. Unfortunately, the number of cases keeps rising year-after-year. Fortunately, we can break the cycle and reverse the trend.

Knowing the facts & their future

The American Academy of Family Physicians stated that patient education and filling prescriptions have about the same impact on health outcomes. Our responsibility is to provide the necessary information patients need to understand the impact of these conditions, steps to prevent them and the difficult future they may experience living with these conditions if precautions are not taken. Empowering patients to act now, by taking steps to wellness, starts with education. Pharmaceutical brand marketers, health content developers, and healthcare providers must work together to create expert disease prevention content. But what is the right time and method to make an impact? The encounter must be highly engaging personal experiences filled with emotion, and distributed through key platforms for easy access by patients.

Support through connections
After educating patients and instilling motivation, the next step is ensuring prolonged commitment to health. This can be accomplished by creating connections between people through online communities and social groups. In a recent Remedy Heath Media study, 7 in 10 people said they were motivated by others to take an action such as eating healthier, exercising regularly, and getting a routine physical. It’s pretty amazing how contagious good health decisions become when surrounded by other like-minded individuals. Plus, there is the opportunity to make new friends who will push you when you need it most.

Through online outlets, health experts such as Amy Hendel (The Health Gal) – physician assistant, nutritionist, and health coach – provide connections for people needing support with their weight-loss, nutrition and fitness goals. These experts give people a sense of belonging and that they are not alone – they have somebody to turn to for trustworthy insights, advice, and guidance – keeping them focused and on track.

Other connections can be made through health and wellness social groups, like the one my wife started last year by connecting with neighbors, exercising together and sharing healthy family eating habits, grocery shopping, fitness tips, and more. Not only did it build a community focused on health and wellness, it created a support system sustaining their commitment. When a member of our wellness group cannot attend meetings the group reaches out and rallies together to ensure they remain engaged. Yes, peer pressure is still alive and well… but for good reason.

Remarkable health heroes spark inspiration

We have found that people become empowered through emotional storytelling. Remedy’s research indicates that among respondents who were highly motivated by emotional storytelling, 90% felt inspired after hearing an emotionally charged personal story.

To spark motivation, sites such as are developing emotional marketing programs including Be Well, Be Brave™, which captures the spirit of being brave by challenging themselves to lead a healthy life. Be Well, Be Brave™ presents emotional personal stories of everyday health heroes, who, despite huge hurdles, made important choices needed to live well. These stories depict the real-life transformations of people taking charge of their health. In turn, they inspire others to take action. The health hero’s story are chronicled in a long-form multi-media experience with video and text infused with expert supporting content – buying guides, diet and fitness plans – providing support, inspiration, and engagement for others to go above and beyond what they thought possible.

Whether it’s connecting online, through a social group, or via emotional storytelling, people need to spark their motivation to live healthier. That motivation comes from being educated, not just about where they are today, but what their future holds if changes aren’t made. Motivation will drive action and ultimately lead to a more healthy life, without the worry of preventable conditions. Remember, today the number of people being diagnosed with diabetes, heart disease, and obesity is climbing year-after-year; but by working together, our mission is to break this cycle, stop the trend, and reverse these growing numbers.

Ryan LeMonier

May 20, 2015

Pharma marketers spend much time and effort developing and improving ways to support patients in their specific disease areas. This is important work. An estimated 150 million people are living with at least one chronic condition in 2015, and by 2030 the number is estimated to grow to 171 million.[1]

However, this effort does not take into account an important reality: many patients are dealing with more than one condition at the same time. This means that current efforts may be too narrow to offer the full breadth of support that your consumers need every day. Almost one in three Americans has multiple chronic conditions (MCCs).[2] Specifically, about 27.9% of adults aged 45 to 64 and more than half (51.6%) of adults 65 and over suffer from two or more chronic conditions, with the major burden of MCCs on older Americans aged 65 and over.[3] As the baby boomer generation continues to age, the problem is expected to increase.

The CDC reports that the most prevalent combination of two chronic conditions in the United States is hypertension and arthritis, and for people who have the most common combination of three diseases, they add diabetes to that duo. Other common chronic conditions include high cholesterol, heart disease, cancer, depression, substance use disorders, asthma, HIV/AIDS, and dementia. But what makes this challenge so pervasive is that even though these diseases are most common, there are many others. Each person is unique, and so are the health challenges they face every day.

The price of living with MCCs is steep: 71 cents of every dollar of US healthcare spending goes to treating people with MCCs, according to the US Department of Health and Human Services Agency for Healthcare Research and Quality[4] (see the details in a great infographic here). And these are definitely your customers. People with three chronic conditions fill an average of 23 prescriptions per year, and that number jumps to 50 prescriptions per year for people with five chronic conditions.

What can we do to provide information and support for people with multiple conditions? It is a conceptual, logistical, and IT challenge to be sure, and one that pharma does not face alone: government, nonprofit groups, and other health organizations are also structured to provide support that is segmented:

  • The CDC provides a wealth of information and resources for patients on its website, but all are segmented by disease:
  • The nonprofit National Council on Patient Information and Education (NCPIE) recently launched a 10-step adherence program called Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda as part of its campaign platform at  Though the resource gallery includes links and resources for the most common, costly, and preventable of all health problems in the US, there is not one place where patients can turn to address all of their conditions and symptoms.
  • Data aggregators, sites you probably know that are set up for patients to log their health data to be combined with others and inform clinical research, are set up for patients to track their diagnosis and treatment for one disease/condition at a time.

How can pharma marketers face this challenge to help their patient consumers? It’s a multi-faceted problem, but here are some starting points to open the discussion:

  1. Stop focusing on just disease and focus instead on the tools of coping, juggling and living. Not only do most people have more than one medical condition, but everyone is trying to get through each day successfully managing their health along with their relationships, their jobs, and more.
  2. Engage with patients the way patients want to engage (not the way pharma prefers). It’s not about controlling the message – instead, put yourselves in your customer’s shoes, work to deeply understand their journey, and see how you can help.
  3. Provide peer-to-peer support. When it comes to their health, patients want to hear from people that they feel are like them. Because it is likely that others are dealing with multiple conditions, peer support that connects patients with real people who have volunteered to share their experiences and provide support can make a significant impact on disease management. Helping to connect people so they can share what has worked for them in their journey means they can learn from and help each other.

The takeaway here is that the convergence of social media, empowered patients, and The Internet of Things has brought us to a point where consumers expect the tools they rely on to blend seamlessly into their lives, providing the information and support they need, the way they need it. Pharma needs to help patients navigate the complexities of their own health in all aspects, not just around one drug.


[1]Wu, S. Green, A. “A Projection of Chronic Illness and cost inflation 2000”

[2] U.S Department of Health and Human Services Agency for Healthcare Research and Quality, “The Importance of Investing in Care for People with Multiple Chronic Conditions,”

[3] National Council on Patient Information and Education, “Chronic Conditions 101,”

[4] U.S Department of Health and Human Services Agency for Healthcare Research and Quality, “The Importance of Investing in Care for People with Multiple Chronic Conditions,”

Cheryl Lubbert