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September 25, 2015 0
Bob Ehrlich
“Hillary has a tax proposal that will kill DTC.”
-Bob Ehrlich

Outdoing Bernie is hard to do but Hillary seems to be more anti-drug company than the avowed socialist candidate. Hillary is tired of high drug prices. Here is someone that charges a public university $225,000 for a canned speech and is outraged at high prices from drug companies. Never let hypocrisy affect a good political talking point.

Hillary has a tax proposal that will kill DTC. She wants to make drug marketing a non-tax deductible business expense. That has been proposed before and successfully defeated. The advertising lobby knows that deciding to make drug advertising non-deductible is a slippery slope. Does the government then make advertising fast foods non-deductible because it harms public health? What about violent video game advertising? Beer? Having the government decide what can be advertised is dangerous. Proposing tax policy to discourage advertising certainly gets all the media company lobbyists nervous.

Hillary also wants to allow Medicare to negotiate drug prices, an oft-mentioned proposal by many on the left. She also wants to limit to $250 a month what consumers pay for drugs for chronic conditions. By doing this she thinks drug companies will be forced to lower prices.

Hillary knows when to time her outrage. The drug industry has increased prices more than inflation recently. Much of this is because they invented and marketed some high price cures for Hep C. There has also been a lot of negative publicity recently about a drug that went from $13.50 a pill to $750 a pill for reasons not well explained by the small drug company who recently bought the drug. Sometimes the critics have a fair point and the drug industry must be reasonable on pricing. This company responded to the harsh criticism and announced it would go back to the $13.50 soon.

Democrats like to use government power to limit prices. They usually have no business sense in proposing these price actions. They think if they mandate lower prices, that there will be no negative impact on innovation or supply. These proposals are quite naïve about how business works. That is likely because many key Democrats have no business background. Hillary thinks drug companies have these bags of ill gotten cash sitting in vaults. If she mandates they charge less, then these drug barons will just act as if nothing has changed. The drug companies, in her view, will still make enough to behave the same in terms of drug development. After all how many bags of cash do they need?

Drug companies are the greedy enemies of society, according to Hillary and Bernie because they charge more than decent people should pay. The left would like to decide what profits are acceptable for many industries they find are greedy. Oil companies and banks are also frequent targets. Free markets do a good job of deciding a fair price. Government is just not very good as a market referee.

Price controls just do not work. You reduce price and you get less re-invested on new products. In Bernieland the noble government scientist invents cures and gives them away for cost. In Hillaryland, the paternal government tells industry what a fair profit should be. I agree drugs should be affordable, but cost of research does matter. Drug companies are entitled to make good money. Hillary and Bill and are free to charge a market rate for a canned speech. If Hillary could only get $5000 a speech would she do as many?

Free markets can be messy but they ensure that those with needed products have incentives to keep making them. It is silly to think the laws of economics will be changed by government mandates. Cap drug prices and see how many breakthrough new products are developed. That expensive cure for Hep C would never have been invented. It will be politically popular to stick it to drug companies but incredibly stupid. That next pandemic that will inevitably occur will not be cured by Bernie or Hillary. It will be those “evil” drug barons who do it, but only if they have those bags of cash available to invest.

Bob Ehrlich

September 24, 2015 0

We are creatures of habit. We buy the same products and follow the same daily routine. Unless compelling information is served to us the moment we’re making a decision, we are reluctant to change.

As the saying goes, old habits die hard.

For healthcare marketers, changing behavior within our industry can seem impossible. Earlier this year in DTC in Focus, I discussed the difficulty in implementing innovation within healthcare marketing. Changing patient behavior can be even harder.

Years ago, we sat on the exam table surrounded by outdated collateral and posters that seemed more decorative than anything else. A clutter of pamphlets about influenza or the dangers of smoking meant nothing if you were visiting the doctor for migraines. These were the early years of point-of-care marketing. With only mass delivery of paper collateral in their toolbox, healthcare marketers lacked the technology and focus to truly target campaigns. The lack of targeted delivery meant that the information being served was actually, by design, misinformation.

Doctor Discussing Records With Senior Female Patient

But the landscape has changed. For the past decade marketers have applied digital innovations to target consumers at high-impact moments. Digital point-of-care marketing makes it possible to address patients with relevant information at a time when their treatment is top of mind. When patients are sitting in the doctor’s office thinking about their condition right before speaking with their doctor the messaging that surrounds them is very powerful. Starting with the waiting room and following the journey through the appointment into the exam room, point-of-care messaging has become an increasingly necessary part of patient education.

As DTC marketers, it is becoming increasingly more important to ensure we target our exact patient. According to a study by ZS Associates, the majority of treatments are now targeted toward less than 1% of the US population. New point-of-care channels allow us to target specific patients – the ones that can benefit from these exact treatments. As a result, point-of-care spend is growing 8x faster than the overall DTC spend, totaling ~$400M in 2014. Point-of-Care marketing is no gamble, but a tried and true solution that consistently delivers ROI.

None of this is news, but it’s an exciting indicator of the road ahead.

While digital marketing is an incredible tool for DTC marketers, actually changing patient behavior the ultimate goal. Fortunately for us, innovation has progressed and we now have more tools to increase the frequency of engaging patients. New innovations like Mobile advertising capabilities are just the beginning of rounding out the patient journey. By taking a comprehensive approach to POC marketing and embracing the tools that are now at our disposal, we can actually achieve the impossible: change patient behavior.

At the same time, we as patients are increasingly incentivized to take advantage of these tools and be hyper-engaged in our treatment. With recent changes to the healthcare landscape, we are now responsible for more out-of-pocket healthcare costs. This means we want and need to know more about our conditions and the treatment options that are at our disposal. Read: we crave the information and consume it, especially when we’re at a doctor’s visit.

Similarly, healthcare providers are taking advantage of improvements in technology to redesign their workflow and create a more efficient practice with better care coordination. EMRs are rapidly improving in quality, which, when integrated with point-of-care messaging, can create a customized, contextual experience for every patient.

Medical tablet

Imagine walking into an office and receiving messaging on your mobile device that is relevant to the specific point in your treatment. Imagine being able to see, in the exam room, visualizations of your past visits, alongside your treatment options. As a patient, you will have more access to information that will better inform your decision-making.

So, remember those behaviors that were so hard to change? It is now easier than ever to understand the impact of changing them. Tech companies have made these technologies a reality, and they will continue to make it easier to guarantee returns for brands.

DTC marketers have built an industry creating hundreds of effective solutions to a singular challenge – how to change patient behavior – and we are at an inflection point. We have the opportunity to address the challenge with unprecedented accuracy, which means we need to approach these new channels intelligently and empathetically, always with the patient in mind. Our goal is to change patient behaviors for the better, and if we embrace and continue to innovate the platforms available, we will make that goal a reality.

There are millions of patients that need to change their behavior to live healthier. Let’s do something about it.

Ashik Desai

September 24, 2015 0

During his January 2015 State of the Union Address, President Barack Obama introduced the Precision Medicine Initiative as an effort that “will bring us closer to curing diseases like cancer and diabetes – and give all of us access to the personalized information we need to keep ourselves and our families healthier.” The question is how we will achieve this goal. The answer is through Point of Care (POC) ranging from POC testing to POC prescribing. Relying on prompt diffusion of innovation with this initiative will create maximum results and minimum waste in practicing health care.

Precision Medicine

DiPersio-Sept2015artwork1The National Research Council describes Precision Medicine (PM) as adapting medical treatment to the specific characteristics of each patient. It arranges individuals into subpopulations that differ in their likelihood to contract any particular disease. PM is the advanced and detailed understanding of the root causes of a disease and how best to respond with proper treatment taking into consideration genetic changes and ultimate cures.

POC Testing

The innovation of portable diagnostic and monitoring devices for POC testing depends on moving towards predictive, personalized, and preventive medicine while simultaneously moving forward with remedy medicine for existing diseases. POC testing allows pharmaceutical companies to develop more effective drugs geared to personalized needs. This synergy is influenced by the following factors:

  • Speed. Not only does testing produce instantaneous results, it also eliminates the need for laboratory bound samples requiring a wait time.
  • Portability. The size, portability, and battery power of POC testing devices allows them to be used in different environments including within the community or in a large hospital.
  • Convenience. Clinicians spend less time preparing paperwork for laboratory testing.
  • Reduced workload. Non-laboratory staff conducts testing instead of overworked trained clinicians whose time can be leveraged to achieve more medical advancements.
  • Connectivity. Errors are reduced by using USB and wireless connections not mandating manual transcription while central database input allows for data mining and research.
  • Sample quality. Time does not interfere with quality due to the lack of transport to the central laboratory.
  • Analytic viability. Integrity is maintained with analysis performed within a short time of sample being withdrawn.

POC Prescribing

DiPersio-Sept2015artwork2Preventive and therapeutic interventions, such as physicians dispensing prescription medications during medical visits, benefit patients without high cost or side effects. Health care professionals have the ability to prescribe the right drug for the right patient at the right time at the right place. Patient savings are realized in terms of time, energy, convenience, and money. Also, better health outcomes are achieved with patient adherence because the early stage obstacle of compliance is removed – the patient taking the time to process the prescription through mail order or at a pharmacy. Furthermore, assigning clinicians the power of POC prescribing confronts the dilemma of health disparities.

Diffusion of Innovation: Dynamics and Strategies for Success

Comprehending how to improve the pace of disseminating the concepts of this new Precision Medicine Initiative is of paramount importance to its success. Rapid diffusion of innovation is accomplished through the following guidelines and action plans.

  1. DiPersio-Sept2015artwork3Relative advantage. Gather an understanding of the ROI and cost mindset of the patient, medical staff, and decision makers.
  2. Trial ability. Engage ways to divide the process for tangible benefits.
  3. Observability. Choose viral marketing to uncover the invisible.
  4. Communication channels. Select mass media to inform and interpersonal methods to persuade while identifying the connectors and the correct target audience.
  5. Homophilous groups. Look for other homophilous groups outside of physicians, nurses, health strategic planners, and patient advocacy groups.
  6. Pace of innovation/reinvention. Situate listening standards for early warning about issues and monitor practices for potentially dangerous mishaps.
  7. Norms, roles, and social networks. Concentrate on target groups and expose chances to leverage existing social networks or create new ones.
  8. Opinion leaders. Identify opinion leaders and look for principals who have a broad range of information and a reputation for being most knowledgeable and respected.
  9. Compatibility. Become aligned with current behavior and values and mimic everyday universal functions.
  10. Infrastructure. Grasp current and future regulatory constraints.

In conclusion, the way to achieve the goal of the Precision Medicine Initiative recently launched by President Obama is utilizing two Point of Care methods which change the way medicine is practiced and health care is delivered. POC testing and POC prescribing promotes the health care climate shift toward prevention, early diagnosis, management of multiple chronic conditions, and eventual cure of existing diseases while increasing patient health engagement by encouraging patients to take a more active role in their health. Health care is more personalized through customization of interventions to individual patients based on the way information is processed. Specific transmittal dynamics accomplish the diffusion of innovation without delay and catapult the overall efficiency of medical practice.



Berry, P. “Drug Dispensing at the Point of Care Benefits Patients.” Northwind Pharmaceuticals. (2015)
Cain, M. and Mittman, R. “Diffusion of Innovation in Health Care.” Institute for the Future and California HealthCare Foundation. (2002)
Moreno, C. “What Precision Medicine Is and How It Might Save Your Life Someday.” Reuters. (2015)
“Point of Care Diagnostic Testing.” National Institutes of Health. (2013)
Wickham, M., McComas, D. and Wickham, C. “Point of Care in Clinical Trials.” PharmaPhorum. (2010)


September 24, 2015 0

In just the past handful of years, the Point of Care (POC) options available for messaging have undergone dramatic expansion. Where once POC meant patient messaging at the pharmacy or specialized magazines distributed to doctor office waiting rooms, we now have choices that offer an array of patient and healthcare provider (HCP) media solutions. New companies offer messaging services through in-office displays, Electronic Health Records (EHR), patient registration tablets, telemedicine, place-based apps, wearables and more.


With so many compelling choices to consider, the importance of creating a plan to execute, measure, and optimize programs delivered through these companies is critical. While goals may differ brand to brand, there are three strategies that can help you get the most from POC programs.

  1. Data driven insights are used to craft a complementary combination of relevant messages delivered to the right audience at the right place and time. For example, while messaging according to decile-based HCP target lists remains a staple consideration, it’s important to think about additional segmentation criteria made possible through the use of anonymous-patient data. The ability to select doctors according to their patients’ access to your brand, adherence, pattern of adoption, and more, allows us to consider a variety targeting criteria to help ensure campaign effectiveness.Staying with the HCP as our target example, a network of POC partners must be selected so that the combination of partners brings the desired reach across the targeted HCP offices. Such a network can be comprised of a single POC vendor type, like a group of in-office-display partners. Or it might make sense to knit together a variety of POC partners to include vendors that provide EHR messaging plus in-office display companies. The resulting plan can touch patients in the waiting room with a complementary message to the HCP through the EHR platform.
  1. True patient outcomes are used to understand what works best for each program and message type. Each POC media partner and message type represents a measurable tactic. It’s vital that the same data source and business rules are used for all measurement across a campaign so that each message and tactic can be evaluated in relation to the other. Staying with the example above, each patient response is aggregated to their targeted doctor and the relative impact of each POC media partner can be ranked. It’s important to employ anonymous patient data to ensure that a clear signal of behavior change is captured. Depending on the objective of the campaign, key performance indicators (KPIs) such as changes in new patient brand starts, adherence, or other metrics may be used to determine program effectiveness.
  1. Incremental results versus a control group need to be consistently monitored to optimize spend according to what’s working best. If new patient brand starts are the KPI of interest, then each new patient can be tied to the cost of acquisition through the POC tactic(s) that drove the outcome. POC media partners and tactics can be adjusted during the campaign in order to optimize spend where the tactics are having the greatest effect in driving new patient brand starts.

Of course, each campaign is different. Innovations in place-based messaging and other complimentary capabilities will continue to help POC programs bring new opportunities to drive HCP and patient behavior and improve overall outcomes.

These considerations represent an approach to optimization, and while there are other viable methods, media analytics are a fast evolving science. The explosion of available data in recent months makes it possible to apply cross channel targeting and optimization to all media channels (POC, digital, television, print) at the patient and HCP level. Today, we have more ways to assess our work and, most importantly, to use the findings to develop more effective messages and delivery channels that help HCPs, as well as improve direct-to-patient outcomes.

Two of Dave Nussbaum’s Publicis Health Media colleagues, Matt McNally & Sharon Patent, will delve further into this topic during their session on leveraging big data, only at the 2015 PEPP National Conference. Their discussion will teach you to know how, when, and where to engage with patients and HCPs. Don’t miss out – 2015 PEPP National Conference, held Nov 5-6 at the Ritz Carlton in Philadelphia. Register today!


Dave Nussbaum


September 22, 2015 0

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September 11, 2015 0
Bob Ehrlich
“Do drug companies make outrageous profits?”
-Bob Ehrlich

Bernie Sanders, the fast rising socialist/populist candidate for President, does not particularly like drug companies. He thinks they make outrageous profits and is for introducing legislation to cap prices. He will propose Medicare negotiate prices, something prohibited under the prescription drug act. He will also require disclosure of costs of developing drugs, and require transparency on what the drug costs in other countries. Finally his bill would permit importation of drugs from Canada.

These proposals have been made before, many times over. The same argument continues to be made that drug companies sell drugs for more in the U.S. than other developed countries. The typical Democrat response is to propose price controls and cite outrageous prices knowing the issue is political red meat to their constituents.

Do drug companies make outrageous profits? I compared the net profits at drug companies to other industries based on data summarized by the NYU Stern School of Business. Drug companies make about 16% net margin. That is a healthy profit but not that different from soft drinks at 13%, entertainment 13%, computers 14%, banks 19%, railroads 18%. Good profits yes, outrageous no. Career politicians who have no business knowledge consistently fail to understand that drug prices cannot be interpreted in a vacuum without looking at costs. Costs are more than the marginal production cost of stamping out a pill.

The argument that Medicare should negotiate better prices based on foreign price comparisons is in effect government price controls. Price controls in other countries do mean lower prices for the Europeans and Canadians. If price controls were instituted here profits would decline, and research would be geared to me-too drugs. Senator Sanders, a proud socialist, is not concerned with the cost of drug development and thinks he knows the acceptable level of profits for drug companies.

The importation of drugs from Canada will cause drug companies to quickly limit what is supplied to Canada. Drug companies will supply their higher priced markets first and will not allow re-importation to destroy their U.S. pricing. In the short run Canadian consumers will not be able to get their drugs because of increased demand here for cheaper Canadian drugs.

While it sounds easy to make prices lower here through government edict, one must be aware of unintended consequences. Bernie Sanders will get lots of applause talking about greedy corporations, but he is being naïve if he thinks he can have new drug innovation with price controls. We will end up with companies focused on high return R&D for minor me-too improvements only in large disease categories.

We need drug companies to take big risks to find cures for the next Ebola, bird flu, or resistant bacteria. While we like to think there is always a brilliant government scientist ready to find a cure but the reality is different. It is private sector drug research that finds our cures and that is expensive. High risk research deserves high rewards, even outrageous rewards Senator Sanders.

Bob Ehrlich